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Pediatrics Shelf > 08: 6-day-old female with jaundice > Flashcards

08: 6-day-old female with jaundice Flashcards

1
Q

What are the 2 main reasons that infants get jaundiced?

A
  1. Underdeveloped liver can’t conjugate the bilirubin

2. Lack of GI flora to metabolize bile, so the bilirubin is re-unconjugated and sent back into the bloodstream

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2
Q

What form of bilirubin can cross the BBB?

A

Unconjugated

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3
Q

What 2 parts of the brain are affected by Kernicterus?

A
  1. Basal ganglia

2. Cranial nerve nuclei

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4
Q

What are the effects of kernicterus in the brain?

A

Tone/reflex abnormalities, choreoathetosis, tremor, oculomotor paralysis, sensorineural hearing loss, cognitive impairment

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5
Q

Aside from opioid withdrawal, what can cause a high-pitched cry in a newborn?

A

Acute bilirubin encephalopathy

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6
Q

When does acute bilirubin encephalopathy occur?

A

Within the first few weeks of life

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7
Q

What type of bilirubinemia does phototherapy cure?

A

Unconjugated

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8
Q

What type of jaundice is

A

Physiologic jaundice

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9
Q

Which type of jaundice happens the first week in life and is caused by a relatively low milk supply, leading to low enteric intake, decreased GI motility, and increased B-glucoronidase activity?

A

Breastfeeding (or lack of breast-mik) jaundice

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10
Q

Which type of jaundice happens within the first 4-7 days of life but peaks around days 10-14, and has an unclear etiology?

A

Breast milk jaundice

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11
Q

What test is positive in antibody-positive hemolysis, such as Rh, ABO, minor antigen incompatibility?

A

Direct COOMBS (DAT)

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12
Q

What can bruising from birth trauma, large cephalohematoma, polycythemia, or swallowed blood during delivery all cause?

A

Jaundice due to non-hemolytic RBC breakdown

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13
Q

What are 2 rarer causes of jaundice?

A

Crigler-Najjar and Gilbert Syndrome

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14
Q

Can galactosemia and hypothyroidism cause jaundice?

A

Yes

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15
Q

What might be the cause of jaundice in the newborn with hepatosplenomegaly, microcephaly and/or rash?

A

TORCH infection

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16
Q

Which 3 infections does breastfeeding protect against?

A
  1. Otitis media
  2. Respiratory infections
  3. Diarrhea
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17
Q

Does breast milk contain growth factors?

A

Yes

18
Q

Is colostrum higher or lower in non-nutritive but beneficial substances?

A

Higher

19
Q

When can a child first drink unmodified cow milk?

A

Age 1

20
Q

Approximately 50% of calories in human milk come from ______?

A

Lipids

21
Q

Why is it important that an infant empty the breast before going to the next breast?

A

Because the highest lipid concentration is at the end of the session

22
Q

What’s the whey:casein ratio in breast milk?

A

70:30

23
Q

A healthy-appearing infant who develops jaundice, dark urine, and pale stools between 3-6 weeks may have ______ ______?

A

Biliary atresia

24
Q

Any infant who develops jaundice after 2 weeks of age must be evaluated with __________ bilirubin?

A

Fractionated (i.e., total and direct bilirubin levels)

25
Q

What surgical procedure can fix biliary atresia by anastomosing the intrahepatic bile ducts to a loop of intestine?

A

Kasai procedure

26
Q

How often should the infant urinate by day 3?

A

3 times

27
Q

How often should the infant urinate by day 6?

A

6 times

28
Q

What color should infant urine be?

A

Pale yellow

29
Q

What should the infant stool be like at day 3?

A

Meconium should be gone and stool appears yellow

30
Q

How many times should infants poop by day 6?

A

3-4, or after every feed

31
Q

Should infant stool smell bad?

A

No, it should have very little odor

32
Q

What’s a subperiosteal hemorrhage that is localized to the cranial bone that was traumatized during delivery, and does NOT extend across suture lines?

A

Cephalohematoma

33
Q

What’s an edematous swelling over the presenting portion of the scalp of an infant that has boggy swelling that DOES cross suture lines?

A

Caput succadaneum

34
Q

What’s the average diameter of the anterior fontanelle?

A

2.5-5cm

35
Q

Is the posterior fontanelle palpable at birth or later in most full term newborns?

A

No

36
Q

Is a liver edge palpable 1cm below the inferior costal margin a normal finding in a newborn?

A

Yes

37
Q

What do infants with galactosemia present with (3)?

A
  1. Hepatomegaly
  2. Ascites
  3. Edema
38
Q

Breastfed infants may lose up to ___% of their birthweight in the first 5 days?

A

10%

39
Q

What does Vitamin D rickets usually respond to?

A

Vitamin D

40
Q

At what age should babies receive fluoride supplements if their water lacks it?

A

6 months

Pediatrics Shelf (24 decks)

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