Jaundice Flashcards
_______ bilirubin goes to liver
Unconjugated
Unconjugated bilirubin changed to conjugated in
Liver
Post-liver increased bilirubin usually caused by
Obstruction
Post-liver obstruction usually causes increases in
Conjugated bilirubin
Conjugated or direct hyperbilirubinemia
Biliary atresia. Sepsis. Metabolic derangements
Hepatic damage will cause __________ hyperbilirubinemia
Mixed. unconjugated and conjugated
Disorders of uptake in liver. Look similar to prehepatic jaundice with increased unconjugated bilirubin
Crigler-Najar and Gilbert’s
Have problem with excretion. Have increased conjugated bilirubin
Dubin Johnson, Rotors
Has a charge, so water soluble. Cannot cross cell membranes well. Becomes trapped in urine and turns urine dark
Conjugated (direct) bilirubin
Can’t cross BBB and cause kernicterus
Direct (conjugated) bilirubin
Lipid soluble. Crosses BBB and causes kernicterus.
Unconjugated (indirect) bilirubin
Slow onset (over 3-4 days). Leaves NBN well then turns yellow
Physiologic jaundice
Resolution usually in less than a week, or two weeks for premies. Bili is unconjugated. Rise won’t be more than 5 points per day
Physiological jaundice
Jaundice within first day. Takes much longer than week to resolve. Usually won’t resolve without intervention. Rises fast.
Pathological jaundice
Usually conjugated bilirubin
Pathological jaundice
______________ hyperbilirubinemia is the one that must be conjugated
Unconjugated
First test done to evaluate physiological hyperbilirubinemia
Coombs test
Problem with quantity. Not enough food causing decreased Bowel Fn. Bilirubin sits around longer and is reabsorbed
Breast feeding jaundice
Day 1-7. Physiological jaundice. Unconjugated
Breast feeding jaundice
Quality issue. Mom’s milk inhibits conjugation of bilirubin. Unconjugated bilirubin.
Breast milk jaundice
Happens after day 7
Breast milk jaundice
