L11: Neonatal Cholestasis

Question 1

Def of Neonatal Cholestasis

Answer 1

Question 2

Level of Conjugated Bili to Dx Neonatal Cholestasis

Answer 2

Question 3

Incidence of Neonatal Cholestasis

Answer 3

Affects 1 in 2500 live births.

Question 4

Etiology of Neonatal Cholestasis

Answer 4

Question 5

Etiology of Neonatal Cholestasis

• Most Common

Answer 5

Biliary atresia → Most common cause = 25% of cases

Question 6

Etiology of Neonatal Cholestasis

• Intra-Hepatic

Answer 6

Question 7

Intra-Hepatic of Neonatal Cholestasis

• Hepatocellular

Answer 7

Question 8

Hepatocellular Causes of Neonatal Cholestasis

• Infective

Answer 8

• Sepsis
• UTI
• TORCH infection
• HBV
• HCV
• Malaria
• HIV
• other viral infections

Question 9

Hepatocellular Causes of Neonatal Cholestasis

• Metabolic

Answer 9

• Galactosemia
• Fructosemia
• Bile Acid Disorders
• Tyrosinaemia
• AAT deficiency
• FAO defects
• Cystic fibrosis
• Hemochromatosis
• Zellweger’s
• Neiman pick’s disease

Question 10

Hepatocellular Causes of Neonatal Cholestasis

• Miscellaneous

Answer 10

• Hypothyroidism
• TPN
• Downs
• Shock
• Hypoperfusion
• Congenital Heart
• Vascular Abnormality

Question 11

Hepatocellular Causes of Neonatal Cholestasis

• Idiopthic

Answer 11

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Question 12

Intra-Hepatic Causes of Neonatal Cholestasis

• Paucity of intra-hepatic bile

Answer 12

Question 13

Extra-Hepatic Causes of Neonatal Cholestasis

Answer 13

• Biliary Atresia
• Choledochal cyst
• Spontaneous perforation of bile ducts
• Biliary stenosis
• Inspissation of bile ducts
• Mass peritoneal bands

Question 14

Algaille’s Syndrome

Answer 14

Question 15

Algaille’s Syndrome

• Another name

Answer 15

arterio-hepatic dysplasia

Question 16

Algaille’s Syndrome

• Genetics

Answer 16

AD

Question 17

Algaille’s Syndrome

• CP

Answer 17

Question 18

CP of Neonatal Cholestasis

Answer 18

Question 19

Evaluation of Neonatal Cholestasis

Answer 19

Question 20

Evaluation of Neonatal Cholestasis

• Basic Evaluation

Answer 20

Question 21

Evaluation of Neonatal Cholestasis

• Test for Infectious Causes

Answer 21

Question 22

Red flags in Jaundice

Answer 22

Question 23

Evaluation of Neonatal Cholestasis

• Metabolic Workup

Answer 23

Question 24

Evaluation of Neonatal Cholestasis

• Diagnostic Imagimg

Answer 24

Question 25

Diagnostic Imaging in **Neonatal Cholestasis**

Answer 25

Question 26

Diagnostic Imaging in **Neonatal Cholestasis** - US

Answer 26

Question 27

Diagnostic Imaging in **Neonatal Cholestasis** - Triangular Cord Sign

Answer 27

A cone shaped fibrotic mass cranial to the bifurcation of portal vein

Question 28

Diagnostic Imaging in **Neonatal Cholestasis** - Hepatobiliary Scintigraphy

Answer 28

Question 29

Diagnostic Imaging in **Neonatal Cholestasis** - Intrahepatic Choliangiogram

Answer 29

Question 30

Invasive Studies in **Neonatal Cholestasis**

Answer 30

Question 31

Invasive Studies in **Neonatal Cholestasis** - Percutaneous Liver Biopsy

Answer 31

Question 32

Percutaneous Liver Biopsy - Significance - Shows - Difference Between findings in biliary duct proliferation & Neonatal Hepatitis

Answer 32

Question 33

Invasive Studies in **Neonatal Cholestasis** - ERCP

Answer 33

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Question 34

Invasive Studies in **Neonatal Cholestasis** - MRCP

Answer 34

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Question 35

Compare Between Neonatal Jaundice & Neonatal Cholestasis - Def - Incidence - Dx - Prognosis

Answer 35

Question 36

Consequences of **Neonatal Cholestasis**

Answer 36

Question 37

Consequences of **Neonatal Cholestasis** - Retention of substances dependent on bile secretion

Answer 37

Question 38

Consequences of **Neonatal Cholestasis** - Progressive hepatocellular damage

Answer 38

portal hypertension, liver cirrhosis

Question 39

Managment of **Neonatal Cholestasis**

Question 40

Managment of **Neonatal Cholestasis** - Goals

Answer 40

Question 41

Managment of **Neonatal Cholestasis** - Medical Management

Answer 41

Question 42

Managment of **Neonatal Cholestasis** - Surgical Management

Answer 42

Question 43

Surgical Managment of **Neonatal Cholestasis** - Kasai Operation

Answer 43

Question 44

Surgical Managment of **Neonatal Cholestasis** - Choledocal Cyst Excision

Answer 44

It should be done before the age of 2 months.

Question 45

Surgical Managment of **Neonatal Cholestasis** - Liver Transplant

Answer 45

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Question 46

Prognosis of **Neonatal Cholestasis**

Answer 46

Question 47

Answer 47

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Question 48

Answer 48

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