Neonatal Jaundice Flashcards Preview

Jason's MD3 Women's > Neonatal Jaundice > Flashcards

Flashcards in Neonatal Jaundice Deck (37):
1

When see jaundice in sclera?

Around 40

2

When see jaundice in skin?

Around 80

3

Factors in neonatal jaundice to consider?

Lighting
Skin colour
Thin sclera
Red skin when in baby

4

Saturation of babies in utero?

50-60% , which is why they're blue when born

5

Reference range of bilirubin in adults

Less than 20

6

How long does RBC live for in baby?

60 days

7

Bilirubin cycle?

Haem-bilirubin-albumin-liver cell-defecate

8

Why bilirubin unconjugated in fetus?

Because if conjugated, can't cross placenta.

9

Normal bilirubin level in fetus?

30-40

10

how many babies get Hyperbilirubinaemia?

100%
Jaundice is different

11

Brain damage from hyperbilirubinaemia affects what parts?

Basal ganglia and other gray matter areas
Athetoid CP

12

Athetoid CP, IQ?

Not affected

13

When worry about bilirubin levels in fetus? Threshold?

Greater than 340

14

When does biliary atresia occur?

Not right at birth

15

Jaundice in first 24 hours?

BIG TROUBLE.
Haemolysis

16

Number 1 cause of haemolysis?

Antibodies - Rhesus D
ABO - usually doesn't because IgM,
Coombs +ve. If IgG

17

What test to see how many fetal cells in maternal blood?

Kleihauer Test

18

Why is Kell so dangerous?

Expressed early, around 16 weeks

19

Why is "c" antibodies important in testing?

Usually not tested in Rhesus tests. Need different test

20

Hydrops

Thick, oedema, pulmonary oedema,

21

If fetal Anaemia, how to treat?

Fetal transfusion
Delivery (depending on gestation)

22

2 tests important in preg blood

Blood group
Indirect anti-globulin test

23

G6PD, who's likely to get it?

Males
X-linked

24

What triggers G6PD?

Aspirin
Antimalarials
Moth balls: naphthalene - inhaled/transdermal, clothes or bedding

25

What racial groups in G6PD?

Equatorial

26

Membrane defects

Hereditary spherocytosis

27

Hereditary spherocytosis what genetics?

Autosomal dominant

28

Haemolysis, what to test?

ABO
Enzymes: G6PD
Membrane: HS
Blood Group: Direct antibodies(on cell)
Blood film: reticulocyte count

29

What causes liver damage in neonate?

Galactesaemia
CF
TPN
Hepatitis
Biliary atresia

30

Newborn screening tests?

CF
PKU
Thyroid (only TSH)

31

Another less common cause of haemolysis for later cause of jaundice?

Sneaky Sepsis (UTI)

32

What else can affect physiological jaundice severity?

Dehydration: under feeding
Birth trauma

33

Rx of neonatal jaundice?

Phototherapy - blue light - isomerizes and allow excretion, protect their eyes.
Exchange transfusion

34

How to check for dehydration in neonate reliably?

Weight them

35

Exchange transfusion is?

replace ALL the blood TWICE.

36

Exchange transfusion blood bank, pH is? What to watch out for?

pH6.8
Big acid load, VQ mismatch, P02 drops,
Need to give 02 and calcium(counter citrate in blood bags)

37

Baby at 12 hours has bilirubin at 300 in the country hospital? What to do?

TRANSFER the baby.
Throw phototherapy at it ASAP
do blood groups and Coombs