ALTE

Apparent life threatening event

MADCAPPING

• Metabolic - hypoglycemia, lytes, hypocalcemia, mitochondrial d/o. Consider genetics w/u: plasma amino acids, urine organic acids, lactate, pyruvate, ammonia
• Anatomic - tonsil hypertrophy, macroglossia, TEF, tracheomalacia: Consider ENT consult, neck xray
• Drugs - toxins, munchausen by proxy: urine/serum tox screen
• Cardiac - arrythmia/CHD: EKG, echo
• Air Holding - (breath-holding spell)
• Prematurity - CNS immaturity (dx of exclusion): theophylline, caffeine, o2, stimulation
• Physiologic - congenital central hypoventilation: sleep study
• Infectious - RSV, pertussis, meningitis, encephalitis: CBC, blood cx, urine cx, LP
• Neurologic - seizures, mass, trauma, nonaccidental trauma, intracerebral hemorrhage: CT, MRI, EEG
• GI: GERD - temporal relation to feeds: scinti scan first, then Barium swallow/UGI. pH probe