Neonatal jaundice, newborn screening, and common pediatric infectious disease management scenarios tested on USMLE Step 2 CK.
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- Physiologic neonatal jaundice appears after how many hours of life?
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After 24 hours of life.- Jaundice appearing within the first 24 hours of life is considered what?
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Always pathologic.- What enzyme immaturity causes physiologic neonatal jaundice?
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UDP-glucuronosyltransferase (UGT1A1).- What is kernicterus?
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Bilirubin-induced brain damage from unconjugated hyperbilirubinemia.- Kernicterus classically deposits bilirubin in which brain structures?
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The basal ganglia.- What is the mechanism of phototherapy for neonatal jaundice?
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It converts unconjugated bilirubin into water-soluble isomers that can be excreted without conjugation.- When is exchange transfusion indicated for neonatal jaundice?
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Severe hyperbilirubinemia with risk of kernicterus that fails to respond to intensive phototherapy.- Breastfeeding jaundice occurs in the first week of life due to what cause?
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Inadequate breast milk intake leading to dehydration and reduced bilirubin excretion.- Breast milk jaundice typically develops when, and due to what cause?
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After the first week of life, due to substances in breast milk that inhibit bilirubin conjugation.- ABO incompatibility jaundice occurs with which mother-baby blood type combination?
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A type O mother with a type A or B baby.- In Rh incompatibility hemolytic disease of the newborn, what does the direct Coombs test show?
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Positive (antibody-coated fetal red blood cells).- What does the direct Coombs test detect?
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Antibodies bound to the surface of red blood cells.- Conjugated (direct) hyperbilirubinemia in a newborn is always considered what?
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Pathologic.- What is the classic newborn presentation of biliary atresia?
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Jaundice with acholic (pale) stools, dark urine, and conjugated hyperbilirubinemia.- Crigler-Najjar syndrome is caused by a genetic deficiency of which enzyme?
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UDP-glucuronosyltransferase (UGT1A1).
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