jaundice

Question 1

normal causes of neonatal jaundice

Answer 1

release of haemoglobin from the breakdown of red cells (high hb)
RBC life span - 70 days
hepatic bilirubin metabolism is less efficient

Question 2

risk of neonatal jaundice

Answer 2

kernicterus: unconjugated bilirubin can be deposited in the basal ganglia

Question 3

Kernicterus

Answer 3

encephalopathy from the deposition of unconjugated bilirubin in the basal ganglia

Question 4

at what stage might you get kernicterus

Answer 4

when there is more UC than albumin to bind

Question 5

why can UC cross BBB

Answer 5

fat soluble

Question 6

symptoms of kernicterus

Answer 6

lethargy 
poor feeding
irritability
hypertonia
seizures 
coma

Question 7

opisthotonos

Answer 7

baby to lie with an arched back

Question 8

Kernicterus long term sequely

Answer 8

cerebral palsy
learning difficulties
sensorineural deafness

Question 9

disease during pregnancy than can lead to jaundice

Answer 9

rhesus haemolytic disease

Question 10

how to stop rhesus haemolytic disease

Answer 10

prophylactic anti-D immunoglobulin

Question 11

jaundice in the first 24 hours is usually due to

Answer 11

haemolysis

Question 12

severe presentation of rhesus haemolytic disease

Answer 12

anaemia, hydrops and hepatosplenomegaly and jaundice

Question 13

hydrops

Answer 13

full body oedema

Question 14

what can cross the placenta in group O women

Answer 14

n IgG anti-A-haemolysin

Question 15

what does n IgG anti-A-haemolysin do

Answer 15

haemolyse the red cells of a group A infan

Question 16

test for haemolytic disorders

Answer 16

coombs

Question 17

G6PD ethnicity

Answer 17

Mediterranean, Middle-East

Question 18

G6PD m/f

Answer 18

m

Question 19

name some other causes of jaundice

Answer 19

physiological
congenital infection
dehydration

Question 20

Crigler–Najjarsyndrome

Answer 20

enzyme glucuronyl transferase is deficient

Question 21

what drugs to avoid in jaundice

Answer 21

displace bilirubin from albumin, e.g. sulphonamides and diazepam

Question 22

treatment of neonatal jaundice

Answer 22

Phototherapy

Exchange transfusion

Question 23

when is jaundice prolonged

Answer 23

> 2 weeks of age

Question 24

causes of prolonged neonatal jaundice

Answer 24

Breast milk jaundice (most common)
infection (uti)
Congenital hypothyroidism

Question 25

Conjugated hyperbilirubinaemia signs

Answer 25

dark urine and unpigmented pale stools, hepatomegaly

Question 26

causes of Conjugated hyperbilirubinaemia

Answer 26

neonatal hepatitis syndrome and biliary

atresia