Neonatal Jaundice

Question 1

LT complic

Answer 1

Kernicterus brain damage as bili x BBB

Deaf

Question 2

Pathol IF

Answer 2

Under 24 hr of life
Too high acc to NICE charts for age (cut offs for photo tx or transfus)
Lasting over 2wk if term or 3 wk if preterm
Too conjugated (over 20% of bili)

Question 3

Physiol

Answer 3

Immature liver enz in preterm
More comm in breast fed
Usually ? Unconjugated

Question 4

Early

Answer 4

Due to haemolysis (ABO mism, rhesus, sepsis), G6PD, HS, hepatitis.

Question 5

High bili due to eg

Answer 5

Dehyd
Infec
Poor feed
Breast milk
Haemolysis
Polycythaemia
Bruising or haematoma
BO

Question 6

Ix

Answer 6

Transcutaneous bili monit
Bloods- FBC, film, serum bili and split SBr
Weight loss over 10% in 1st few days eg dehyd
Group and coombs (haemolysis)
Septic screen
?congenital infec screen, G6PD screen, stool virol

Question 7

hx

Answer 7

Birth hx
Sepsis or infec
Feeding and weight

Question 8

mx

Answer 8

Phototherapy- s/e fluid loss
Hysdration
Exchange transfusion

Question 9

Conjugated causes

Answer 9

Biliary atresia, need early tx
LT TPN
Hep
Choledochal cyst
Metab eg galactosaemia

Question 10

Conjugated ix

Answer 10

Bloods- LFT, bone screen, viral serol, a1 antiT
Liver USS
HIDA scan
Liver biop
Plasma and urine aa’s

Question 11

LT jaundice hx Qs

Answer 11

Conjug/un
Thriving
Pale stool, dark urine means obstruc eg atresia
Breast milk, poor feeding
Haemolysis
Infec
Hypothyr
Gilberts

Question 12

prolonged jaundice screen if well

Answer 12

FBC and film
Split SBr
TFT
Urine MC and S

Question 13

Bronzed jaundice

Answer 13

Suggests conjugated esp if dark urine and pale stool