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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
Examination for Liver ... and Biliary Diseases ... erythema 2) Face: Jaundice ... Xanthelasma and jaundiced ... Bruising, Edema #biliary
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 #
Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
of Severe Acute Liver ... hepatitis - Acute biliary ... - Drug-Induced liver ... Hemochromatosis - Primary biliary ... Acute #Causes #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
Liver Mass Differential Diagnosis
Solid:
 • Benign: Hepatic Hemangioma, Focal nodular hyperplasia, Hepatocellular adenoma, Regenerative nodules
 •
Liver Mass Differential ... Cystadenoma, Polycystic liver ... disease, Biliary ... Echinococcus #Liver ... #Mass #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
Right Upper Quadrant Pain
Liver:
 - Infectious: Acute viral hepatitis, Liver abscess
 - Non-infectious: hepatitis (Alcohol, Medications),
Quadrant Pain Liver ... viral hepatitis, Liver ... Budd-Chiari syndrome Biliary ... "biliary colic") ... #RUQ #Pain #differential
Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... discomfort Signs: Jaundice ... Liver biopsy findings ... #PBC #Primary #Biliary