22.2 Neonatal Jaundice

Question 1

why neonate have likely jaundice?

Answer 1

• shorter red cell survival
• decreased metabolism from liver
• increased enterohepatic circulation, less stool

Question 2

definition of hyperbilirubinaemia?

Answer 2

unconjugated at >205umol/l

Preterm: >255umol/l

Question 3

causes of unconjugated hyperbilirubinaemia?

Answer 3

• increased production
• haematoma
• decreased conjugation
• increased enterohepatic circulation

Question 4

physiological jaundice happens when?

Answer 4

> 24 hours

Question 5

breast milk jaundice is?

Answer 5

delayed milk production, relative calorie deprivation

Question 6

causes of conjugated jaundice?

Answer 6

• hepatitis
• biliary atresia
• A1 antitrypsin deficiency
• total parenteral nutrution

Question 7

prolonged jaundice need to exclude two important causes?

Answer 7

• obstructive jaundice

- hypothyroidism

Question 8

Kernicterus is?

Answer 8

bilirubin staining in brain, free unconjugated bilirubin crosses BBB

Question 9

risk of kernicterus increased when?

Answer 9

premature
low albumin
rapid rise
hypoxia, sepsis, hypoglyc

Question 10

risk groups for neonatal jaundice?

Answer 10

maternal: DMII
perinatal
TORCH infections

Question 11

why asian background more likely to have neonatal jaundice?

Answer 11

higher incidence of G6PD deficiency

Question 12

investigations for neonatal jaundice?

Answer 12

• bilirubin levels: fractions
• haemolysis: BLOOD FILM
• infection
• metabolic

Question 13

treatment for jaundice?

Answer 13

phototherapy
IVG
exchange transfusion

Question 14

indications for exchange transfusion?

Answer 14

• ABO/incompatibilities and bili exceeds 340umol/l

- preterm infant and exceeds 340umol/l

Question 15

transcutaneous phototherapy use in what setting?

Answer 15

• lower levels

- NOT after you’ve started phototherapy