Gastroenterology part 2 Flashcards
Why do 50% of all newborns become jaundiced?
Incr release of Hb from breakdown of RBC
Shorter RBC lifespan in children
Hepatic bilirubin metabolism less effective 1st few days life
What serious condition can neonatal jaundice lead to
Kernicterus
What is kernicterus
Unconjugated bilirubin is deposited in BG –> encephyalopathy as can cross BBB
Sx acute kernicterus
Lethargy
Sx severe kernicterus (2)
Irritability
Seizures
What condition can kernicterus lead to
Cerebral palsy
Causes of neonatal jaundice - <24hrs old (5)
Rhesus ABO incompatibility G6DP deficiency Spherocytosis Infection - TORCH/Rubella/CMV, HSV
How can ABO incompatibility lead to neonataljanudice>
Group O women’s IgG’s haemolyse RBC of group A infants
or group B
Causes of jaundice - 24h to 2w (7)
Physiological Breast milk jaundice Infection Haemolysis Bruising Polycythaemia Crigler-nijjar
Causes of jaundice - conjugated - >2 weeks (3)
Bile duct obstruction
Neonatal hepatitis
Biliary atresia
Causes of jaundice - unconjugated - >2w (6)
Physiological/breast milk Infection - UTI Hypothyroidism Haemolytic - G6PD GI obstruction - pyloric stenosis Crigler Nijjar
Ix neonatal jaundice
Serum bilirubin - is it conjugated or unconjugated
FBC
Coombs
Infection screen prn
Mx neonatal jaundice
Correct dehydreation
Phototherapy - UV light 450nm. Cover infants eyes and repeat serum biliruin levels at 4-6hrs
exchange transfusion if severe via art line
What will happen if you perform phototherapy on a conjugated hyperbilirubinaemia baby
baby will get macular rash and bronzed skin
What is biliary atresia
Progressive fibrosis and obliteration of extrahepatic and intrahepatic biliary tree