Jaundice

Nota:

• 0-water soluble. 1-orange yellowish.

Adjunto:

• early Diseases (0-7 days of life )
• jaundice ( indirect hyper Bilirubin )

1. physiological jaundice
2. breast milk jaundice

   Nota:

   • BMJ Vs BFJ
3. over production (hemolysis)
   1. Blood group incombatepilty

      Nota:

      • 0-Rh ,ABO , subgroup as kell ,Duffy.
   2. RBCs enzyme defect

      Nota:

      • 0-G6PD deficiency. 1-pyruvate kinase deficiency  2-Hereditary spherocytosis , elliptocytosis  3-Hb pathy (alpha-thalasemia). 4-acquired hemolysis (infection ,drug,Vit k , Sulfonamide). 5-extravascular bleeding as peteche .hematoma ,pulmonary cerebral . Occult hemorrhage. 6-polycythemia as materno-fetal:- delay claming of umbilical cord.
   3. Increase entero-hepatic circulation

      Nota:

      • 0-pyloric stenosis. 1-meconium plug syndrome 2-Hischsprung disease. 3-intestinal atresia. 4-stenosis including :- annular pancreas. 5-Fasting or hypoperistalses. 6-drug induce paralytic ileus. 7-swallewed blood .
   4. Damages or reduces the activity of the transferese enzymes

      Nota:

      • 0-Hypoxia  1-infection. 2-thyroid deficiency. 3-genetic defect. 4-Crigler Najjar syndrome 5-inhibition of conjucation by drug.
   5. Decrease bilirubin uptake across hepatocyte

      Nota:

      • 0-competitive inhibition e.g. drug,breast milk jaundice ,Miscellaneous as hypothyrodism ,Hypoxia ,acidosis 
   6. Miscellaneous

      Nota:

      • 0-sepsis  1-UTI 2-hypoglycemia. 3-infant of Diabetic mother.
   7. Drugs

      Nota:

      • e.g. Oxytocin

1. Hepatocyte injury

   Nota:

   • 0-infection / bacteria/sepsis /viral/infections /TB ,syphilis. 1-Toxic :- total parenteral nutrion. / sepsis with endotoxaemia. / Drug related. 2-Metabolic cause :- alpha 1-antitrypsin deficiency / Tyrosinaemia / Glactosaemia. 3-idipathic neonatal hepatitis  (unknown cause). 4-Miscellanouse:- hypopituitarism / Hypothyrodism / cystic fibrosis /chromosomal disorders as 21 trisomies down syndrome 
2. intrhepatic biliary disease or flow obstruction
3. Extrahepatic bile flow obstruction

   Nota:

   • 0-Biliary atresia. 1-choledochal cysts. 2-Neonatal sclerosing cholangitis 3-Bile Duct stenosis 4-inspissated bile syndrome 
4. neonatal cholestasis

   Nota:

   • 0-at 1st day of life .

   Adjunto:

   • Neonatal Cholestasis