Paediatrics an der University Of Stellenbosch | Karteikarten & Zusammenfassungen

Lernmaterialien für Paediatrics an der University of Stellenbosch

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How do you determine conjugated hyperbilirubinaemia with lab test results 
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If conjugated fraction is greater that 20% of the total bilirubin 
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what is a Benign neonatal hyperbilirubinemia that is transient and with normal increase in bilirubin levels occurring in almost all newborns infants

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 physiological jaundice

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What are the Risk factors for jaundice
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J- jaundice within first 24 hrs of life or premature
A - a sibling who was jaundiced as neonate
U - unrecognized hemolysis (ABO)
N nursing - non-optimal sucking/nursing
D- deficiency of G6PD, DRUGS, Ceftriaxone,
 I - infection
C-Cephalhematoma/bruising
E - East Asian/North Indian
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What are the characteristics of UNCONJUGATED (INDIRECT)

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 Bind to albumin

 Fat-soluble 

Can cross the blood-brain barrier 

 Toxic in high level to the brain

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What are the characteristics of Hemolytic disease of the newborn due to ABO incompatibility?
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  • Mothers with type O blood may have circulating antibodies of lg G class to other red cell antigens that can cross the placenta and cause hemolytic disease in a baby with a different blood type, such as blood type A or B.(ABO incompatibility)
     
  • The baby develops jaundice on the 1st day of life( < 24hr) 

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How to conduct a history (sequence) as an approach to jaundice

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 Onset and duration

  Associated nausea, vomiting and pain 

 Loss of weight 

 Itching

  Color of stools 

 Color of urine

  Past medical history 

 Family history

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jaundice Appearance or persistence after 3rd week

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Infections (UTI)

Biliary atresia 

Hypothyroidism, hypopituitarism 

Pyloric stenosis 

Metabolic abnormalities: Mitochondrial enzymopathies (including fatty acid oxidation disorders), Lipid storage disease, Glycogen storage disease type IV, Urea cycle defects.Galactosemia, fructosemia, tyrosinemia 

Cystic fibrosis

Trisomy 21

Toxic: drug-induced, total parenteral nutrition 

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Causes of jaundice from 2nd day – 3rd week of life


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Physiological but disappear after 1st week

 Breast milk 

 Sepsis

 Polycythemia 

 cephalhematoma

Crigler-Najjar syndrome

  Hemolytic disorder

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Causes of jaundice  In the 1st 24 hrs

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 Hemolytic disorders

 TORCH – Congenital infection

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what is the DEFINITION OF JAUNDICE

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Yellow discoloration of the skin, sclera and mucous membranes due to
increased serum bilirubin
It becomes clinically apparent at 85-120µmol/l

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APPROACH TO JAUNDICE IN A BABY

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 Determine birth weight, gestation and postnatal age
 Assess the clinical condition (well or ill) and the degree of jaundice
 Decide whether jaundice is physiological or pathological
 Look for evidence of bilirubin encephalopathy in deeply jaundiced new borns

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What is kernicterus

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1. it is a form of bilirubin Encephalopathy

2. Kernicterus is a type of brain damage that can result from high levels of bilirubin in a baby's blood. It can cause athetoid cerebral palsy and hearing loss. Kernicterus also causes problems with vision and teeth and sometimes can cause intellectual disabilities


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Q:
How do you determine conjugated hyperbilirubinaemia with lab test results 
A:
If conjugated fraction is greater that 20% of the total bilirubin 
Q:

what is a Benign neonatal hyperbilirubinemia that is transient and with normal increase in bilirubin levels occurring in almost all newborns infants

A:

 physiological jaundice

Q:
What are the Risk factors for jaundice
A:

J- jaundice within first 24 hrs of life or premature
A - a sibling who was jaundiced as neonate
U - unrecognized hemolysis (ABO)
N nursing - non-optimal sucking/nursing
D- deficiency of G6PD, DRUGS, Ceftriaxone,
 I - infection
C-Cephalhematoma/bruising
E - East Asian/North Indian
Q:

What are the characteristics of UNCONJUGATED (INDIRECT)

A:

 Bind to albumin

 Fat-soluble 

Can cross the blood-brain barrier 

 Toxic in high level to the brain

Q:
What are the characteristics of Hemolytic disease of the newborn due to ABO incompatibility?
A:
  • Mothers with type O blood may have circulating antibodies of lg G class to other red cell antigens that can cross the placenta and cause hemolytic disease in a baby with a different blood type, such as blood type A or B.(ABO incompatibility)
     
  • The baby develops jaundice on the 1st day of life( < 24hr) 

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Q:

How to conduct a history (sequence) as an approach to jaundice

A:

 Onset and duration

  Associated nausea, vomiting and pain 

 Loss of weight 

 Itching

  Color of stools 

 Color of urine

  Past medical history 

 Family history

Q:


jaundice Appearance or persistence after 3rd week

A:

Infections (UTI)

Biliary atresia 

Hypothyroidism, hypopituitarism 

Pyloric stenosis 

Metabolic abnormalities: Mitochondrial enzymopathies (including fatty acid oxidation disorders), Lipid storage disease, Glycogen storage disease type IV, Urea cycle defects.Galactosemia, fructosemia, tyrosinemia 

Cystic fibrosis

Trisomy 21

Toxic: drug-induced, total parenteral nutrition 

Q:

Causes of jaundice from 2nd day – 3rd week of life


A:

Physiological but disappear after 1st week

 Breast milk 

 Sepsis

 Polycythemia 

 cephalhematoma

Crigler-Najjar syndrome

  Hemolytic disorder

Q:

Causes of jaundice  In the 1st 24 hrs

A:

 Hemolytic disorders

 TORCH – Congenital infection

Q:

what is the DEFINITION OF JAUNDICE

A:

Yellow discoloration of the skin, sclera and mucous membranes due to
increased serum bilirubin
It becomes clinically apparent at 85-120µmol/l

Q:

APPROACH TO JAUNDICE IN A BABY

A:

 Determine birth weight, gestation and postnatal age
 Assess the clinical condition (well or ill) and the degree of jaundice
 Decide whether jaundice is physiological or pathological
 Look for evidence of bilirubin encephalopathy in deeply jaundiced new borns

Q:

What is kernicterus

A:

1. it is a form of bilirubin Encephalopathy

2. Kernicterus is a type of brain damage that can result from high levels of bilirubin in a baby's blood. It can cause athetoid cerebral palsy and hearing loss. Kernicterus also causes problems with vision and teeth and sometimes can cause intellectual disabilities


Paediatrics

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