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11 Cards in this Set
- Front
- Back
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Differential diagnosis of neonatal jaundice |
at birth or within 24 hours: Erythroblastosis fetalis Concealed hemorrhage Sepsis Congenital infections Hemolysis 2nd or 3rd day of life Physiological usually: Crigler Najjer Breastfeeding jaundice After 3rd day and within one week Bacterial sepsis Urinary tract infection Infections Ecchymosis or blood extravasation Polycythemia After 1 week of life Breastmilk jaundice Septicemia Biliary atresia Congenital atresia Hepatitis Hypothyroidism Cystic fibrosis Congenital hemolytic anemia Choledochal cyst Alpa 1 antitrypsin defeciency Persistent jaundice during first month: Hepatitis Syphilis Toxoplasma Biliary atresia Gilbert syndrome
Down syndrome Crigler najjerBreastfeeding Crigler najjer Breastfeeding |
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Jaundice associated with pyloric stenosis |
Caloric deprivation Relative deficiency of UDP-glucuronyl tranferase Increased enterohepatic circulation of bilirubin from the ileus |
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Kernicterus |
Neurological syndrome resulting from the deposition of unconjugated bilirubin in the basal ganglia and brainstem nuclei |
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Clinical manifestations kf Kernicterus |
Lethargy Poor feeding Loss of moro reflex Diminished tendon reflexes Respiratory distress Opisthitonus Bulging fontanell Twitching of face and limb Shrill high pitched cry Convulsions Spasms |
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What are the acute forms of kernicterus |
Phase 1(1-2days): poor sucking, stupor, hypotonia, seizures Phase 2(mid 1st week) : Hypertonia of extensor muscles phase 3(after 1 week) : Hypertonia |
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What are the chronic forms of Kernicterus |
1st year: Hypotonia, obligatory tonic neck reflexes, delayed motor skills, active deep tendon reflexes greater than 1 year: movement disorders(choreoathetosis, ballismus, tremor) upward gaze, sensorinural hearing loss. |
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Complications of phototherapy |
Loose stools Erythematous macular rash Purpuric rash Overheating Dehydration Hypothermia Benign bronze baby syndrome Corneal damage |
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Pathological jaundice |
Jaundice considered to be pathological if the time of appearance, duration or pattern varies significantly from that of physiological jaundice |
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Primary prevention of neonatal jaundice |
Promote and support breastfeeding(8-12meals/day 30-60ml every 2-3 hours) |
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Secondary prevention |
Monitor all newborns 8-12 hours for jaundice measure pre discharge serum bilirubin to determine timing of follow up |
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Notes on exchange transfusion |
Use warm blood Crossmatched versus maternal serum Given ideally via umbilical vein Aim to exchange 160ml/kg over 2 hours Monitor ECG, UE, CA, BILIRUBIN, CLOTTING FBC AND GLUCOSE |
