Neonatal Jaundice Flashcards
1
Q
Neonatal Jaundice Aetiology
A
- Bilirubin higher because neonates have higher concentration of red blood cells with shorter lifespan
- Unconjugated then conjugated and excreted
- Usually presents 2/3 days, begins to disappear after first week, resolved by 10 days
- Bilirubin does not rise above 200
2
Q
Neonatal Jaundice (Early) Aetiology
A
- Haemolytic disease (ABO, G6PD, spherocytosis)
- Congenital infection
- Haematoma
- Crigler-Najjar or Dubin-Johnson
3
Q
Neonatal Jaundice (Prolonged) Aetiology
A
- Infection, hypothyroidism, hyperpituatiarism
- Galoctasaemia
- Breast milk jaundice
- GI
4
Q
Neonatal Jaundice Conjugated Bilirubinaemia Causes
A
-Infection, parenteral nutrition, CF, A1ATD, atresia, hepatitis, hypothyroidism, hypopituitarism
5
Q
Neonatal Jaundice RFs
A
Low birth weight, breast fed babies, PHx, diabetic mother
6
Q
Neonatal Jaundice Presentation
A
- First becomes visible in face and forehead, blanching can reveal underlying colour
- Changed in muscle tone, seizures etc. may be kernicterus
- Hepatosplenomegaly, petechiae and microcephaly are associated with haemolytic anaemia, sepsis, and congenital infections
7
Q
Neonatal Jaundice Ix
A
- Do not rely on visual inspection alone
- Transcutaneous bilirubinometer if GA >35, >24hrs
- If GA<35, <24hrs, use serum
- LFTs
- Infection screen (look this up)
- If haemolysis; blood typing, reticulocytes, direct Coombs test (different to Kleihauer), haemoglobin and haematocrit, peripheral blood film, red cell enzymes
8
Q
Neonatal Jaundice Management
A
- Monitor bilirubin
- Refer to hospital if <24hrs
- Treat cause
- Increase fluid intake
- Phototherapy (start immediately if <24hrs or haemolytic disease)
- Do not need phototherapy for conjugated bilirubinaemia as this cannot cause kernicterus
- Exchange transfusion if very bad
- If <24hrs, serious underlying cause
9
Q
Neonatal Jaundice Prolonged Jaundice Management
A
- Look for signs of obstruction
- Measure conjugated
- Carry out FBC
- Blood group and Coombs
- Urine culture
