Pathological Hyperbilirubinaemia Flashcards
What is Jaundice?
Yellow colouration of the skin and the sclerae caused by the accumulation of bilirubin in the skin and mucuous membranes
What is hyperbilirubinaemia?
raised level of bilirubin in the body
What does kernicterus mean?
clinical features of actue or chronis bilirubin encephalopathy, including cerebral palsy, hearing loss and visual problems
What is prolonged jaundice?
Jaundice lasting more than 14 days in term babies and more than 21 days in preterm babies
What are the barriers to bilirubin conjugation?
metabolic disturbances
hypothermia
infection
drugs
free fatty acids
What are the major causes of pathological jaundice?
haemolysis
infections
inherited disorders of RBC metabolism
membrane defects
inherited disorders of bilirubin metabolism
iatrogenic injuries
swallowed blood
increased enterohepatic circulation
decreased liver function
hypothyroidism
hypopituitarism
galactosaemia
What are the symptoms of subtle toxicity?
sleepy baby
poor feeding
reduced tone
high pitched cry
What are the symptoms of progressive toxicity?
lethargy
irritability
hypo/hypertonia
shrill cry
arching of back & neck
What are the symptoms of advanced toxicity?
coma
seizures
marked hypo/hypertonia
bicycling movements of limbs
inconsolable cry
What are the toxic effects of excessive unconjugated bilirubin?
mechanism unclear
increased risk if hypoproteinaemia
competition for binding site on albumin
sepsis, acidosis, hypoxia
How do you care for jaundice babies? (less than 35 weeks gestation)
TcB
What is the diagnosis & management of hyperbilirubinaemia? (<24 hours of age)
Check serum bilirubin
