module 9: Jaundice

Question 1

Jaundice (icterus) visible when bili reaches

non-obstructive occurs d/t ^______, or ____

Answer 1

2.5-3
^unconjugated bili (rbc hemolysis)
hepatocellular damage (hepatits, cirrhosis, CA) bc they can’t conjugate bili

Question 2

Physiologic jaundice in NB caused by lack of _____

Answer 2

lack of conjugating enzyme glucuronyl transferase

Question 3

Non-obstructive jaundice
_total bili
_direct bili
_indirect bili

Answer 3

high total bili
low direct bili
high indirect bili

Question 4

Obstructive jaundice occurs when

Answer 4

the liver conjugates bili but has an obstruction in the flow of bili to the intestines from the liver in the biliary tract

Question 5

Obstructive jaundice, accumulated bili leaks into ___and deposited into ____
will give stools ___ color

Answer 5

vasculature and deposited into tissues

grey stools

Question 6

Obstructive jaundice labs
_total bili
_direct bili
_alk phos
_GGT

Answer 6

^total
^direct
^alk phos
^ggt

Question 7

Hepatitis s/s

Answer 7

^lfts, jaundice, fatigue, anorexia, n/d, fever, cough, clay stool, hepatomegaly

Question 8

Screening for Hep A includes ___ and ___ labs

Answer 8

hep a IgM (acute infection) and hep a IgG (had previous infection/immune)

Question 9

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

Answer 9

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

Question 10

Cleft lip/palate caused by

3 deficiencies, ___and ___during pregnancy, __or___use, maternal ____, maternal ___, ____

Answer 10

vB6, B12, folic acid
smoking/drinking
steroid or statin use
maternal hyperhomocysteinemia, maternal dm, genetic mutations

Question 11

infantile hypertrophic pyloric stenosis is the most common cause of

Answer 11

intestinal obstruction in infancy

Question 12

pyloric stenosis can be caused by 
v\_\_\_\_\_\_\_containing neurons
abnormal innervation of \_\_\_\_\_\_
infantile \_\_\_\_\_
\_\_\_\_\_abx

Answer 12

vNitric oxide synthase containing neurons
abnormal innervation of myenteric plexus
infantile hypergastrinemia
macrolide abx

Question 13

pyloric stenosis has been linked to ^____secretion by mom in ____trimester

Answer 13

^gastrin in 3rd trimester

Question 14

pyloric stenosis sx start within ____of birth
will have non___vomiting after feeding
will want ______
tend to be ___

Answer 14

2-3wks
nonbilous
more food after
constipated

Question 15

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

Answer 15

electrolyte imbalances, malnutrition, weight loss
irritable
rupture of gastric and esophageal vessels

Question 16

neonatal jaundice present when total bili greater than ____for age in hours
or bili level greater than
visible jaundice when bili reaches

Answer 16

95th
20
2

Question 17

pathologic jaundice of the newborn manifests within ___

bili >, indirect >15

Answer 17

24 hrs of birth

>20

Question 18

Pathologic jaundice of NB risk factors

___incompatibility, ____, ___, ___y/o mom, ___, ___passage, birth_____

Answer 18

ABO RH incompatibility, prematurity , breastfeeding, 25+y/o mom, male baby, delayed meconium passage, birth trauma

Question 19

Pathologic jaundice of NB caused by ^____production, v__uptake or excretion of _____bilirubin or delayed maturation of _____mechanisms

Answer 19

^bilirubin production
vHepatic uptake
excretion of unconjugated bili
liver conjugating

Question 20

Most common cause of pathologic jaundice of NB

Answer 20

hemolytic disease of NB

Question 21

unconjugated bili is ___soluble and can cross the ____ causing bilirubin encephalopathy

Answer 21

lipid soluble

blood brain barrier

Question 22

physiologic jaundice manifests within days and disappears after ___-___wks in full terms
__-__in prematures infants
after=pathologic

Answer 22

1-2 weeks

2-4 wks in premies

Question 23

Physiologic jaundice s/s

Answer 23

dark urine, light stools, weight loss

Question 24

premature infants w respiratory distress, acidosis, or sepsis at increased risk for ____ and ____dysfunction

Answer 24

kernicterus and neurologic dysfunction