Neonatal jaundice Flashcards Preview

Paediatrics > Neonatal jaundice > Flashcards

Flashcards in Neonatal jaundice Deck (10)
Loading flashcards...
1
Q

What 3 processes underly the high rate of neonatal jaundice?

A
  • increased haemolysis (Hb F)
  • reduced conjugating ability (immature liver)
  • increased enterohepatic circulation of BR (increased levels of B-glucuronidase in gut)
2
Q

What are the most common causes of neonatal jaundice?

A
  • physiological jaundice
  • breastfeeding jaundice
  • breastmilk jaundice
3
Q

What are causes of jaundice in <24 hrs?

A
  • immune haemolysis (Rh disease, ABO incompatibility)

- non-immune haemolysis (sepsis, G6PD def)

4
Q

What causes BR encephalopathy?

A
  • unbound unconjugated BR is fat soluble and crosses BBB

- toxic to mitochondria in the basal ganglia and neonatal brain

5
Q

5 complications of severe immune haemolysis

A
  • anaemia
  • BR encephalopathy
  • dyskinetic CP
  • sensorineural hearing loss
  • intellectual impairment
6
Q

How does phototherapy work?

A

Photo-isomerisation of tissue BR to lumirubin which is water soluble and excreted in the urine

7
Q

How do you optimize the dose of phototherapy?

A
  • use a strong light
  • use the right wave length light (blue LED)
  • bring light closer to baby (30-40cm)
  • ensure maximum skin exposure
8
Q

What causes conjugated hyperBR in neonates?

A
  • biliary atresia
  • choledocal cyst
  • neonatal hepatitis
  • TPN hepatitis
  • rarer causes like a-1-antitrypsin def
9
Q

What is the surgery for biliary atresia called?

A
  • Kasai procedure
10
Q

What are the commonest causes of neonatal hepatitis?

A
  • CMV
  • cong. syphilis
  • idiopathic giant cell hepatitis
  • TPN hepatitis
  • cong. rubella infection