A 1 month old presents for a well child visit. He is nursing…
A 1 month old presents for a well child visit. He is nursing every 2-4 hours and voiding normally, but is only stooling firm pellets every 5-7 days. On exam, he has macroglossia, hypotonia, and visible jaundice. You order testing for:
Read DetailsA 37 week infant is in the NICU. She received treatment for…
A 37 week infant is in the NICU. She received treatment for congenital pneumonia. Her blood type is O positive, DAT negative and the maternal blood type is O negative, antibody screen negative. She reached goal feeds by day 5. She begins breastfeeding by day 7 and by day 14 she is breastfeeding all feedings, voiding and stooling normally, is back to birthweight, and maintaining her temperature in a crib. She initially received phototherapy for jaundice. Phototherapy was discontinued on day 8 and her bilirubin continued to drop off of phototherapy. As you examine her on day 14, you notice that she appears much more jaundiced. You obtain a bilirubin level – total 16 mg/dL total, direct 0.4 mg/dL. What is the cause of her hyperbilirubinemia and how will you treat it?
Read DetailsA 20 year old G2 P0 woman presents in the ER at 35 weeks ges…
A 20 year old G2 P0 woman presents in the ER at 35 weeks gestation with complaints of abdominal pain. You are called to the ER just as she precipitously delivers a 2200 gram female infant. The infant has Apgar scores of 3, 6 and 7 at 1, 5 and 10 minutes of age. The infant is transferred to the NICU with CPAP due to grunting and tachypnea. Her oxygen requirement increases to 70% and she is intubated, given a dose of surfactant, and placed on a ventilator. She has a blood culture done and is started on Ampicillin and Gentamicin. While initially hypoxic, hypercarbic, and acidotic, she improves with 2 doses of surfactant and her oxygen requirement decreases. At 48 hours of age, she is jaundiced and her blood culture is positive. You check a bilirubin level – total 13 mg/dL and direct 0.2 mg/dL. What type of jaundice does this infant have and how do you need to manage it?
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