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Block 3.4 > Neonatal Jaundice > Flashcards

Neonatal Jaundice Flashcards

1
Q

biliary atresia common in

A

female

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2
Q

idiopathic neonatal hepatitis common in

A

male

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3
Q

Lethargy associated with

A

galactosemia

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4
Q

itching

A

Cholestasis

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5
Q

vomiting

A

galactosemia

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6
Q

dark urine and pale stools: Pale stool persistent vs intermittent

A

Pale stool persistent BA , intermittent NHS

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7
Q

.Fever , rash in pregnancy with and miscarriage with

A

TORCH, metabolic

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8
Q

AGA

A

BA

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9
Q

SGA

A

INH

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10
Q

Poor feeding ,lethargy, hoarse cry constipation

A

hypothyroidism

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11
Q

Convulsion

A

congenital infection

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12
Q

Normal, Delayed development

A

BA , congenital

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13
Q

Poor feeding

A

Galactosemia

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14
Q

Consanguinity: ,Affected sib :

A

metabolic disease, INH

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15
Q

Irritable , lethargic

A

congenital infection , metabolic disease

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16
Q

Large anterior fontanelle

A

Hypothyroidism , down syndrome

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17
Q

Microcephaly, Macrocephaly

A

CMV, Toxoplasmosis

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18
Q

Cataract

A

galactosemia

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19
Q

choreo-retinitis

A

CMV, rubella and toxoplasma.

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20
Q

Cherry red spots:

A

Nieman –pick disease.

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21
Q

Posterior emryotoxo

A

alagille syndrome.

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22
Q

Optic nerve

hypoplasia

A

pan- hypopitutarism

23
Q

FTT

A

INH and congenital infection

24
Q

heart rate and RR.

A

increased in infections

25
Q

dysmorphic features.

A

(Downs syndrome , hypothyroidism, alagille syndrome, cleft lip or palate
with BA)

26
Q

RTI

A

downs syndrome , cystic fibrosis

27
Q

Potty belly, umbilical hernia

A

hypothyroidism

28
Q

Simian crease & clinodactly and sandal gap

.

A

in Down syndrome

29
Q

US: Absent/Small/non visualized gall bladder Ø Lack of post prandial contraction of GB. Ø Triangular cord sign(a cone shaped fibrotic mass cranial to the bifurcation of portal vein

A

BA

30
Q

Hepatobiliary Scintigraphy: delayed uptake, normal excretion, normal uptake, absent excretion

A

Neonatal Hepatitis, Biliary Atresia

31
Q

Percutaneous Liver Biopsy

A

Most important investigation in differentiating INH and BA.

32
Q

Prerequisites: Normal CBC, PT, APTT & USG

A

Percutaneous Liver Biopsy could lead to bleeding, so these tests are needed

33
Q

Kasai procedure followed by Liver Transplantation

A

BA

34
Q

life long thyroxine

A

Hypothyroidism

35
Q

Kasai Procedure statistics

A

Bile flow re-established in 90% if performed prior to
8 weeks of life and less than 20% if performed
after 12 weeks of life.

36
Q

Complications of Kasai procedure

A

ascending cholangitis and re-
obstruction as well as failure to re-establish bile
flow.

37
Q

Liver Transplantation

A

Indications: u Biliary atresia is the most common indication for transplant.
u When initial treatment was given lately/ Portoenterostomy not done
u Failed portoenterostomy
u Decompensated cirrhosis and end stage liver disease despite initial successful Kasai.

38
Q

the single most important determinant in successful management of BA.

A

Early kasai Age(< 8 wks)

39
Q

hepatobiliary disorders resulting in Cholestasis characterized by

A

Jaundice Ø High/dark colored urine Ø Pale stools + Ø Direct bilirubin > 1.5 mg% or > 20% of total, beyond 14 days of life

40
Q 
How does it differ from neonatal jaundice?
onset
Type of bilirubin
Severity
complications
A
41
Q

BA types

A
42
Q

Biliary Atresia

A

Biliary atresia: 1 in 10000 to 15000 infants. Female predominance
u It is a progressive obliterative inflammatory process involving the bile ducts, resulting in
obstruction of bile flow leading to cholestasis, hepatic fibrosis, and eventually cirrhosis.
u Average birth weight , hepatomegaly with firm to hard consistency
u Associated with many anomalies
u No well-documented familial cases

43
Q

Idiopathic Neonatal Hepatitis

A

Idiopathic neonatal hepatitis: 1 in 5000 to 10000 live
birth. With male predominance and familial cases
(15-20%)
u Generally normal stools or acholic stools with onset
at one month-old ,Low birth weight .
u Normal liver on exam or hepatomegaly with normal
to firm consistency. u characteristic “giant cell hepatitis” lesion is present
on liver biopsy & for which no infectious, genetic,
metabolic or anatomic cause is identified

44
Q

BA VS INH

A
45
Q

Choledochal Cyst

A

Localized cystic dilatation of common bile
duct is called choledochal cyst.
u •25% patient present in neonates with prolonged jaundice & cholestasis.

46
Q

Triad of choledochal cyst

A
  1. Intermittent jaundice 2. Recurrent abdominal pain 3. Abdominal mass
47
Q

Galactosemia

A

Here galactose-1-phosphate accumulation occur due to galactose-1- phosphate Uridyl transferase enzyme deficiency.
u• Present with vomiting, loose motion, persistent jaundice, FTT, hepato- splenomegaly, septicemia, cataract, repeated hypoglycemia and convulsion.

48
Q

Inspissated Bile Syndrome

A

Conjugated hyperbilirubinemia resulting from severe jaundice associated
hemolysis due to Rh or ABO incompatibility is termed as inspissated bile
syndrome.

49
Q

Alpha-1-antitrypsin Deficiency

A

Alpha-1-antitrypsin makes up 90% of alpha-1- globulin fraction
u Biopsy also shows accumulation of PAS-positive, diastase-resistant eosinophilic granule.
u Varying degrees of fibrosis correlate with disease prognosis.

50
Q

TPN Related Cholestasis

A

u It develops in >50% of infants with birth weight <1000 gram & in <10% of
term infants after giving prolonged parenteral feeding.
u This may be due to lack of enteral feeding →reduction of gut hormone
secretion → reduce bile flow → biliary stasis.

51
Q

Murmur

A

: congenital rubella syndrome ,down syndrome , alagille
syndrome)
choledochal

52
Q

firm hepatomegaly,

splenomegaly

A

BA

53
Q

Right hypochondric mass:

A

choledochal cyst.

54
Q

Ascites

A

late

stage 3-4 months later

Block 3.4 (4 decks)

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