Jaundice

Question 1

Jaundice

Answer 1

Accumulation of yellow orange pigment bilirubin in the skin, sclera and mucosa

MC transitional finding in the newborn

becomes clinically apparent when serum bilirubin concentration > 5 mg/dL

Question 2

Jaundice w/n 24 h

Answer 2

first born child - ABO child

2nd born child - Rh incompatibility

sepsis - history of prolonged stage of labor; no prenatal check up

history of maternal infection during pregnancy - TORCH - syphilis, cytomegalovirus
(CMV), rubella, and toxoplasmosis

Question 3

Jaundice AFTER 24 hr

Answer 3

physiologic jaundice

breastfeeding jaundice

breastmilk jaundice

Question 4

Direct Hyperbilirubinemia

Intrahepatic Cholestasis

Answer 4

sepsis/TORCH
prolonged TPN
hypothyroidism
galactosemia
cystic fibrosis
alpha 1 antitrypsin deficiency

Question 5

Direct Hyperbilirubinemia

Extrahepatic Cholestasis

Answer 5

choledochal cyst

biliary atresia - paucity of bile duct

Question 6

Used to detect antibodies that are bound to the surface of RBCs

Answer 6

Direct Coombs Test

Question 7

Detect antibodies against RBCs that are present unbound to the patient’s serum

Answer 7

Indirect Coombs Test

Question 8

Coombs Test (+)

Answer 8

ABO Compatibility

Question 9

Coombs Test (-)
INCREASED Hgb and B1

Answer 9

polycythemia
infant of diabetic mother
SGA
delayed cord clamping
twin transfusion/maternal-fetal transfusion

Question 10

MCC of hemolytic disease of newborn

Answer 10

ABO incompatibility

mother - type O
baby - type A or B

Question 11

ABO incompatibility lab test results

Answer 11

(+) direct Coombs test
blood smear - spherocytosis
normal or low Hgb
increased reticulocyte count
increased B1

Question 12

Rh incompatibility lab test results

Answer 12

(+) direct Coombs test
anemia
increased reticulocyte count
B1 rises rapidly in the 1st 6hrs of life

Question 13

Coombs Test (-)
normal or low Hgb
normal reticulocyte count

Answer 13

enclosed hemorrhage
increased enterohepatic circulation
decreased calories - breastfeeding jaundice
disorders of conjugation - breastmilk jaundice

Question 14

Coombs Test (-)
normal or low Hgb
increased reticulocyte count

Answer 14

spherocytosis
elliptocytosis

G6PD deficiency
pyruvate kinase deficiency

Question 15

Neurologic syndrome resulting from the deposition of unconjugated (indirect) bilirubin in the BASAL GANGLIA and BRAINSTEM NUCLEI

Answer 15

Kernicterus (Bilirubin Encephalopathy)

bilirubin > 20 mg/dL