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Paeds AM > Jaundice > Flashcards

Jaundice Flashcards

1
Q

How can causes of neonatal jaundice be separated?

A

<24 hours
24 hours - 2 weeks
>2 weeks

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2
Q

What is jaundice <24 hours indicate of?

A

Always pathological

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3
Q

What can cause jaundice <24 hours?

A

Sepsis

HAemolysis- rhesus haemolytic disease, ABO haemolytic disease, hereditary causes

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4
Q

What can cause jaundice 24 horus to 2 weeks?

A 
Physiological
Breast milk jaundice
Polycythaemia
Sepsis
Haemolysis
Cephalohaematoma
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5
Q

What type of jaundice is physiological jaundice?

A

Unconjugated

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6
Q

What causes physiological jaundice?

A

Short RBC lifespan in inflants
Relative polycythaemia
Relative immaturity of liver function

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7
Q

What type of jaundice is breast milk jaundice?

A

Unconjugated

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8
Q

How long can breast milk jaundice persist?

A

Up to 12 weeks

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9
Q

What does prolonged jaundice indicate?

A

Requires investigation

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10
Q

What can cause prolonged jaundice?

A 
Breast milk
Hypothyroid
Pyloric stenosis
Cholestasis
Haemolysis
Infection
Hepatitis
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11
Q

What can cause conjugated prolonged jaundice?

A

Biliary obstruction
Neonatal hepatitis
Infection

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12
Q

What are some causes of biliary obstruction in neonates?

A

Biliary atresia
Choledochal cyst
Alagille syndrome

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13
Q

What is the presentation of biliary atresia?

A

Raare
Progressive jaundice after 2 weeks
Pale stool, dark urine

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14
Q

What is the investigation of biliary atresia?

A

Bloods- LFTs- increased conjugated bilirubin

US

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15
Q

What is the management of biliary atresia?

A

Urgent Kasai portoenterostomy

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16
Q

What is the presentation of a choledochal cyst?

A

Conjugated jaundice- pale stools, dark urine

17
Q

What investigations ar done for choledochal cyst?

A

Split bilirubin

US

18
Q

What is Alagille syndrome?

A

Inherited syndrome of intrahepatic cholestais, dysmorphism and congenital cardiac disease

19
Q

What can cause unconjugated prolonged jaundice?

A

Hypothyroid
Breast milk aundice
HAemolysis

20
Q

What investigations ar done for prolonged jaundice?

A 
FBC and blood fil, U&amp;Es, LFTs, TFTs
Conjugated and unconjugated bilirubin 
Direct antiglobulin test- Coombs 
Urinalysis
Suspect infection- blood and urine cultures
21
Q

What is the indication for management of jaundice?

A

Treatment threshold chart

22
Q

What is the management and mechanism of management of unconjugated jaundice?

A

Blue light therapy

Visible light converts bilirubin to water soluble isomer for excretion

23
Q

What is the management of severe jaundice?

A

Exchange transfusion

24
Q

Why is management indicated for unconjugated jaundice?

A

Unconjugated bilirubin can cross blood brain barrier and is neurotoxic

25
Q

What can uncnjugated jaundice cause?

A

Kernicterus

26
Q

How does kernicterus present?

A

Encephalopathy- poor feeding, lethargy, seizures

27
Q

What are the complications of kernicterus?

A

Severe cerebral palsy
Learning difficulties
Sensorineural deafness

Paeds AM (28 decks)

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