neonatal jaundice Flashcards
neonatal conjugated vs unconjugated bilirubin - which warrants urgent referral
conjugated, it means obstruction prolly
neonatal jaundice in first 24 hrs - investigations
Total bilirubin, conjugated and unconjugated bilirubin
then FBC, Coombs test
neonatal jaundice - management of biliary atresia
kasai operation
neonatal jaundice - what is prolonged jaundice
jaundice lasting > 2 weeks
neonatal jaundice within first 24 hrs - ddx (5)
sepsis hemolysis - hemorrhage (cerebral,intraabdominal) - extravasation (bruising or trauma) - alloimmunisation (ABO or Rhesus group) - red blood cell enzyme defects (G6PD, thalassaemia, spherocytosis)
neonatal jaundice within first 24 hours - management (at GP level)
refer to paeds for emergency workup
neonatal jaundice in 24hrs - 14 days - ddx (6)
- physiological
- breastmilk jaundice
- sepsis
- dehydration
- hemolysis
- bruising or birth trauma
neonatal jaundice in 24hrs - 14 days - when to investigate
red flags are present
neonatal jaundice - conjugated - ddx (4)
extrahepatic obstruction
- primary biliary atresia, choledochal cyst
intrahepatic
- neonatal hepatitis
- metabolic disorder - alpha1 antitrypsin deficiency
- drugs, TPN
neonatal jaundice - risk factors for severe disease, requiring hospital management (10)
temporal
- prematurity
- jaundice within 24 hours
sx of hemolysis
- blood group incompatibility
- cephalohaematoma or other birth trauma
sx of cholestasis
- dark urine / pale stool
- elevated conjugated bilirubin
systemic illness
- sibling had hyperbilirubinaemia
- weight loss > 10% of birthweight
- unwell or febrile child
- prolonged jaundice
ddx for neonatal haemolytic jaundice (4)
- internal hemorrhage (cerebral,intraabdominal)
- extravasation (bruising or trauma)
- alloimmunisation (ABO or Rhesus group)
- red blood cell enzyme defects (G6PD, thalasssaemia, spherocytosis)
