Neonatal Jaundice Quiz

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Questions and Answers

Which of the following is a late sign of acute bilirubin encephalopathy?

  • High-pitched cry
  • Poor sucking
  • Hypertonia (correct)
  • Lethargy

What is a common complication of exchange transfusion?

  • Infection (correct)
  • Metabolic acidosis
  • Electrolyte imbalance
  • Hyperkalemia

Which of the following is not an adverse effect of phototherapy?

  • Retinal degeneration
  • Erythematous rash
  • Dehydration (correct)
  • Bronze baby syndrome

What is the most effective spectrum of light for phototherapy?

<p>Blue (460-490 nm) (B)</p> Signup and view all the answers

Which enzyme is responsible for the hepatic excretion of bilirubin?

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

What is the main cause of physiological jaundice in newborns?

<p>Immaturity of the liver (D)</p> Signup and view all the answers

At what age does physiological jaundice typically appear in newborns?

<p>2-4 days (B)</p> Signup and view all the answers

What is the normal range of total serum bilirubin (TSB) for physiological jaundice in term neonates?

<p>5-6 mg/dL (C)</p> Signup and view all the answers

Which of the following is a common cause of early onset jaundice in infants?

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

Which of the following is a characteristic of Breast Milk Jaundice?

<p>Duration of 1-3 months (D)</p> Signup and view all the answers

Which of the following is a risk factor for decreased hepatic bilirubin clearance?

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

Which of the following is a limitation of visual recognition of jaundice?

<p>Inaccurate in babies with darker skin tones (B)</p> Signup and view all the answers

Which enzyme is responsible for the hepatic excretion of bilirubin?

<p>UDP-glucuronyl transferase (D)</p> Signup and view all the answers

What is the main cause of physiological jaundice in newborns?

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

Which of the following is a late sign of acute bilirubin encephalopathy?

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

Which of the following is a characteristic of Breast Milk Jaundice?

<p>Caused by breast milk factors (C)</p> Signup and view all the answers

Which of the following is a risk factor for decreased hepatic bilirubin clearance?

<p>Maternal blood group (B)</p> Signup and view all the answers

What is the main cause of physiological jaundice in newborns?

<p>Enterohepatic circulation (A)</p> Signup and view all the answers

Which of the following is a characteristic of Breast Milk Jaundice?

<p>Duration of 1-3 months (B)</p> Signup and view all the answers

What is the normal range of total serum bilirubin (TSB) for physiological jaundice in term neonates?

<p>&lt;5 mg/dL (B)</p> Signup and view all the answers

Which of the following is a common early sign of acute bilirubin encephalopathy?

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

Which of the following is a late sign of acute bilirubin encephalopathy?

<p>Progressive coma (D)</p> Signup and view all the answers

Which of the following is a characteristic of chronic bilirubin encephalopathy (Kernicterus)?

<p>Cognitive function usually relatively spared (B)</p> Signup and view all the answers

Which of the following is a factor in the efficacy of phototherapy?

<p>Skin Area Exposed (B)</p> Signup and view all the answers

Which of the following is a late sign of acute bilirubin encephalopathy?

<p>Recurrent apnea (D)</p> Signup and view all the answers

Which of the following is a characteristic of chronic bilirubin encephalopathy (Kernicterus)?

<p>Gaze abnormalities (paresis of upward gaze) (C)</p> Signup and view all the answers

What is the most effective spectrum of light for phototherapy?

<p>Blue (460-490 nm) (C)</p> Signup and view all the answers

Which of the following is a risk factor for decreased hepatic bilirubin clearance?

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

Which of the following is a risk factor for the development of immune-mediated hemolytic disease in newborns?

<p>Maternal blood group (B)</p> Signup and view all the answers

Which of the following is a characteristic of Breast Feeding 'Failure' Jaundice?

<p>Mild jaundice in a well suckling infant (A)</p> Signup and view all the answers

What is the most common cause of jaundice due to cephalhematoma in newborns?

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

What is the main limitation of using a transcutaneous bilirubinometer for the screening of hyperbilirubinemia?

<p>Inaccuracy in babies with darker skin tones (B)</p> Signup and view all the answers

Which of the following is a risk factor for increased bilirubin load in newborns?

<p>Glucose-6-phosphate dehydrogenase deficiency (D)</p> Signup and view all the answers

Which of the following is a characteristic of physiological jaundice in term neonates?

<p>Resolves by 7-10 days of life (C)</p> Signup and view all the answers

Which of the following is a cause of early onset jaundice in infants?

<p>Rhesus or ABO incompatibility (C)</p> Signup and view all the answers

What is the main cause of physiological jaundice in newborns?

<p>Decreased hepatic bilirubin clearance (D)</p> Signup and view all the answers

Which of the following is a characteristic of acute bilirubin encephalopathy?

<p>Recurrent apnea (A)</p> Signup and view all the answers

Which of the following is a late sign of acute bilirubin encephalopathy?

<p>High-pitched cry (A)</p> Signup and view all the answers

Which of the following is a risk factor for the development of chronic bilirubin encephalopathy (Kernicterus)?

<p>Sensorineural hearing loss (D)</p> Signup and view all the answers

Which of the following is a complication of exchange transfusion?

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

Physiological jaundice typically appears in newborns at what age?

<p>2-4 days of life (D)</p> Signup and view all the answers

What is the most common condition in newborns that causes unconjugated hyperbilirubinemia?

<p>Physiological jaundice (A)</p> Signup and view all the answers

What is the normal range of total serum bilirubin (TSB) for physiological jaundice in term neonates?

<p>5-6 mg/dL (A)</p> Signup and view all the answers

Which of the following is a risk factor for increased bilirubin load in newborns?

<p>Increased turnover of nonhemoglobin heme proteins (C)</p> Signup and view all the answers

Which of the following is a risk factor for the development of immune-mediated hemolytic disease in newborns?

<p>Maternal blood group (C)</p> Signup and view all the answers

What is the main cause of physiological jaundice in newborns?

<p>Increased enterohepatic circulation (D)</p> Signup and view all the answers

Which of the following is a characteristic of chronic bilirubin encephalopathy (Kernicterus)?

<p>Delayed capillary refill (D)</p> Signup and view all the answers

What is the main limitation of using a transcutaneous bilirubinometer for the screening of hyperbilirubinemia?

<p>Inaccuracy in babies with darker skin tones (B)</p> Signup and view all the answers

Flashcards

Hypertonia in bilirubin encephalopathy

Increased muscle tone, a late sign of acute bilirubin encephalopathy.

Complication of Exchange Transfusion

Infection is a known risk related to this treatment.

Non-effect of phototherapy

Dehydration is NOT an adverse effect.

Best light spectrum for phototherapy

460-490 nm is the optimal light for phototherapy.

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Glucuronyl transferase function

This enzyme conjugates bilirubin for excretion.

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Cause of physiological jaundice

The liver is not fully developed to process bilirubin.

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Physiological jaundice onset

Jaundice appears a few days after birth.

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TSB level in phys. jaundice

Normal range is about 5-6 mg/dL in term babies.

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Cause of early jaundice

Rh incompatibility causes early jaundice.

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Breast Milk Jaundice duration

Lasts for about a month or more.

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Risk factor for decreased bilirubin

Prematurity leads to slower bilirubin processing.

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Limitation of visual jaundice check.

Visual jaundice assessment is less accurate.

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Kernicterus

Brain damage from very high bilirubin levels.

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Early sign of acute bilirubin encephalopathy

Infant appears sleepy. Can be a sign of high bilirubin

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Efficacy of phototherapy

Skin area exposed is key for effective phototherapy

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Apnea

Apnea is a type of breathing problem

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Gaze abnormalities

Difficulties moving the eyes correctly.

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Hypertonia

Failure to clear bilirubin

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Maternal blood group issues

Mother and baby have uncompatible blood types.

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Breast Feeding 'Failure' Jaundice

Mild jaundice due to poor feeding.

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cephalhematoma

Polycythemia increase jaundice severity

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Transcutaneous bilirubinometer limitations

Darker skin makes it hard to use bilirubinometer

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G6PD deficiency

G6PD deficiency results in more bilirubin

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Physiological jaundice in term neonates

Resolves in over a week

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Decreased hepatic bilirubin clearance

Decreased bilirubin levels

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Recurrent Apnea

Apnea is a type of breathing problem

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High-pitched Cry

High-pitched means there is potential neurological issues

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Sensorineural hearing loss

Genetic factors can worsen jaundice.

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Complication of exchange transfusion

Hemorrhage is a serious safety risk.

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Study Notes

Jaundice in Newborns

  • Physiological jaundice in newborns is caused by the breakdown of fetal hemoglobin, which leads to an increase in bilirubin production.
  • It typically appears in newborns at around 2-3 days of age.
  • The normal range of total serum bilirubin (TSB) for physiological jaundice in term neonates is 5-15 mg/dL.

Pathophysiology of Jaundice

  • Bilirubin is produced from the breakdown of hemoglobin and is conjugated in the liver by the enzyme glucuronyltransferase.
  • Jaundice occurs when there is an imbalance between bilirubin production and conjugation.
  • Increased bilirubin production can occur due to hemolysis, cephalhematoma, or polycythemia.
  • Decreased conjugation can occur due to liver immaturity or enzyme deficiency.

Types of Jaundice

  • Breast Milk Jaundice: a type of jaundice caused by a substance in breast milk that inhibits bilirubin conjugation.
  • Breast Feeding 'Failure' Jaundice: a type of jaundice caused by inadequate breast milk intake, leading to dehydration and increased bilirubin production.
  • Acute Bilirubin Encephalopathy: a severe type of jaundice that can cause brain damage and even death.
  • Chronic Bilirubin Encephalopathy (Kernicterus): a type of jaundice that can cause permanent brain damage and neurological sequelae.

Treatment and Prevention

  • Phototherapy: a treatment that uses light to break down bilirubin in the skin, reducing the amount of bilirubin in the blood.
  • The most effective spectrum of light for phototherapy is the blue light spectrum.
  • Exchange Transfusion: a procedure in which the baby's blood is exchanged with donor blood to remove bilirubin from the circulation.

Risk Factors and Complications

  • Risk factors for jaundice include hemolytic disease, cephalhematoma, polycythemia, and breastfeeding.
  • Complications of jaundice include kernicterus, hearing loss, and cerebral palsy.
  • Complications of exchange transfusion include infection, bleeding, and cardiovascular instability.

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