Neonatal Jaundice

Key Conditions

Key conditions are the core conditions that the Paediatric Undergraduate and Clerkship Directors of Canada (PUPDOC) felt are essential for graduating medical students to know. The Key Conditions are neither a differential diagnosis nor a clinical approach. They highlight conditions that may be unique to paediatrics, that are essential, or that are common. Key Conditions can present in a number of ways – each is listed as under the most common Clinical Presentation.

• Biliary Atresia​
• Breast Feeding Jaundice
• Breast Milk Jaundice​
• Hemolytic Anemia​
• Kernicterus​
• Physiological Jaundice

Clinical Approach

Clinical approaches represent one of many methods to think through a clinical presentation, and narrow down a differential diagnosis. There are many conditions that can present with similar symptomatology. These presentations are not meant to contain an exhaustive list of differential diagnoses, but rather outline how to think through patient signs and symptoms, and understand some of the most common and important Paediatric conditions. There are many different ways to approach any clinical presentation, and these approaches are not meant to replace clinical judgement.

Pre-Clerkship

Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.

Clerkship

Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.

Objectives

By the end of the Paediatric Clerkship, a medical student will be able to:

1. Calculate the ratio of conjugated bilirubin to total bilirubin and decide if the baby has unconjugated or conjugated hyperbilirubinemia.
2. Propose an investigation plan for a baby with conjugated hyperbilirubinemia.
3. Propose a management plan physiologic, breast-milk and breast-feeding jaundice.
4. Propose a management plan for a baby with kernicterus.
5. Describe the maternal and baby blood groups that are a set-up for hemolytic anemia.

Half Day Cases

• 3 Day old baby girl, 3500 gram infant, 40 weeks, born to a 28 year old G2P1 Caucasian woman after an uncomplicated pregnancy and delivery. Developed jaundice at age 2 days which increased gradually. Rest of exam normal
• 5 Day old baby boy, 4200 gram infant, 41 weeks, born to a 28 year old G1P0 SVD assisted by forceps due LGA. Developed jaundice at age 3 days which increased more today baby looks jaundice and have left parietal cephalhematoma, Rest of exam normal.
• 23 hours baby boy to 24 year old G1P0 Asian mother delivers a 3400g male infant at 38 weeks. Baby noticed to be jaundiced on face and trunk, poor feeding and lethargy.
• 4 weeks old baby girl born full term 39 weeks at birth weight was 2300g to Asian mother 31 years old G3P1 with uncomplicated pregnancy and delivery came to ER as her parents concerned that their baby had jaundice, since of 1 week of age which increased gradually.

Resources

The following resources have been reviewed and collated by canuc-paeds. These resources are aimed to provide information at the level of the medical student. These include overviews of topics, clinical resources, and useful guidelines that contain relevant materials.