Jaundice Flashcards

1
Q

Indirect (unconjugated) hyperbilirubinemia

A

Physiological jaundice

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

Presents first 36-48 hours of life, reaches peak total bilirubin levels 10-15 at 5-7 days of life

A

Physiological jaundice

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

If severe or prolonged, occurs within first 24 hours of life, or associated with increased directed (conjugated) component

A

Less likely to be physiological

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

Initial evaluation should include both ________ to establish whether high bilirubin levels are direct or indirect

A

Total and direct bilirubin

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

Increase feedings, UV phototherapy, exchange transfusion for severe jaundice. Trend serum bilirubin levels

A

Treatment for physiological jaundice

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

Has an enzyme that delays hepatic bilirubin conjugation and prolongs jaundice in newborns

A

Breast milk

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

Presents after first 3-5 days of life and peaks at 2 weeks. Total bilirubin levels reach 19-20 and may persist for 1-2 months

A

Breast milk jaundice

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

Rarely requires phototherapy. Encourage breast feeding because jaundice will usually go away on its own

A

Breast milk jaundice

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

Direct bilirubin of > ________ OR __________ of total bilirubin indicates a hepatobiliary or general metabolic disorder

A

10%

2 mg/dL

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

Very high levels of unconjugated bilirubin (> _______ ) can cross the blood-brain barrier and deposit in the basal ganglia causing kernicterus (irreversible, potentially fatal encephalopathy)

A

30 mg/dL

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

Indirect

A

Unconjugated bilirubin

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

Direct

A

Conjugated bilirubin

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

Jaundice, lethargy, poor feeding, high-pitched cry, hypertonicity, and seizures

A

Kernicterus

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

Order CBC (to assess for anemia), reticulocyte count, and peripheral smear (assess for hemolysis)

A

Hyperbilirubinemia

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

________ test can distinguish antibody mediated disease (ABO incompatibility) from non-immune mediated (G6PD deficiency, hereditary spherocytosis)

A

Coombs

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

Most common inherited disorder of bilirubin glucoronidation

A

Gilbert’s syndrome

17
Q

Caused by defective UGT1A1

A

Gilbert’s syndrome

18
Q

Rarely diagnosed before puberty. See in adolescence due to hormonal changes

A

Gilbert’s syndrome

19
Q

Repeated episodes of jaundice with stressors (illness, fever, dehydration, fasting)

A

Gilbert’s syndrome

20
Q

No treatment available for

A

Gilberts syndrome

21
Q

Abnormal functioning of the bilirubin-UGT enzyme

A

Crigler-Najjar Syndrome

22
Q

Liver transplant is the only cure for

A

Crigler-Najjar Syndrome

23
Q
Increased unconjugated (indirect) bilirubin with normal hepatic enzymes.  
Persistent hyperbilirubinemia despite treatment with phototherapy and exchange transfusion (plasmapharesis)
A

Crigler-Najjar Syndrome

24
Q

Chronic cholestasis due to paucity (lack) of bile ducts

A

Alagille syndrome

25
Q

Associated with JAG1 or NOTCH2 mutation

A

Alagille syndrome

26
Q

Associated with dysmorphic facies and other anomalies of heart, eyes, and vertebrae

A

Alagille syndrome

27
Q

Pruritus (itchiness) due to cholestasis.
Growth failure due to malnutrition.
Increased bilirubin, increased GGT, Increased AST/ALT.

A

Alagille syndrome

28
Q

Diagnosed by liver biopsy showing limited number of bile ducts

A

Alagille syndrome

29
Q

Treat _________ with ursodiol, rifampin, and bile acid-binding resins

A

Pruritus

30
Q

Some patients with this disease (20%) will require a liver transplant

A

Alagille syndrome