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8 Cards in this Set
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when hyperbillirubinemia in child is pathological?
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-1st day of life
-billirubin rises >5mg/dl/day -billirubin >12 mg/dl -direct billirubin >2mg/dl at any time present after 2nd week of life |
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Tx of hyperbillirubinemia in infant?
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Phototherapy (if billirubin> 10mg/dl). Complications: rash, loose stool, dehydration, bronze baby syndrome.
if not effective or billirubin encephalopathy use exchange transfusion. |
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breastfeeding jaundice
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baby not nursing well (first time mothers)
dehydration, not enough calories jaundice - in first days of life Tx: lactation consultation, rehydrate |
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Breast milk jaundice
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occurs due to a glucuronidase present in some breast milk.
jaundice in 2nd week of life Tx 1. stop breast feeding for 1-2 days, then resume 2. Or continue breastfeeding + formula supplement if needed |
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Crigler-Najjar
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type 1 - autosomal-recessive:
rise in unconjugated bilirubin in first days. Kernicterus. Tx Photo, transfusions type 2 autosomal dominant milder Tx respond to oral phenobarbital |
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Gilbert syndrome
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low glucoroniltransferase
unconjugated hyperbillirubinemia No treatment needed |
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Inherited conjugated hyperbillirubinemia
(Dubin Johnson, Rotor syndrome) |
chronic, mild
detected in adolescence |
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Infectious mononucleosis
Dx Tx Complications |
Dx: heterophil Ab (monospot test)
atypical lymphocytosis most specific - IgM to viral capsid Tx supportive (Nsaids, fluids) Steroids only for complications (anemia, thrombocytopenia, airways obstruction, seizures, meningitis) other complications: splenic rupture fatigue (can be 1-2 years. but it is NOT a chronic fatigue syndrome) |
