Neonates

Question 1

What are the causes of neonatal jaundice?

Answer 1

TIME

2 weeks: Breast milk jaundice; Sepsis; Haemolysis; Neonatal hepatitis; Biliary atresia; Choledochal cyst.

Question 2

How long does physiological jaundice usually last?

Question 3

If serum bilirubin level is high in physiological jaundice how can this be managed?

Answer 3

Phototherapy

Question 4

How does phototherapy work in jaundice?

Answer 4

Converts harmful unconjugated bilirubin into water-soluble bilirubin which can be excreted by the body.

Question 5

What baseline investigations would you like to order in neonatal jaundice to assess severity, type and possible cause of the jaundice?

Answer 5

Serum bilirubin
Blood group, Coombs’ test and FBC
Bilirubin conjugated and unconjugated fractions
Urine (MC&S)

Question 6

What fraction of conjugated bilirubin is present in unconjugated hyperbilirubinaemias?

Question 7

What fraction of conjugated bilirubin is present in conjugated hyperbilirubinaemias?

Answer 7

> 20%

Question 8

What is important to administer when giving phototherapy?

Answer 8

Extra fluid to prevent dehydration

Question 9

What are the management steps in haemolytic jaundice due to Rhesus or ABO incompatibility?

Answer 9

Cord blood for Hb, hct, fetal blood group, maternal antibodies, Coombs’ test and bilirubin level.
Phototherapy
Regular 6-hourly serum bilirubin, Hb and haematocrit
Exchange transfusion if bilirubin levels become too high

Question 10

How is HSV 1 usually transmitted?

Answer 10

Saliva

Question 11

How is HSV 2 usually transmitted?

Answer 11

Genital secretions or via vaginal delivery