Infant Health and Bilirubin Management

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Questions and Answers

What is the significance of weight loss greater than 7% of birth weight in infants?

  • Indicates a higher risk of jaundice.
  • Indicates a higher risk of significant hyperbilirubinaemia. (correct)
  • Indicates a need for immediate surgery.
  • Indicates the need for increased feeding frequency.

Which of the following is a key indicator for the need for exchange transfusion in infants?

  • TSB level less than 85 µmol/L.
  • TSB decreasing consistently over 12 hours.
  • TSB rises despite intensive phototherapy. (correct)
  • Total Serum Bilirubin (TSB) below 100 µmol/L.

What is a common acute manifestation of bilirubin toxicity in preterm babies?

  • Increased apnoea. (correct)
  • Frequent episodes of fever.
  • Rapid weight gain.
  • Higher incidence of jaundice.

At what Total Serum Bilirubin level should intensive phototherapy be started?

<p>3 mg/dl above the conventional phototherapy level. (C)</p> Signup and view all the answers

What is the role of high-dose IV immunoglobulins (IVIG) in treating infants with Rh and ABO haemolytic diseases?

<p>Reduces the need for exchange transfusion. (A)</p> Signup and view all the answers

What distinguishes biliary atresia from neonatal hepatitis regarding incidence in families?

<p>Biliary atresia is unlikely to recur within the same family. (A)</p> Signup and view all the answers

Which type of biliary atresia is characterized by atresia of the common bile duct?

<p>Type I (A)</p> Signup and view all the answers

Which clinical feature is specific to acute kernicterus?

<p>Lethargy (B)</p> Signup and view all the answers

What is the typical initial symptom of spastic cerebral palsy?

<p>Initial hypotonia (C)</p> Signup and view all the answers

In cases of kernicterus, which factor increases the permeability of the blood-brain barrier to bilirubin?

<p>Sepsis (C)</p> Signup and view all the answers

Flashcards

Hyperbilirubinemia

A condition where a baby's bilirubin levels are too high, leading to yellowing of the skin and eyes.

Acute Bilirubin Encephalopathy (ABE)

Acute bilirubin encephalopathy (ABE) is a serious complication of hyperbilirubinemia, affecting the brain. It can manifest as poor feeding, lethargy, and even seizures in severe cases.

Bilirubin-Induced Neurological Dysfunction (BIND)

A test to assess the severity of bilirubin toxicity, particularly in infants.

Intensive Phototherapy

Phototherapy is a treatment for hyperbilirubinemia, using blue light to break down bilirubin. In intensive phototherapy, the baby is exposed to a higher intensity of blue light.

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Exchange Transfusion

Exchange transfusion is a medical procedure where the infant's blood is replaced with donor blood. This is used in severe cases of hyperbilirubinemia.

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Biliary Atresia

A rare condition characterized by the absence or destruction of the extrahepatic biliary tree and intrahepatic biliary ducts, resulting in conjugated neonatal hyperbilirubinemia.

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Viral Croup (Laryngotracheobronchitis)

An inflammatory condition affecting the larynx, trachea, and bronchi, primarily caused by the parainfluenza virus. It presents with a characteristic barking cough, inspiratory stridor, hoarseness, and respiratory distress in children aged 6 months to 6 years.

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Kernicterus

A neurologic syndrome caused by bilirubin deposition in the basal ganglia and brainstem nuclei, primarily affecting newborns with high levels of unconjugated bilirubin (>20 mg/dL). It can lead to significant long-term morbidity and mortality.

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Acute Rheumatic Fever (ARF)

Also known as rheumatic fever, is a multisystem inflammatory disease that occurs 2-4 weeks after a group A β-hemolytic streptococcal infection. It can affect the heart, joints, nervous system, and skin, resulting in complications like carditis, arthritis, Sydenham chorea, erythema marginatum, and subcutaneous nodules.

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Kernicterus: Pathophysiology

A severe and often fatal condition affecting newborns with high levels of unconjugated bilirubin. Unconjugated bilirubin crosses the blood-brain barrier, depositing in the basal ganglia and brainstem nuclei, leading to a wide range of neurologic impairments.

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Study Notes

Table of Contents

  • Contains a list of topics covered in the notes, with page numbers.

Approach to Symptoms

  • Includes information on anaemia, jaundice, and fever & rash, along with their associated causes and clinical features.
  • Discusses investigations like FBC, PBF, iron studies, and more to identify the cause.

Approach to Disorders

  • Details various topics related to diseases, such as Growth & Development, Cerebral Palsy, Macrocephaly & Microcephaly, and more.
  • Each topic provides an overview for students to study.

Neonatology

  • Covers topics such as Prematurity, Apnoea in the Newborn, Neonatal Sepsis, and Ophthalmia Neonatorum.

Respiratory Medicine

  • Includes topics about asthma, acute bronchiolitis, viral croup, epiglottitis, and pneumonia.

Cardiology

  • Covers congenital heart diseases and related problems, such as hypercyanotic spells, and infective endocarditis (IE).

Infectious Diseases

  • Explores topics pertaining to infectious diseases, such as pertussis, Kawasaki disease, scarlet fever, and more.

Neurology

  • Includes topics like status epilepticus (SE), febrile seizure, epilepsy, and more.

Endocrinology

  • Details diabetic ketoacidosis (DKA) and its diagnosis and management.

Gastroenterology

  • Covers topics including acute gastroenteritis (AGE) and its aetiology.
  • Discusses causes, pathophysiology, symptoms, investigation, and management strategies.

Nephrology

  • Details nephrotic & nephritic syndrome, including their definitions, clinical features, investigations, and management.

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