Term
| Where does jaudice appear on the body first? |
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Definition
| Face and the progresses inferiorly |
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Term
| When should you work up or follow a jaundiced baby |
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Definition
Billirubin levels cross percentiles or
They are extremely high |
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Term
| What are the advantages and disadvantages to uncongugated billirubin |
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Definition
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Term
| What are the sources of billrubin in the body |
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Definition
Senescent RBCs
Non-hemoglobin Heme containing proteins |
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Term
How is billirubin transported in the blood
How can you quantify billirubin production |
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Definition
Albumin transport(2 sites per protein)
CO for quantification(produced by heme oxidase) |
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Term
| What substance colors feces |
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Definition
| urobilin from biliribin conversion in the intestine |
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Term
| What are the characteristics of physiological jaundice |
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Definition
Peak<12
Peak day 3-5
Normal by day 14
Cord <5
Most is unconjugated |
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Term
| What are the causes of physioloic Jaundice |
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Definition
Higher Hemoglobin
Shorter RBC life span
Low enterohepatic circulation
Deficient Ligandin and UDPGT |
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Term
| Factors increasing liklihood of physiological jaundice |
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Definition
jaundice Sibling
Diabetic Mother
Oxytocin in labor
Large weight Loss
Sequestered blood/Bruising
Certain Ancestry: Greek island, eskimo, native american, East asian |
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Term
| Causes of unconjugated hyperbilirubin from overproduction in a neonate? |
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Definition
Hemolytic Disease
ABO Incombatibility
Spherocytes
RBC Enzyme defect(G6PD)
Hemoglobinopathies
Sequestered blood
Polycythemia
Diabetic mother
Sepsis
Bowel obstruction |
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Term
| Causes of unconjugated Hyperbilirubinemia from decreased conjugation |
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Definition
UDPGT deficiencies
Crigler-Najjar I: AR phototherapy or transplant
Crigler-Najjar II: AR/AD Phenobarbital(Less Severe)
Gilbert : AD/AR
Galactosemia
Congenital Hypothyroid
Breast Feeding: Day 1-2;Decreased calories
Day 3-5;LCFA's block UDPGT, increase enterohepatic, add formula and stop breast |
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Term
| What is the cause of kernicterus |
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Definition
Bilirubin in brainstem nuclei
Blocks:
mitochondrial function
neurotransmitter production
precusor uptake |
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Term
| What are the causes of neonatal Conjugated hyperbilirubinemia |
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Definition
Infection
Cholestatic jaundice
Hepatitis
Intestinal obstruction
Total Parenteral Nutrition
Liver Ischemia
HematologicErythroblastosis fetalis, Erythropoietic porphyria
Metabolic
Ductal Disturbance
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Term
| How do you typically treat Unconjugated Hyperbilirubinemia and Cholestatsis? |
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Definition
Conjugated: Phototherapy
Cholestasis: Pheobarbital, Ursodeoxycholic Acid
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