12. Journey through the liver Bilirubin taken up Conjugated to form water soluble conjugate Conjugate secreted into bile
13.
14. In The Gut Bilirubin diglucuronide may be Deconjugated or Metabolised by bacteria to urobilinogenpartially reabsorbed (remainder makes the stool brown)
27. Now that you’re a pro.. You’re called by a nurse for a new admission regarding a baby with elevated bili..what do you want to know
28. Approach to jaundiced baby Get age of baby (hours), gestational age, pregnancy hx, septic risk factors, complications with delivery Assess clinical condition (well or ill) Decide whether jaundice is physiological or pathological Look for evidence of kernicterus* in deeply jaundiced NB *review..what do you look for?
29. Approach to jaundiced baby Get age of baby (hours), gestational age, pregnancy hx, septic risk factors, complications with delivery Assess clinical condition (well or ill) Decide whether jaundice is physiological or pathological Look for evidence of kernicterus* in deeply jaundiced NB *Lethargy and poor feeding, poor or absent Moro's, opisthotonus or convulsions
35. Treatment During pregnancy (if severe) Intrauterine blood transfusion Early delivery After pregnancy Increase feeds (especially in breast feeding jaundice) Phototherapy Exchange transfusion (if severe)