jaundice

Question 1

neonatal - jaundice <48hrs
common causes
not to be missed

Answer 1

common
- physiological
- breast feeding/establishment jaundice = dehydration
- breast milk jaundice
- cephalohematoma
NOT TO MISS
- hemolysis (rh incompat, ABO incompat, other blood grp incomp)
- red cell enzyme defects G6PD
- red cell membrane defects - spherocytosis
- sepsis
- polycythemia

Question 2

breast feeding jaundice

Answer 2

• onset 2-4days of birth
• infrequent BF w reduced fluid intake
• increased reabsorption bilirubin frm bowel

Question 3

cephalohematoma

Answer 3

breakdown of extravasated blood

Question 4

jaundice <24hrs

Answer 4

ALWAYS PATHO

• haemolysis (most common)
• Sepsis
• Red cell enzyme and membrane defects

Question 5

Jaundice >10 days

Answer 5

conjugated hyperbilirubinemia 
- Breast milk jaundice unlikely
- infections - hep b, TORCH, sepsis
- congenital - malformations (biliary atresia, choledochal cyst, bile duct atresia)
- metabolic - (galactosemia, tyrosinemia, alpha1-antitryp, glycogen storage disease type 4, hypothyroidism)
- idiopathic neonatal hepatitis
sepsis
hypothyroidism
haemolysis

Question 6

Late breast milk jaundice

Answer 6

• occurs day 4-7 peaks 7-15

- less common.