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?
- After 24 hours of life.
- Jaundice appearing within the first 24 hours of life is considered what?
- Always pathologic.
- What enzyme immaturity causes physiologic neonatal jaundice?
- UDP-glucuronosyltransferase (UGT1A1).
- What is kernicterus?
- Bilirubin-induced brain damage from unconjugated hyperbilirubinemia.
- Kernicterus classically deposits bilirubin in which brain structures?
- The basal ganglia.
- What is the mechanism of phototherapy for neonatal jaundice?
- It converts unconjugated bilirubin into water-soluble isomers that can be excreted without conjugation.
- When is exchange transfusion indicated for neonatal jaundice?
- 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?
- Inadequate breast milk intake leading to dehydration and reduced bilirubin excretion.
- Breast milk jaundice typically develops when, and due to what cause?
- 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?
- 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?
- Positive (antibody-coated fetal red blood cells).
- What does the direct Coombs test detect?
- Antibodies bound to the surface of red blood cells.
- Conjugated (direct) hyperbilirubinemia in a newborn is always considered what?
- Pathologic.
- What is the classic newborn presentation of biliary atresia?
- Jaundice with acholic (pale) stools, dark urine, and conjugated hyperbilirubinemia.
- Crigler-Najjar syndrome is caused by a genetic deficiency of which enzyme?
- UDP-glucuronosyltransferase (UGT1A1).