Jaundice Flashcards
List the 5 categories of neonatal jaundice
- Physiological
- Haemolytic
- Non-haemolytic pathological
- Hepatic
- Obstructive
Timeline of physiological jaundice
Starts by day 3, stops by day 7
What types of jaundice present with high UNCONJUGATED bilirubin
Physiological
Haemolytic
Non-haemolytic pre hepatic
What types of jaundice present with high CONJUGATED bilirubin
Hepatic
Obstructive
Which type of jaundice will NOT cause kernicterus? Why?
Hepatic/ obstructive
Conjugated bilirubin cannot cross the blood brain barrier
Which type of bilirubin is excreted in stools
Stools = Conjugated bilirubin
Which type of bilirubin is excreted in urine
Urine = Unconjugated bilirubin
At what bilirubin level is jaundice concerning
> 308umol
At what bilirubin level is jaundice visible
> 34umol
2 main treatments for jaundice
Phototherapy
Blood transfusion
How does phototherapy work
Adds oxygen to bilirubin so it dissolves easily in water -> easier for liver to break down
Breastmilk jaundice vs breastfeeding jaundice
Breastmilk = insufficient gut flora at birth, so longer time to breakdown bilirubin
Breastfeeding = insufficient milk intake, so not passing out stools & urine as often
Causes of haemolytic jaundice
- Thalassaemia
- G6PD deficiency
- Rhesus incompatibility
- Sepsis
Causes of non-haemolytic pathological jaundice
- Breastfeeding jaundice
- Breastmilk jaundice
- UTI, other infections
- Gilbert’s syndrome
Causes of hepatic jaundice
Hepatitis TORCH infections (toxoplasmosis, Rubella, CMV, HSV, Others: VZV)
Causes of obstructive jaundice
Biliary atresia
What timeline of jaundice suggests pathological cause
Jaundice <24h or >14 days
3 main pathophysiology for physiological jaundice
- Foetal RBC lifespan 90 days instead of 120 days in adult
- Low conversion of bilirubin to urobilinogen by intestinal flora
- Low activity of enzyme glucuronosytransferase (converts unconjugated bilirubin to conjugated bilirubin for excretion in GI tract)
What kind of jaundice does inborn errors of metabolism cause
Hepatic jaundice
Definition of prolonged jaundice in
- term baby
- premature baby
Term: jaundice >2 weeks
Premature: jaundice >3 weeks
