jaundice Flashcards
normal causes of neonatal jaundice
release of haemoglobin from the breakdown of red cells (high hb)
RBC life span - 70 days
hepatic bilirubin metabolism is less efficient
risk of neonatal jaundice
kernicterus: unconjugated bilirubin can be deposited in the basal ganglia
Kernicterus
encephalopathy from the deposition of unconjugated bilirubin in the basal ganglia
at what stage might you get kernicterus
when there is more UC than albumin to bind
why can UC cross BBB
fat soluble
symptoms of kernicterus
lethargy poor feeding irritability hypertonia seizures coma
opisthotonos
baby to lie with an arched back
Kernicterus long term sequely
cerebral palsy
learning difficulties
sensorineural deafness
disease during pregnancy than can lead to jaundice
rhesus haemolytic disease
how to stop rhesus haemolytic disease
prophylactic anti-D immunoglobulin
jaundice in the first 24 hours is usually due to
haemolysis
severe presentation of rhesus haemolytic disease
anaemia, hydrops and hepatosplenomegaly and jaundice
hydrops
full body oedema
what can cross the placenta in group O women
n IgG anti-A-haemolysin
what does n IgG anti-A-haemolysin do
haemolyse the red cells of a group A infan
test for haemolytic disorders
coombs
G6PD ethnicity
Mediterranean, Middle-East
G6PD m/f
m
name some other causes of jaundice
physiological
congenital infection
dehydration
Crigler–Najjarsyndrome
enzyme glucuronyl transferase is deficient
what drugs to avoid in jaundice
displace bilirubin from albumin, e.g. sulphonamides and diazepam
treatment of neonatal jaundice
Phototherapy
Exchange transfusion
when is jaundice prolonged
> 2 weeks of age
causes of prolonged neonatal jaundice
Breast milk jaundice (most common)
infection (uti)
Congenital hypothyroidism
Conjugated hyperbilirubinaemia signs
dark urine and unpigmented pale stools, hepatomegaly
causes of Conjugated hyperbilirubinaemia
neonatal hepatitis syndrome and biliary
atresia
