BIOS 251 Week 1 Case Study Questions and Correct Answers Approved and Certified 100% A++
8 views 0 purchase
Course
Biology
Institution
Biology
(19) A 30 hour old full term infant has face and chest jaundice. He is breastfeeding well and has
an otherwise normal examination. His bilirubin level is 15.5 mg/dL. Which of the following is
the most appropriate course of action?
A. Recommend cessation of breast feeding for 48 hours and suppl...
Answers Approved and Certified 100% A++
(19) A 30 hour old full term infant has face and chest jaundice. He is breastfeeding well and has
an otherwise normal examination. His bilirubin level is 15.5 mg/dL. Which of the following is
the most appropriate course of action?
A. Recommend cessation of breast feeding for 48 hours and supplement with formula.
B. Start photo-therapy
C. Wait 6 hours and retest the serum bilirubin level
D. Start an exchange transfusion
E. No action is needed - CORRECT ANSWER ✔✔ -B. Although the etiology of
hyperbilirubinemia must be investigated, photo-therapy should be started.
(19) The hyperbilirubinemia associated with Crigler-Najjar syndrome type 1 is caused by which
of the following?
A. Increased production of bilirubin
B. Impaired conjugation of bilirubin
C. Deficient hepatic uptake of bilirubin
D. Severe deficiency of uridine diphosphate glucuronosyltransferase
E. Glucose 6-phosphate dehydrogenase deficiency - CORRECT ANSWER ✔✔ -D. Although all
infants are relatively deficient in uridine diphosphate glucuronosyltransferase, those with
,Crigler-Najjar syndrome type 1 have a severe deficiency, causing high bilirubin levels and
encephalopathy. Treatment is photo-therapy. Encephalopathy is rare with Crigler-Najjar type 2 ,
in which bilirubin levels rarely exceed 20 mg/dL.
(19) Which of the following decreases the risk of neurologic damage in a jaundiced newborn?
A. Acidosis
B. Displacement of bilirubin from binding sites by drugs such as sulfisoxazole
C. Hypoalbuminemia
D. Sepsis
E. Maternal ingestion of phenobarbital during pregnancy - CORRECT ANSWER ✔✔ -E.
Administration of phenobarbital induces glucuronyl transferase, thus reducing neonatal jaundice.
Sepsis and acidosis increases the risk of neurologic damage by increasing the blood brain
barrier's permeability to bilirubin. Hypoalbuminemia reduces the infant's ability to transport
unconjugated bilirubin to the liver, and similarly drugs that displace bilirubin from albumin
elevate free levels of unconjugated bilirubin in the serum.
(19) You are about to return a phone call to the mother of an 8 day old infant who continues to
have jaundice which was first noted on the second day of life;you are about to report to her that
his latest total and direct bilirubin levels are 12.5 and 0.9 mg/dL, respectively. You look over
your chart and see that he and his mother have O type blood, the direct and indirect Coombs test
is negative, his reticulocyte count is 15%, and a smear of his blood reveals no abnormal cell
shapes. He is bottle-feeding well, produces normal stools and urine, and has gained weight well.
Which of the following diagnoses remains in your differential diagnosis?
, A. Gilbert syndrome
B. Disseminated intravascular coagulation (DIC)
C. Spherocytosis
D. Polycythemia
E. An undiagnosed blood group isoimmunization - CORRECT ANSWER ✔✔ -A. Gilbert
syndrome would present with a negative Coombs test, a normal or low hemoglobin, a normal or
slightly elevated reticulocyte count, and prolonged hyperbilirubinemia. Red cell morphology
would be abnormal in DIC and spherocytosis, polycythemia would present with an elevated Hg
level (that listed above is normal for a newborn), and blood group isoimmunization would
present with a positive Coombs test.
(22) A 2150 g infant is delivered at 34 week gestation. The mother had prenatal care in Mexico
and says she had no problems. Her highest temperature during labor was 100.8. The amniotic
fluid had a brown-stained appearance. At birth the infant had a diffuse erythematous pustular
rash, pallor, poor feeding, tachypnea, and cyanosis. His CBC indicates marked monocytosis. He
dies at 4 hours of age, soon after initiation of antibiotics. He most likely had which of the
following?
A. Congenital syphilis
B. Congenital varicella
C. Disseminated herpes
D. GBS disease
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Eddiestudy. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $8.39. You're not tied to anything after your purchase.
