27: Pediatric GI And Jaundice

Question 1

Impedance testing for GER

Answer 1

Measures direction of bolus movement in esophagus via measuring changes in resistance to alternating electrical current as a bolus passes by a pair of metal rings on a catheter

Question 2

Why is it important to treat unconjugated hyperbilirubinemia

Answer 2

Its not bound to albumin -> can cross BBB -> Kernicterus and BIND

Question 3

Direct vs indirect Coombs test

Answer 3

1. Direct: looks for Abs directly on RBCs of pt - looking for hyperbilirubinemia due to hemolysis, esp. ABO incompatibility
2. Indirect: looks for Abs that could bind to certain RBCs in serum

Question 4

Why is passing stool important in enterohepatic circulation

Answer 4

Passing stool helps infant get rid of excess bilirubin

Question 5

Mom’s blood types (2) that are most at risk for hyperbilirubinemia

Answer 5

Type O, Rh negative

Question 6

BIND stands for?

Answer 6

Bilirubin-induced neurologic dysfunction

Question 7

Describe pathophys behind BIND/Kernicterus

Answer 7

Free unconjugated bilirubin -> crosses BBB -> deposited in basal ganglia and brainstem -> permanent neurologic dysfunction