Yellow Babies

Question 1

liver dysfunction tests in yellow baby? (4)

Answer 1

bilirubin (total/split)
ALT/AST
Alkaline phosphatase
Gammaglutamyl transferase

Question 2

when is AlkP and GGT elevated?

Answer 2

biliary disease

Question 3

when is ALT/AST elevated?

Answer 3

elevated in hepatocellular damage

Question 4

liver function tests? (3)

Answer 4

coagulation (PT/INR)
Albumin
Bilirubin

Question 5

classification of early jaundice?

Answer 5

less than 24 hours old

always pathological

Question 6

classification of intermediate jaundice?

Answer 6

24hr - 2 weeks

physiological

Question 7

classification of prolonged jaundice?

Answer 7

more than 2 weeks

Question 8

how does intrahepatic jaundice appear?

Answer 8

mixed unconjugated/conjugated

Question 9

reasons for physiological jaundice? when does it develop?

Answer 9

shorter RBC (80-90d)
polycythaemia
immaturity of liver function

unconjugated jaundice after the first day of life

Question 10

how long can breast milk jaundice persist for?

Answer 10

up to 12 weeks

Question 11

what is Kernictus?

Answer 11

unconjugated bilirubin can cross BBB and deposit in the brain - neurotoxic

Question 12

Kernictus early signs?

Answer 12

encephalopathy, poor feeding, lethargy, seizures

Question 13

treatment for unconjugated jaundice?

Answer 13

phototherapy which converts bilirubin to water soluble isomer

Question 14

prolonged infant jaundice causes? (4)

Answer 14

anatomical (biliary obs)
neonatal hepatitis
hypothyroidism
breast-milk jaundice

Question 15

what is the most important test in prolonged jaundice?

Answer 15

split bilirubin

conjugated jaundice is always abnormal and needs investigations

Question 16

causes of prolonged jaundice? (3)

Answer 16

biliary atresia
choledochal cyst
Alagille syndrome

Question 17

what do you want to assess in jaundice?

Answer 17

stool colour - look at nappy

Question 18

treatment for biliary atresia?

Answer 18

Kasai portoenterostomy