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What is the pathophys of hemorrhagic disease of the newborn?
the newborn has had no chance for gut bacteria to colonize and begin producing vitamin K. normally, E coli lines the gut and produces this from the diet
so they are at very high risk of hemorrhage
What coagulation factors is the newborn deficient in?
Factors II, VII, IX and X
Protein C and S
where does the bleeding often occur
GI tract so you see rectal bleeding
urinary tract
and through the umbilicus as well
So what do we do to prevent this?
we give them a single dose IM Vitamin K
Does this decrease mortality?
yep
when do we screen newborns?
all newborns are screened PRIOR to discharge
8 diseases that we screen for
PKU
CAH
biotinidase
Beta thalassemia
Galactosemia
hypothyroidism
homocysteinuria
cystic fibrosis
What is the inheritance for G6PD deficiency?
it's X linked
How does G6PD deficiency present
with episodes of hemolytic crisis following oxidative stress
what si the mgmt. for G6PD deficiency?
reducing oxidation in the diet, avoiding meds with sulfa/nitro, avoiding nitrates in the diet etc.
at times splenectomy
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