BAHASA INGGRIS.pptx

7/30/2019 BAHASA INGGRIS.pptx

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Written by : Yunita Wulandari

030.08.263


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Neonatal hyperbilirubinemia elevation ofthe bilirubin level in the blood yellowishstaining of the skin and whites of thenewborn's eyes (sclerae).

In most infants normal phenomenon.


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Healthy infants

up to 12mg% in 3rd day; in premature, 5thday.

No hemolysis or bleedings

No underlying metabolic disease


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Type of bilirubin :1. Unconjugated bilirubin

2. Conjugated bilirubin

Serum unconjugated bilirubin levels mayexcessively rise PROBLEM


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Gestational Age

Race

Family history of jaundice requiring

phototherapy Hemolysis (ABO or other)

Severe bruising

Breastfeeding


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1. Infants have too many red blood cells and itis a natural process for the body to breakdown these excess red blood cells to form alarge amount of bilirubin.

2. The newborn's liver is immature and cannotprocess bilirubin as quickly as the infant willbe able to when older.


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Metabolism of heme. 6-10 mg/kg/day. (adults 3-4mg/kg/day)

1gr Hemoglobine produces 34mg of bilirubin

75%: from old RBCs released from RES 25%: from ineffective erythropoyesis, myoglobine,

cytochromes, catalase, peroxidase.


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Heme Biliverdin + CO +Fe

Heme Oxygenase + O2

Biliverdin reductase

Indirect (unconjugated) bilirubinBinds to albumin in plasma


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Liver Uptake (binds to ligandin) Endoplasmic reticullum

Bilirubin Mono and diconjugated bilirubin

UDPG-T

Stool

Beta glucuronidase

Bacteria

GutEliminationEnterohepatic recirculation

Urobilinoids

Indirect bilirubin

Liver


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Yellow color of the skin. Sometimes, infants with significant jaundice

have extreme tiredness and poor feeding.


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Blanch skin with a finger Jaundice

Significant when appears at palms or below knees.

Transcutaneous bilirubinometer

Bruising, cephalohematoma, others.

Organomegaly


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Phototherapy Exchange transfusion


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Prolonged hyperbilirubinemia chronicbilirubin encephalopathy (kernicterus).

Kernicterus fever, increased lethargy, andrefusal to eat.

High pitched crying.


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Jaundice is a normal phenomenon, but can bea pathological case if bilirubin levels increasewith extreme.

Good management can have an impact bothon the baby.


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1. Neonatal Hyperbilirubinemia. Available at : http://www.medterms.com/ script/main/art.asp?articlekey=16385. Accesed June 13, 2010.2. Neonatal Jaundice. Encyclopedia of Childrens Health. Available at :

http://www.healthofchildren.com/N-O/Neonatal-Jaundice.html . Accesed June13, 2010.3. Neonatal Jaundice. Available at : http://emedicine.medscape.com/article/974786-

overview. Accesed June13, 2010.

4. Dennery P A, Seidman D S, Stevenson D K. Neonatal Hyperbilirubinemia. The NewEngland Journal of Medicine 2001:344:581-90. Available at :http://content.nejm.org/cgi/content/full/344/8/581. Accesed June 13, 2010.

5. Juetschke, L.J. (2005, Mar/Apr). Kernicterus: still a concern. Neonatal Network, 24(2), 7-19, 59-62

6. Colletti JE, Kothari S, Kothori S, Jackson DM, Kilgore KP, Barringer K (November 2007)."Anemergency medicine approach to neonatal hyperbilirubinemia". Emerg. Med. Clin. NorthAm.25 (4): 111735, vii.

7. Watchko JF (December 2006). "Hyperbilirubinemia and bilirubin toxicity in the latepreterm infant". Clin Perinatol33 (4): 83952; abstract ix.

8. Shah Z, Chawla A, Patkar D, Pungaonkar S (March 2003). "MRI in kernicterus". Australas

Radiol47 (1): 557.9. Malik BA, Butt MA, Shamoon M, Tehseen Z, Fatima A, Hashmat N (December 2005).

"Seizures etiology in the newborn period".J Coll Physicians Surg Pak15 (12): 78690.10. Vohr BR, Lester B, Rapisardi G, et al. (August 1989). "Abnormal brain-stem function

(brain-stem auditory evoked response) correlates with acoustic cry features in terminfants with hyperbilirubinemia".J. Pediatr.115 (2): 3038.
http://www.medterms.com/%20script/main/art%20.asp?articlekey=16385http://www.medterms.com/%20script/main/art%20.asp?articlekey=16385http://www.medterms.com/%20script/main/art%20.asp?articlekey=16385http://www.healthofchildren.com/N-O/Neonatal-Jaundice.htmlhttp://www.healthofchildren.com/N-O/Neonatal-Jaundice.htmlhttp://emedicine.medscape.com/article/974786-overviewhttp://emedicine.medscape.com/article/974786-overviewhttp://emedicine.medscape.com/article/974786-overviewhttp://emedicine.medscape.com/article/974786-overviewhttp://emedicine.medscape.com/article/974786-overviewhttp://emedicine.medscape.com/article/974786-overviewhttp://www.healthofchildren.com/N-O/Neonatal-Jaundice.htmlhttp://www.healthofchildren.com/N-O/Neonatal-Jaundice.htmlhttp://www.healthofchildren.com/N-O/Neonatal-Jaundice.htmlhttp://www.healthofchildren.com/N-O/Neonatal-Jaundice.htmlhttp://www.healthofchildren.com/N-O/Neonatal-Jaundice.htmlhttp://www.medterms.com/%20script/main/art%20.asp?articlekey=16385http://www.medterms.com/%20script/main/art%20.asp?articlekey=16385http://www.medterms.com/%20script/main/art%20.asp?articlekey=16385http://www.medterms.com/%20script/main/art%20.asp?articlekey=16385


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BAHASA INGGRIS.pptx