Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Child Health > Jaundice > Flashcards

Jaundice Flashcards

1
Q

how common is jaundice

A

very common
60% of term
80% of preterm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

at what age does most jaundice appear

A

day 2-3 of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what clinical sign is due to high levels of bilirubin

A

jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what produces bilirubin

A

breakdown of red blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what does haem breakdown produce

A

unconjugated bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is most unconjugated bilirubin bound to when circulating

A

albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

some bilirubin is free in plasma - why do we worry about this stuff

A

it can cross the blood brain barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

heme —> _______ —-> bilirubin

A

biliverdin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

which type of bilirubin is water insoluble

A

unconjugated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

which type of bilirubin is water soluble

A

conjugated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

where is unconjugated bilirubin metabolised to conjugated bilirubin

A

liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is unconjugated bilirubin sometimes called

A

indirect bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is conjugated bilirubin sometimes called

A

direct bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what enzyme metabolises/causes conjugation of bilirubin

A

UDPGT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

why are newborns inefficient at managing bilirubin

A

ligandin and UDPGT are low in the newborn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what does enterohepatic circulation refer to in newborns (bilirubin)

A

a percentage of the conjugated bilirubin that passes into the gut reverts to unconjugated bilirubin and is recirculated into the bloodstream.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

give an example of a disease causing an enzyme abnormality that affects conjugation of bilirubin

A

Gilbert’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

which gene is mutated in gilbert’s disease

A

UGT1A1

19
Q

what does unconjugated bilirubin crossing the BBB cause

A

encephalopathy which can lead to kernicterus

20
Q

what additional factors are required to put a baby at significant risk of encephalopathy

A

decreasing gestation
asphyxia
acidosis
hypoxia
hypothermia
meningitis
sepsis

21
Q

why do we worry about jaundice

A

because of the neurological effects it can have

22
Q

Pathological jaundice

A

physiological jaundice that’s too high
haemolysis
sepsis
metabolic disorders
liver disease

23
Q

which timing of jaundice is considered pathological until proven otherwise

A

early jaundice - 0-24hrs

24
Q

in what time frame does physiological jaundice usually appear

A

24-72hrs

25
Q

late prolonged jaundice

A

persisting over 14 days in term and 21 days in preterm

26
Q

why does physiological jaundice develop

A
  • increased bilirubin production; foetal RBC lifespan is shorter, high Hct, bruising
  • decreased uptake and binding by liver cells (normal development of baby)
  • decreased conjugation (most important)
  • decreased excretion
  • increased enterohepatic circulation of bilirubin
27
Q

are babies great at conjugating bilirubin

A

nope

28
Q

what underlying cause should you watch out for in early jaundice

A

sepsis

29
Q

what is jaundice under a day old usually due to

A

a haemolytic event, with excessive production of bilirubin

30
Q

why might a baby be born with jaundice (so like immediate jaundice)

A

severe haemolysis
hepatitis (unusual)

31
Q

causes of haemolysis

A

ABO incompatibility
Rh immunisation
Sepsis

32
Q

when would you consider hepatitis as a cause of haemolysis

A

if there is substantial elevation of conjugated bilirubin (>15% of the total)

33
Q

which tests detect antibodies on the baby’s red cells

A

Direct Agglutination Test
elution test

34
Q

what test would be positive in blood group incompatibility

A

Direct Agglutination Test (DAT)

35
Q

what would Direct Agglutination Test result be in haemolysis

A

negative

36
Q

bilirubin encephalopathy symptoms

A
  • lethargy
  • poor feeding
  • temperature instability
  • hypotonia
37
Q

bilirubin encephalopathy severe and very rare symptoms

A
  • arching of head, neck and back (Opisthotonos)
  • spasticity
  • seizures
38
Q

conjugated bilirubin above which percentage needs investigating?

A

> 15% of the total bilirubin

39
Q

causes of persistent UNconjugated hyperbilirubinaemia

A
  • breast milk jaundice
  • poor milk intake
  • haemolysis
  • infection (especially UTI)
  • hypothyroidism
40
Q

what does persistent CONJUGATED hyperbilirubinaemia signify

A

a hepatitis

41
Q

what is biliary atresia

A

a rare condition causing obstructive jaundice
a section of the bile duct is either narrowed or absent

42
Q

biliary atresia symptoms

A

jaundice
pale, clay coloured stools
dark urine

43
Q

what operation do babies with biliary atresia need before 3 months of age

A

Kasai portoenterostomy

Child Health (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions