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pedia - jaundice

med22

QuestionAnswer
What is the definition of Hyperbilirubinemia in a neonate? Total Bilirubin (T.Bil) greater than 1. In a neonate (first 28 days of life), how must jaundice first be classified?
What is the crucial lab definition for Direct Hyperbilirubinemia that requires immediate investigation? Direct bilirubin more than 2 mg/dL OR more than 20% of the Total Serum Bilirubin (TSB).
Is direct hyperbilirubinemia ever considered physiologic? No, it is always pathologic and requires urgent investigation.
What color urine and stool are key historical clues for Direct Hyperbilirubinemia? Dark tea-colored urine and pale (acholic) stool.
What is the Total Serum Bilirubin (TSB) nomogram used to determine in a jaundiced neonate? The need for Phototherapy or Exchange Transfusion based on the baby's age in hours and risk factors (e.g., Bhutani nomogram).
List the three main mechanisms that cause Physiologic Jaundice (the most common IDH cause). Increased breakdown of fetal RBCs, immature UDPGT enzyme, and increased enterohepatic circulation.
List three hemolytic causes of Indirect Hyperbilirubinemia (IDH). G6PD deficiency, ABO/Rh incompatibility, or Spherocytosis.
List three non-hemolytic causes of Indirect Hyperbilirubinemia (excluding physiologic). Breast Milk Jaundice, Hypothyroidism, or Extravasation of blood (e.g., Cephalohematoma or bruising).
What blood test detects antibodies causing red cell destruction in Rh or ABO incompatibility? The Direct Coombs Test.
List four laboratory tests included in the initial workup for Indirect Hyperbilirubinemia. TSB and Direct Bilirubin levels, CBC, Mother and Baby blood group/Rh status, and Direct Coombs test.
What is the primary non-invasive treatment for Indirect Hyperbilirubinemia? Phototherapy (PT), which converts unconjugated bilirubin into excretable products.
When is Intravenous Immunoglobulin (IVIG) used to treat Indirect Hyperbilirubinemia? When the cause is ABO or Rh incompatibility (hemolysis) and the baby is at high risk for Exchange Transfusion.
What is the term for the most severe complication of untreated severe Indirect Hyperbilirubinemia? Kernicterus (Bilirubin Encephalopathy).
What is the invasive procedure used for severe, refractory indirect hyperbilirubinemia at risk of neurotoxicity? Exchange Transfusion (ET).
List three causes of Direct Hyperbilirubinemia due to obstruction/anatomic defects? Biliary Atresia, Choledochal cyst, or Gallstones.
List three infectious causes of Direct Hyperbilirubinemia. TORCH infections (Toxoplasmosis, Other, Rubella, CMV, Herpes), Sepsis, or Viral Hepatitis (B or C).
List three metabolic causes of Direct Hyperbilirubinemia. Alpha-1-antitrypsin deficiency, Galactosemia, or Tyrosinemia.
What is the most common cause of Direct Hyperbilirubinemia that is often a diagnosis of exclusion? Idiopathic Neonatal Hepatitis.
What is the key timing for jaundice that raises high suspicion for Biliary Atresia? Jaundice that persists beyond 2 weeks of life.
What is the classical stool description in a patient with Biliary Atresia? Pale or acholic stools (lack of bile pigment).
What is the key finding on liver ultrasound that suggests Biliary Atresia? The Triangular Cord Sign and/or absent gallbladder.
What is the definitive diagnostic and therapeutic procedure for Biliary Atresia? Kasai Portoenterostomy (surgical procedure).
Why must Biliary Atresia be diagnosed and treated urgently (ideally before 60 days of life)? To achieve the best prognosis and increase the success rate of the Kasai procedure.
What is a key component of management for Biliary Atresia (besides surgery) to prevent malnutrition? Supplementation with fat-soluble vitamins (A, D, E, K).
What is the main route of transmission for Hepatitis B Virus (HBV) in infancy? Perinatal transmission from a carrier mother.
What percentage of infants who contract HBV perinatally become chronic carriers? At least 90%.
What is the treatment for acute Hepatitis B virus infection? There is no specific treatment for acute HBV infection; management is supportive.
What HBV serology marker denotes ongoing infectivity and is used for screening? Hepatitis B Surface Antigen (HBsAg).
What HBV serology marker is positive in acute infection? IgM antibodies to the core antigen (anti-HBc).
What is the significance of a mother being Blood Type O and the baby being A or B in the patient history? It raises suspicion for ABO incompatibility (a hemolytic cause of IDH).
What weight loss percentage in a neonate is considered abnormal in the postnatal period and suggests poor feeding/FTT? Weight loss beyond 7% of birth weight.
Created by: MeanHeem
 

 



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