1-new born with jaundice

Question 1

what time frame means early jaundice for neonates?

Answer 1

presents with jaundice within first 24hrs

Question 2

what time frame means late jaundice for neonates?

Answer 2

after 14 days

Question 3

when is neonatal jaundice pathological until proven otherwise?

Answer 3

if its early or late presenting neonatal jaundice
- important as jaundice is common but mostly physiological unless early or late presenting

Question 4

briefly describe bilirubin pathway?

Answer 4

haem of haemoglobin is broken down into unconjugated bilirubin in 2 steps. (unconjugated means not soluble and has to be carried by albumin). this carried to liver where liver conjugates to make conjugated bilirubin which is soluble and goes through biliary system to be excreted

Question 5

what are most common types of neonatal jaundice?

Answer 5

physiological jaundice (because underdeveloped liver) or breast milk jaundice (because breast milk contents)

Question 6

what is haemolytic disease of newborn?

Answer 6

it happens if mum Rh- and foetus Rh+ and in birth of 1st child blood is mixed so mum makes antibodies against D antigens of Rh+ to destroy. doesn’t harm 1st child but 2nd pregnancy the IgG antibodies can cross placenta, recognise D antigens and trigger complement pathway & MAC leading to haemolysis and hyperbilirubinemia

Question 7

what is common & best treatment of jaundice for neonates?

Answer 7

phototherapy with blue light - it helps with process of excretion through bilirubin pathway

Question 8

what is coombs test?

Answer 8

blood test used to detect antibodies that act against the surface of red blood cells