Infant Conditions Flashcards
Hyperbilirubinemia
defined as infant >35 w as total serum bilirubin greater than __
product of __
__ circulates in blood bound to __ and transferred to __
___ allows for conjuation of bilirubin w ___, excreted in __
bile excreted in __
__ broken into urobilin by ___ (req gut flora which babies ____)
instead, conj biliruin is __ by betaglucuronidase
__ is reasborebd and ___ (enterohepatic recycling)
95 percentile
heme breakdown
unconj bilirubin, albumin, liver
UGT, glucuronic acid, bile
digestive tract
conj bilirubin, bacterial enzymes, do not have
deconj
uncoj bilirubin, recycled
Term newbors have __x as much bilirub as adults bc of inc __ and shorter ___
__ is deficient, not reaching adult levels until __ of age
inc in ___
lack of __ leads to lack of clearance
__ gets unconj and __
Inc bilirubin w H__ due to A__, R__, S__, E__, G__, P___, Congenital __, S__
P
S__ such as cephalohematoma
Dec clearance
C___ type 1 (__ absent) and type 2 (UGT activity is __)
G, C, H, P__ leading to inc _
2-3x, Hct, RBC lifespan UGT, 14w enterohepatic circ gut flora conj bilirubin, reabsorbed
hemolysis, ABO incomp, Rh incomp, spherocytosis, eliptocytosis, G6PD, PKD, erythropoeietic porphyria, sepsis
polcythemia
sequestration
crigler najar, absent
low
gilberts
congenital hypoT, human milk jaundice, poor feeding, enterohepatic recycling
Common causes of uconj hyperbilirubinemia in newborn
B
B
A
P
impaired intestinal motility secondary to __ or __ obstruction (such as __)
Breastfeeding jaundice
delay in establishing effective __
Maternal factors: poor __/p/f/a/s
neonatal factors: poor __/__ stay/ineffective __/__/__
weight __, hypo__, hyper___, jaundice by __d
exaggeration of ___
breastfeeding jaundice breast milk jaundice ABO incompat prematurity fxnal/true, pyloric stenosis
breastfeeding
tech, pain, fatigue, analgesia, sedation
transition, nicu, suck/swallow/breathe
loss, volemia, natremia, 3-5d
physio jaundice
Breast milk jaundice
begins toward end of __, usually bw day __ to __
peaks win __ after birth
declines to mormal by __ of age or sooner
BM has inc conc of __ which prevents ___ and allows inc __/___
1st w, 6-14d
2wks
12w
beta glucuronidase, bilirubin conjugation, intestinal reabsorp/enterohepatic recirc
Prematurity- same mech as _
immaturity of __/__/__
more likely to have __ or delay in ___ leading to inc __
BIND and kernicterus
TSB > __ mg assc w billirubin induced __
unconj bilirubin crosses __ and deposits in __
acutely known as __
H/A/R/O/F/High pitched __
chronic known as __
athetoid __, __/__ loss, __ probs, M
term
RBC, hepatic cells, GI tract
feeding issues, enteral feeding, enterohepatic circ
25-30mg, neuro dysfxn
BBB, brain tissue
Acute bilirubin enceph
hypertonia, arching, retrocollis, opisthotnos, fever, cry
kernicterus
CP, hearing/vision, dental, mental retard
under nonstressed cx, fetal glucose derived entirely from __ via ___
fetus produces __ to reg
serum __ declines after birth, then __ and maintained w __
hypoGly due to inadequate ___
inadequate __ and impaired __
inc ___ via excessive __
mother, placental transfer
insulin
glucose, inc, regular feedings
glucose supply
glycogen, glucose prod
glucose utilization, insulin sec
Inadequate glucose supply
P__ as glucose crosses placenta in __
IUGR- difficulty __, leading to __ and faster utilization of __
some __ can cause disruption of __/__
__ dysfxn
Inc Utilization
Hyper __ of infant from __ or perinatal __/__
P__- overutilization by inc number of ___
S_
prematurity, third trimester
transition, stress, glycogen
IEoM, glycogenolysis/gluconeogensis
hepatic
insulinism, diabetic mother, asphyxia/stress
polycythemia, RBC
sepsis
Signs of hypoGly brain primarily uses \_\_ for metabolic demands J/S S I Poor \_\_ H
hypoGly has risk for permanent __, depending on severity/duration
linked to __ later w __
glucose jitters, seizures sweating irritability suck hypotonia
neuro injury
poor school performance, neurosensory disability
VK deficient bleeding clotting factor synthesized by \_\_\_ neonates have \_\_\_ absence of \_\_ low levels of \_\_ of VK \_\_ cannot store it
can present at __ or __
Skin __, mucosal __, __ bleeding, __ bleeding, IC __
maternal RF
A__
meds for __
__ antagonist
intestinal bacteria low VK gut flora transplacental passage fetal liver
birth, weeks later
bruising, bleeding, umbilical/circumsion, hemorrhage
antiepileptics
tb meds
VK
prophylactic __ is given to newborns after birth
__ is not available, not efficacious for __ VKDB
Hemolytic dz of newborn
can be from __ or __ blood groups
Major blood groups
R__ and A__
VK1 (Phytonadione)
oral, late onset
major/minor
Rh Hemolytic dz
ABO incompatability
RH hemolytic disease
classified as __ neg/pos based upon expression of __ on RBC
independent of __
only effects __ if mother has been previously ___
Rh __ woman preg w Rh __ baby
During delivery, __ enter mom circulation through breaks in ___
mother makes __ during/after preg
mothers anti-Rh anibodies crss __ and destroy ___
Rhesus, major D antigen
ABO
fetus, sensitized
neg, positive
Rh antigens, placenta
anti-Rh antibodies
placenta, blood cells
Rh hemolytic dz presents w \_\_ in 1st 24 hrs Symptomatic \_\_ (L\_\_ and T) more severe than \_\_\_ inc more \_\_ w successive \_\_ leads to \_\_
Hydrops fetalis- most severe form of __
may present as __ at delivery
often need __
high ___
hyperbilirubinemia anemia, lethargy/tachycardia ABO incompat severe, preg hydrops fetalis
hemolytic disease
shock
transfusion
mortality rate
Rh Hemolytic dz prevent
Any Rh neg mother given __ to prevent alloimunization
given at __ gestation as outpatient for __
given at any time mother is __ and risk of __
ABO incompat can occur at __
exclusively in mothers that are blood type __
less severe than __
body produces ab around __ from antigens in __
anti-D IgG
28w, prophylaxis
untx, bleeding
1st preg
O
Rh
6m, environment
ABO dx
direct vs indirect antiglobulin test
Direct- testing newborn __ to see if __ attached
indirect- wash newborn __ and test __ to see if __ prset
RBC, maternal ab
RBC, serum, antibodies
Group A blood Antigen for \_\_ Ab for \_\_ can have cannot have \_\_ or \_\_ blood can have \_\_ or \_\_ blood
Gorup B atigen for \_\_ Ab for \_\_ cannot have \_\_ or \_\_ blood can have \_\_ or \_\_ blood
A
B
AB/B
A/O
B
A
AB/A
B/O
