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Pediatrics > Neonatal Jaundice > Flashcards

Neonatal Jaundice Flashcards

1
Q

What percentage of newborns are jaundice?

A

up to 60%

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2
Q

What is the definition of a neonate?

A

A baby from birth until 28 days

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3
Q

What is the definition of jaundice

A

yellowing of the sin caused by a serum bilirubin of over 30mmol/l

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4
Q

What are the main causes of neonatal jaundice that develops within 24hours after birth? 5

A 
Mainly haematological causes 
Rhesus Haemolytic disease
ABO incompatibility 
G6PD deficiency 
Spherocytosis 
Congenital Infection
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5
Q

What are the main causes of neonatal jaundice that develops between 24 hours and 2 weeks old?

A 
Physiological 
Breast milk jaundice 
Infection
Haemolytic disorders
Bruising
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6
Q

What are the main causes of neonatal unconjugated jaundice that develops >2 weeks old?

A 
Physiological 
Brest milk jaundice 
infection
Hypothyroidism 
Haemolytic disorders
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7
Q

What are the main causes of neonatal conjugated jaundice that develops more than 2 weeks after birth?

A 
sepsis
Total parenteral nutrition
Neonatal hepatitis
Cystic Fibrosis
Bile duct obstruction
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8
Q

What is physiological neonatal jaundice?

A

Starts at 24 hr old, peaks after a few days then resolves within 14 days.

It is caused by the immaturity of the neonatal liver which means it does not properly conjugated bilirubin.

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9
Q

At what serum bilirubin is action required in neonatal jaundice?

A

> 260mmol/l

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10
Q

How does infection cause neonatal jaundice?

A

poor fluid intake
may be haemolysis
Reduced hepatic function
Increased enterohepatic circulation

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11
Q

What clinical features would indicated that a jaundice was conjugated in a neonate?

A

Pale stoll + dark urine

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12
Q

What is unique about the progression of jaundice in an neonate?

A

it moves in a cephalic-caudal direction

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13
Q

What is Kernicterous? What are the manifestations?

A

A bilirubin induced brain dysfunction.

Lethargy
Poor feeding
Irritability
Increased tone

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14
Q

What investigations may you consider in an neonate with jaundice?

A

Urine dip stick - infection

Bloods - Bilirubin, FBC and blood film (spherocytosis), TORCH, LFTs, TFTs, CF testing?

Imaging - liver USS

Liver biopsy if features highly suggestive of biliary atresia

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15
Q

What are the 2 most important drivers of management in neonatal jaundice?

A

The baby’s age and the serum bilirubin level

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16
Q

What are the priniciples of management in neonatal jaundice?

A

Encourage regular feeding
Phototherapy
Exchange transfusion - if SBR is very high

17
Q

How does phototherapy work in neonatal jaundice?

A

it converts unconjugated bilirubin into harmless water-soluble pigment

18
Q

What is TORCH in biochemistry?

A

a screening tool for infection. Tests for:

Toxoplasma
Rubella
Cytomegalovirus 
Herpes Simplex Virus 
HIV

Pediatrics (15 decks)

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