Flashcards in Neonatal Jaundice Deck (37):
When see jaundice in sclera?
When see jaundice in skin?
Factors in neonatal jaundice to consider?
Red skin when in baby
Saturation of babies in utero?
50-60% , which is why they're blue when born
Reference range of bilirubin in adults
Less than 20
How long does RBC live for in baby?
Why bilirubin unconjugated in fetus?
Because if conjugated, can't cross placenta.
Normal bilirubin level in fetus?
how many babies get Hyperbilirubinaemia?
Jaundice is different
Brain damage from hyperbilirubinaemia affects what parts?
Basal ganglia and other gray matter areas
Athetoid CP, IQ?
When worry about bilirubin levels in fetus? Threshold?
Greater than 340
When does biliary atresia occur?
Not right at birth
Jaundice in first 24 hours?
Number 1 cause of haemolysis?
Antibodies - Rhesus D
ABO - usually doesn't because IgM,
Coombs +ve. If IgG
What test to see how many fetal cells in maternal blood?
Why is Kell so dangerous?
Expressed early, around 16 weeks
Why is "c" antibodies important in testing?
Usually not tested in Rhesus tests. Need different test
Thick, oedema, pulmonary oedema,
If fetal Anaemia, how to treat?
Delivery (depending on gestation)
2 tests important in preg blood
Indirect anti-globulin test
G6PD, who's likely to get it?
What triggers G6PD?
Moth balls: naphthalene - inhaled/transdermal, clothes or bedding
What racial groups in G6PD?
Hereditary spherocytosis what genetics?
Haemolysis, what to test?
Blood Group: Direct antibodies(on cell)
Blood film: reticulocyte count
What causes liver damage in neonate?
Newborn screening tests?
Thyroid (only TSH)
Another less common cause of haemolysis for later cause of jaundice?
Sneaky Sepsis (UTI)
What else can affect physiological jaundice severity?
Dehydration: under feeding
Rx of neonatal jaundice?
Phototherapy - blue light - isomerizes and allow excretion, protect their eyes.
How to check for dehydration in neonate reliably?
Exchange transfusion is?
replace ALL the blood TWICE.
Exchange transfusion blood bank, pH is? What to watch out for?
Big acid load, VQ mismatch, P02 drops,
Need to give 02 and calcium(counter citrate in blood bags)