Page 1 of 1: paediatrics

mediman · Credits: 167 My Scrapbook

AIIMS 99

a full term 80 hrs. old newborn baby develops
jaundice.what should be min. level of serum bilirubin
to start phototherapy?
1. 20
2. 12.5
3. 18
4. 15

akanksha · Credits: 41247 My Scrapbook My Reading List 14 Books

as far as i remember,

in a term baby,the level of bilirubin to start phototherapy is--

<24 hrs----levels >5mg

24-48hrs---levels >10mg

>48hrs----levels >15mg 8)

now here,the baby is term,80hrs old,dat means min level to start phototherapy shd be 15!

akanksha · Credits: 41247 My Scrapbook My Reading List 14 Books

for exchange transfusion in term baby min levels are--

<24 hrs------>10mg

24-48hrs---->15mg

>48hrs------>20 mg 8)

so wat abt the pre term ones? 8)

decembermist · Credits: 41081 My Scrapbook

its acc to a chart based on wt & s.bili values !!!

rakhijain · Credits: 14517 My Scrapbook

decembermist i hope what akanksha says is right wdo u have some other views?

decembermist · Credits: 41081 My Scrapbook

oops....i was mentioning abt the pre term.

yeah ans is correct !!!

parin · Credits: 14540 My Scrapbook My Reading List 1 Books

Well, according to Nelson....

In term infants without hemolysis

24-48 hrs: P if =>15-18, IP & preparation for ET if =>25, ET if P fails if =>20
49-72 hrs: => 18-20, => 30, => 25
>72 hrs: => 20, => 30, => 25

P- phototherapy
IP- Intensive phjototherapy
for ET if P fails- Intensive phototherapy should be initiated hwich usually reduces s. bilirubin levels 1-2 mg/dL in 4-6 hours.. often asso with i.v. fluids at 1-1.5 times maintenance with oral alimentation continue...

Jaundice in 1st 24 hours is not seen in "healthy" infants & jaundice appearing in 2nd wk of life or continuing beyond 2nd wk of life with significant hyperbilirubinaemia levels to warrant therapy should be investigated in detail as it is most probably d/t a serious underlying cause such as biliary atresia, galactosemia, hypothyroidism or neonatal hepatitis...

Maximal indirect s. bilirubin concentrations in preterm infants

wt uncomlicated complicated
<1000 g 12-13 10-12
1000-1250 g 12-14 10-12
1251-1499 g 14-16 12-14
1500-1599 g 16-20 15-17
2000-2500 g 20-22 18-20

complicated means perinatal asphyxia, acidosis, hypoxia, hypothermia, hypoalbuminaemia, meningitis, intraventricular haemorrhage, hemolysis, hypoglycemia, signs of kernicterus...

P is started at 50-75% of the maximal level. ET is indicated if values greatly exceed this level, P is unsuccessful or kernicterus is evident...

Maximal intensive phototherapy includes special blue fluorescent tubes, placing lamps within 15-20 cm of the infant & placing a fibreoptic phototherapy blanket under infant's back to increase exposed surface area...

Complications of phototherapy:

loose stools
wrythematous macular rash
overheating & dehydration
chilling from exposure of the infant
bronze baby syndrome
eye injuries & nasal occlusion from bandages

changu · Credits: 583 My Scrapbook

features of neuroblastoma include all except

1.>1% in children
2.abdominal mass
3.stippled calcification
4.hematogenous spread

vivek_patel · Credits: 2551 My Scrapbook

regarding the first Q....is it D) 15...pls confirm on that and as for changu's Q....is it 4. hematogenous spread

		Sign In New User? Sign Up Sign in to access your control panel and messenger!
				TechZone \| SpiderNevi \| HowTo? \| Scrapbook!