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Approach to the neonate with jaundice

#Diagnosis #Peds #Pediatrics #Neonatal #Jaundice #Algorithm #Differential #Workup

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Approach to the neonate ... with jaundice ... Peds #Pediatrics #Neonatal ... #Jaundice #Algorithm ... #Differential #
Clinical Examination for Liver and Biliary Diseases
1) Hands: Clubbing, Dupuytren's contracture, Leuconychia, Bruising, Flapping tremor (hepatic
for Liver and Biliary ... erythema 2) Face: Jaundice ... Xanthelasma and jaundiced ... Aspiration of ascitic ... Splenornegaly, Ascites
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG)
SAAG ≥ 1.1:
 - Ascitic protein
Diagnosis of ascites ... SAAG ≥ 1.1: - Ascitic ... metastases - Ascitic ... syndrome SAAG < 1.1: Biliary ... gradient #hepatology #differential
Approach to Neonatal Jaundice

Causes of pathologic hyperbilirubinemia can be classified as due to (1) increased bilirubin
Approach to Neonatal ... Jaundice Causes ... Peds #Pediatrics #Neonatal ... #Jaundice #Algorithm ... #Differential #
Jaundice - Differential Diagnosis Algorithm
Pre-Hepatic - Unconjugated Hyperbilirubinemia
Increased Production
 • Hemolysis
 • Ineffective Erythropoiesis
 • Hematoma
Decreased
Jaundice - Differential ... on Ultrasound Biliary ... Gallstones • Biliary ... Cholangitis #Jaundice ... #Differential #
Diseases of the Biliary Tract
Asymptomatic gallstones - Asymptomatic
Symptomatic gallstones - Biliary pain
Cholesterolosis of gallbladder - Usually
Diseases of the Biliary ... cholecystitis - Biliary ... Asymptomatic or biliary ... pain, jaundice, ... #diseases #differential
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
Ascites - Differential ... Failure, Pancreatic, Biliary ... Chylous <1% #Ascites ... #Differential #
Classification of Jaundice
Unconjugated hyperbilirubinemia (predominantly indirect bilirubin)
 • Increased bilirubin production (eg, hemolytic anemias, hemolytic reactions,
Classification of Jaundice ... Dysfunction - Biliary ... postoperative jaundice ... neoplasms #Jaundice ... #unconjugated #differential
Ascites - Diagnostic Approach and Differential Diagnosis
The most common causes: cirrhosis, malignancy and heart failure. Approx
Ascites - Diagnostic ... Approach and Differential ... Cell count and differential ... concentration (bowel or biliary ... #workup #Differential
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... - Differential ... failure • Primary biliary ... amzn.to/2LmUODZ #Ascites ... #Differential #