6-hour-old girl is evaluated in the newborn nursery due to respiratory distress. She was born at 37 weeks
gestation via spontaneous vaginal delivery after induction of labor for preeclampsia with severe features. Since
birth, the baby has not been able to feed due to tachypnea. Birth weight is at <3rd percentile for gestational age.
Temperature is 37.2 C (99 F) and blood pressure is normal. Pulse oximetry is 96% saturation on room air.
Examination reveals a plethoric infant. The head is normocephalic with an open and flat anterior fontanelle.
Cardiac examination reveals sinus tachycardia and no murmurs. Pulmonary examination reveals tachypnea;
breath sounds are clear throughout, and there are no retractions. The infant has normal female infantile genitalia.
Chest x-ray shows clear lung fields and a normal cardiac silhouette. Laboratory results are as follows
Hematocrit 71% (42%-65%)
Platelets 200,000/mm3 (150,000-300,000/mm3)
Leukocytes 20,500/mm3 (9,400-24,000/mm3)
Serum chemistry
Glucose 35 mg/dL (:::50 mg/dL)
Which of the following is the most likely cause of this patient’s symptoms?
- 0 A. Congenital adrenal hyperplasia
- O B. Cyanotic heart disease
- 0 C. Dehydration
- 0 D. Glycogen storage disease
- 0 E. Polycythemia
- 0 F. Transient tachypnea of the newborn
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