Jaundice

Question 1

What is the definition of jaundice?

Answer 1

yellowing of the skin, the sclera of the eyes, and mucous membranes

Question 2

What is billirubin released from?

Answer 2

it is released from haem when red blood cells are broken down

Question 3

What is the lifespan of a babies red blood cells?

Answer 3

80-100 day, this is a lot shorter than adults, meaning that they have a higher turnover of bilirubin to excrete

Question 4

What kind of bilirubin is fat soluble?

Answer 4

unconjugated bilirubin

Question 5

What does bilirubin bind with to enter the liver?

Answer 5

albumin

Question 6

How is conjugated bilirubin excrete?

Answer 6

urine and faeces

Question 7

How many babies will expreience jaundice?

Answer 7

50-70% of new born infants

Question 8

Name three reasons why babies suffer from jaundice?

Answer 8

When born babies have an immature liver, making it more difficult to excrete bilirubin as they have relied on their mother for so long.
They have a shorter lifespan of red blood cells.
At birth, babies are overloaded with red blood cells

Question 9

When will physiological jaundice be visible? and how long is prolonged jaundice?

Answer 9

24 hours after birth

prolonged jaundice= 14 days or over

Question 10

What are some issues that can further affect a babies ability to process bilirubin?

Answer 10

During labour, babies can occur bruising, or cephalhaematomas, which increases the amount of rbc’s needed to break down.
Albumin binding ability can be affected by infections, hypoxia, asphyxia, low blood sugars or maternal drugs like diazepan.
Reduced oxygen supply to the liver, and an immature liver.
Bowel obstructions can affect ability to excrete bilirubin, and dehydration aswell.

Question 11

What is one major concern of high unconjugated bilirubin levels?

Answer 11

Unconjugated bilirubin is fat soluble, therefore it is attracted to the fatty areas in the body; particularly the brain and nervous tissues. Once bilirubin deposits have got to these areas, it is irreversible and can cause cerebral palsy, learning difficulties and hearing loss.

Question 12

What is the term used to describe when bilirubin passes the blood-brain barrier?

Answer 12

kernicterus

Question 13

What are the early, progressive and severe symptoms of kernicterus?

Answer 13

early= difficulty feeding, floppy baby
progressive= high pitched cry, vomitting, decreasedmuscle tone, apnoea(brief pauses in breathing)
severe= cerebral palsy, deafness, learning disabilities, fits,

Question 14

What increases a babies chance of developing pathological jaundice?

Answer 14

haemolytic anaemia, haemmorhage, polycythaemia (high red blood cells), blood group imcompatability, cephalhaematomas.

Question 15

What are the risk factor for jaundice?

Answer 15

drugs, previous sibling on phototherapy, prematurity, twins/triplets, males, maternal illness and ethnicity

Question 16

What ethnicites in particular are more at risk?

Answer 16

Mediterranean, asian, or black/afro Caribbean

Question 17

What are some ways that we can manage jaundice?

Answer 17

observe feeding, observe behaviours, babies wee and poo output, phototherapy which changes the structure of unconjugated bilirubin to make it easier to break down.