Jaundice in the new born

Question 1

cause of jaundice in first 24 hours

Answer 1

PATHOLOGICAL

rhesus haemolytic disease
ABO haemolytic disease
hereditary spherocytosis
glucose-6-phosphodehydrogenase

Question 2

causes of jaundice 2-14 days

Answer 2

PHYSIOLOGICAL

more red blood cells, more fragile red blood cells and less developed liver function.

Question 3

who is jaundice in 2-14 days of life most commonly seen in

Answer 3

breast fed

Question 4

what is categorised as prolonged jaundice

Answer 4

signs of jaundice >14 days and 21 days if premature

Question 5

what does a prolonged jaundice screen involve?

Answer 5

conjugated and unconjugated bilirubin: the most important test as a raised conjugated bilirubin could indicate biliary atresia which requires urgent surgical intervention

direct antiglobulin test (Coombs’ test)

TFTs

FBC and blood film

urine for MC&S and reducing sugars

U&Es and LFTs

Question 6

causes of prolonged jaundice

Answer 6

biliary atresia

hypothyroidism

galactosaemia

urinary tract infection

breast milk jaundice
jaundice is more common in breastfed babies
mechanism is not fully understood but thought to be due to high concentrations of beta-glucuronidase → increase in intestinal absorption of unconjugated bilirubin

prematurity
due to immature liver function
increased risk of kernicterus

congenital infections e.g. CMV, toxoplasmosis