PSYCH 2AP3 Lecture Notes - Lecture 7: Pallor, Exchange Transfusion, Blood Film
13 Aug 2020
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Jwh, jm, ajs: dehydration and infection cause increased haemolysis. Hepatitis: not common in the uk but could be caused by: hep a, ebv, malaria etc. Congenital hypothyroidism: screened for in heel prick, typical features: coarse facial features, hoarse cry and umbilical hernia, causes prolonged jaundice in the newborn. Metabolic disorders: galactosaemia (produce toxic metabolite in the breakdown of galactose), Crigler-najjar syndrome (absence of hepatic glucoronyl transferase most die of kernicterus in first year of life) , alpha-1-antitrypsin deficiency (causes emphysema and cirrhosis) Full set of observations (may have an infection etc) General observation: how severe is the jaundice? (begins in face and works down body, pallor haemolytic anaemia could have made the patient anaemic. Hepatomegaly hepatitis or pku deficiency: splenomegaly in haemolytic anaemia. Examine the contents of nappy (pale stools and dark urine) Examination: liver is palpable 4cm below the costal margin, entire body is significantly jaundiced, small umbilical granuloma. Urine dip shows bilirubin but the absence of urobilinogen.
