neonatal jaundice Flashcards

1
Q

what symptoms may the neonate with jaundice get?

why is it bad for these neonates to be dehydrated?

A
  • lethargy, anorexia

- Dehydration causes haemoconcentration, making the baby feed less well hence causing more severe dehydration

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2
Q

what are the causes of unconjugated hyperbilirubinaemia? (8)

A
  • Rhesus and ABO incompatibility
  • infection (TORCH)
  • excessive bruising
  • internal haemorrhage
  • prematurity
  • hypothyroidism
  • breast milk jaundice
  • physiological
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3
Q

what are the causes of conjugated hyperbilirubinaemia? (3)

A
  • neonatal hepatitis
  • Cystic fibrosis
  • biliary atresia
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4
Q

what two reasons make jaundice clinically important?

A
  • can cause irreversible brain damage (kernicterus)
  • kernicterus causes deafness, cerebral palsy and retardation
  • prolonged jaundice may indicate severe underlying disease
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5
Q

what should you suspect if a baby has conjugated hyperbilirubinaemia?

A
  • CF
  • neonatal hepatitis
  • biliary atresia
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6
Q

what other symptoms may these neonates have?

A
  • hepatosplenomegaly
  • petechiae
  • anaemia
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7
Q

What does the Coombs test test for?

A
  • determines whether there is an antibody on the RBC membrane
  • (positive in rhesus incompatibility)
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8
Q

There are 4 indications that a baby should be investigated rapidly for serious causes of jaundice, what are they?

A
  • evidence of jaundice in the 1st 24 hours of life, suggesting underlying haemolysis
  • clinical evidence of deep jaundice
  • prolonged conjugated jaundice lasting more than 2 weeks, suggesting a serious underlying cause
  • increasing levels of conjugated bilirubin (suggesting a severe hepatic cause)
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9
Q

how can you tell the total bilirubin level just by looking at baby?

A
  • limited to head and neck (mild)
  • over trunk and thighs (moderate)
  • Extending to hands and feet (severe)
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10
Q

why might you do a lumbar puncture and urine cultures in jaundice?

A
  • meningitis/ infection causing it
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11
Q

how should these babies be treated?

A
  • avoid kernicterus, have a look at charts to see level of unconjugated bilirubin that is dangerous
  • phototherapy (unconjugated)
  • exchange transfusions
  • treat the cause in conjugated- much more worrying
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12
Q

what does jaundice in 1st 24 hours suggest?

A
  • haemolysis or sepsis
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13
Q

what signs are there of kernicterus?

A
  • irritability
  • high pitch cry
  • coma
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