yellow baby

Question 1

what are the classes of neonatal jaundice ?

Answer 1

<24 hours - always pathological, causes haemolysis and sepsis

24hr - 2 weeks- physiological, breast milk, sepsis, haemolysis

> 2 weeks - extra hepatic obstruction, hepatitis, hypothyroid, breast milk

Question 2

what is physiological jaundice ?

Answer 2

shorter RBC lifespan
relative polycythaemia
relative immaturity of liver
develops after first day

Question 3

what can cause haemolytic jaundice ?

Answer 3

ABO incompatibility 
rhesus diseases
bruising
spherocytosis - blood film
G6PD - assay test

Question 4

what are signs of Kernicterus ?

Answer 4

encephalopathy - poor feed, lethargy, seizures

late consequence - cerebral palsy, learning difficulties, sensorineural deafness

Question 5

how do you treat neonatal jaundice ?

Answer 5

blue light therapy

Question 6

what causes prolonged infant jaundice ?

Answer 6

anatomical - con
neonatal hepatitis - con
hypothyroidism - uncon
breast milk jaundice - uncon

Question 7

what is key with conjugated jaundice in infants ?

Answer 7

ALWAYS abnormal

important test is split bilirubin

Question 8

what causes biliary obstruction ?

Answer 8

biliary atresia - conjugated, pale stool
choledochal cyst - conjugated, pale stool
alagille - intrahepatic cholestasis, dysmorphism, congenital cardiac defect

Question 9

how do you treat biliary atresia ?

Answer 9

Kasai portoenterostomy

Question 10

how do you investigate causes of prolonged jaundice ?

Answer 10

biliary atresia - split bilirubin, stool colour, USS, liver biopsy
choledochal cyst - split bilirubin, stool colour, USS
alagille syndrome - dysmorphism, genotype