Neonatal Jaundice Quiz: Test Your Knowledge on Newborn Disorders

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Questions and Answers

What is the primary cause of yellow staining of nuclear centers of the brain in neonates?

Direct bilirubin

Hemoglobin

Biliverdin

Indirect bilirubin (correct)

What is the primary function of surfactant in the lungs?

Regulates blood flow

Increases surface tension of fluids

Reduces surface tension of fluids (correct)

Maintains lung pressure

What is the most common cause of Respiratory Distress Syndrome (RDS) in newborns?

Pneumonia

Premature birth (correct)

Hypoglycemia

Sepsis

What is the consequence of unequal alveolar expansion and collapse in RDS?

Respiratory failure Signup and view all the answers

What is the critical period for the final unfolding of the alveolar septa in fetal development?

Last trimester Signup and view all the answers

What is the incidence of RDS in newborns?

7% Signup and view all the answers

What is the primary goal of phototherapy in treating neonatal jaundice?

To decrease total serum bilirubin (TSB) by 4-5 mg/dL or < 15 mg/dL Signup and view all the answers

What is a common complication of exchange transfusion?

Infection Signup and view all the answers

What is the primary mechanism of phototherapy in treating neonatal jaundice?

Converting bilirubin to a water-soluble form Signup and view all the answers

What is the significance of a bilirubin level > 5 mg/dL in a physical exam?

It signifies a higher risk of neurotoxicity Signup and view all the answers

What is the purpose of exchange transfusion in treating neonatal jaundice?

To correct anemia and remove bilirubin Signup and view all the answers

What is the indicators of a higher bilirubin level in neonatal jaundice?

Caudal progression of jaundice Signup and view all the answers

What percentage of term newborns have clinical jaundice?

25% to 50% Signup and view all the answers

What is the primary source of bilirubin production in newborns?

Haemoglobin breakdown Signup and view all the answers

What is the characteristic of physiological jaundice in term babies?

Peak in the fourth or fifth day, not exceeding 12 mg/dl Signup and view all the answers

What is the feature of pathological jaundice in the first 24 hours?

Jaundice in the first 24 hours Signup and view all the answers

What is the classification of jaundice based on the source of bilirubin production?

Hemolytic and non-hemolytic Signup and view all the answers

What is the factor that contributes to the development of physiological jaundice in newborns?

Immature hepatic uptake and conjugation Signup and view all the answers

Study Notes

Kernicterus

Caused by high levels of indirect bilirubin
Leads to neural loss, poor feeding, lethargy, fits, rigidity, spasticity, deafness, and respiratory distress

Respiratory Distress Syndrome (RDS)

Affects 7% of newborns, potentially life-threatening
Caused by surfactant deficiency and physiologic immaturity of the thorax
Common in premature infants
Causes: sepsis, exposure to cold, airway obstruction, metabolic acidosis, acute blood loss, drugs, pneumonia, hypoglycemia, and cardiac defects
Pathophysiology: preterm infants' lungs are not fully mature, leading to underdeveloped and un-inflatable alveoli

Neonatal Jaundice

Yellowish discoloration of skin and mucous membranes due to increased serum bilirubin (hyperbilirubinemia)
Bilirubin is produced as a breakdown product of hemoglobin
Physiological jaundice:
- Appears in 25-50% of term newborns
- Starts after 24 hours, peaks on the 4th or 5th day (<12 mg/dl in term babies, <15 mg/dl in premature)
- Clears in a week in term and two weeks in premature babies
Pathological jaundice:
- Starts within the first 24 hours
- Rapidly rising total serum bilirubin (>5 mg/dL per day)
- TSB > 17 mg/dL
Categories:
- Increased bilirubin load
- Decreased conjugation
- Impaired bilirubin excretion
Causes:
- Hemolytic disease (e.g., Rh incompatibility, ABO incompatibility)
- Non-hemolytic disease (e.g., G6PD deficiency, extravascular sources)
- Biliary obstruction (e.g., biliary atresia, Rotor's and Dubin-Johnson syndromes)
- Infection (sepsis)
- Metabolic disorders
- Chromosomal abnormalities

Diagnosis and Evaluation

Physical exam: bilirubin > 5 mg/dL, milder jaundice on face and upper thorax
Laboratory tests: blood and transcutaneous bilirubin levels
Depends on serum bilirubin level and age (hours) of the baby after delivery

Therapeutic Management

Phototherapy:
- Converts bilirubin to a water-soluble form that is easily excreted
- Forms: fluorescent lighting, fiberoptic blankets
- Goal: decrease TSB by 4-5 mg/dL or < 15 mg/dL
- Complications: retinal damage, nasal obstruction, mild diarrhea, dehydration, bronzed baby syndrome
Exchange transfusion:
- Removes bilirubin and antibodies from circulation, corrects anemia
- Most beneficial to infants with hemolysis, generally used after intensive phototherapy
- Indicated when bilirubin reaches toxic levels
- Removes bilirubin, antibodies, and corrects anemia
- Complications: infection, cardiac failure, acidosis, electrolytes imbalance

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Description

This quiz covers the basics of jaundice in newborns, including its causes, symptoms, and diagnosis. Learn about the role of bilirubin in jaundice and how it affects newborns. Test your knowledge and understanding of neonatal disorders.