module 9: Jaundice Flashcards
Jaundice (icterus) visible when bili reaches
non-obstructive occurs d/t ^______, or ____
2.5-3
^unconjugated bili (rbc hemolysis)
hepatocellular damage (hepatits, cirrhosis, CA) bc they can’t conjugate bili
Physiologic jaundice in NB caused by lack of _____
lack of conjugating enzyme glucuronyl transferase
Non-obstructive jaundice
_total bili
_direct bili
_indirect bili
high total bili
low direct bili
high indirect bili
Obstructive jaundice occurs when
the liver conjugates bili but has an obstruction in the flow of bili to the intestines from the liver in the biliary tract
Obstructive jaundice, accumulated bili leaks into ___and deposited into ____
will give stools ___ color
vasculature and deposited into tissues
grey stools
Obstructive jaundice labs _total bili _direct bili _alk phos _GGT
^total
^direct
^alk phos
^ggt
Hepatitis s/s
^lfts, jaundice, fatigue, anorexia, n/d, fever, cough, clay stool, hepatomegaly
Screening for Hep A includes ___ and ___ labs
hep a IgM (acute infection) and hep a IgG (had previous infection/immune)
Hep B labs
test for acute infection/infectious
__negative in acute infections
if hep b antibody is positive and everything else negative =
positive hep b total core antibody w all others neg=
hep b core antibody (IgM) positive in ___
acute infection when both ___ and ____ are positive
chronic hep b infection
chronic hep c infection will have
Hep B surface antigen hep B surface antibody got the vaccine (acquired immunity) prior infection of hep b acute infections surface antigen and total core antibody positive positive hep c antibody
Cleft lip/palate caused by
3 deficiencies, ___and ___during pregnancy, __or___use, maternal ____, maternal ___, ____
vB6, B12, folic acid
smoking/drinking
steroid or statin use
maternal hyperhomocysteinemia, maternal dm, genetic mutations
infantile hypertrophic pyloric stenosis is the most common cause of
intestinal obstruction in infancy
pyloric stenosis can be caused by v\_\_\_\_\_\_\_containing neurons abnormal innervation of \_\_\_\_\_\_ infantile \_\_\_\_\_ \_\_\_\_\_abx
vNitric oxide synthase containing neurons
abnormal innervation of myenteric plexus
infantile hypergastrinemia
macrolide abx
pyloric stenosis has been linked to ^____secretion by mom in ____trimester
^gastrin in 3rd trimester
pyloric stenosis sx start within ____of birth
will have non___vomiting after feeding
will want ______
tend to be ___
2-3wks
nonbilous
more food after
constipated
Severe cases of pyloric stenosis will lead to ____, ____,____ can be fatal in 4-6wks
hungry infants will be ___
vomit can be blood streaked d/t
electrolyte imbalances, malnutrition, weight loss
irritable
rupture of gastric and esophageal vessels
neonatal jaundice present when total bili greater than ____for age in hours
or bili level greater than
visible jaundice when bili reaches
95th
20
2
pathologic jaundice of the newborn manifests within ___
bili >, indirect >15
24 hrs of birth
>20
Pathologic jaundice of NB risk factors
___incompatibility, ____, ___, ___y/o mom, ___, ___passage, birth_____
ABO RH incompatibility, prematurity , breastfeeding, 25+y/o mom, male baby, delayed meconium passage, birth trauma
Pathologic jaundice of NB caused by ^____production, v__uptake or excretion of _____bilirubin or delayed maturation of _____mechanisms
^bilirubin production
vHepatic uptake
excretion of unconjugated bili
liver conjugating
Most common cause of pathologic jaundice of NB
hemolytic disease of NB
unconjugated bili is ___soluble and can cross the ____ causing bilirubin encephalopathy
lipid soluble
blood brain barrier
physiologic jaundice manifests within days and disappears after ___-___wks in full terms
__-__in prematures infants
after=pathologic
1-2 weeks
2-4 wks in premies
Physiologic jaundice s/s
dark urine, light stools, weight loss
premature infants w respiratory distress, acidosis, or sepsis at increased risk for ____ and ____dysfunction
kernicterus and neurologic dysfunction
