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BIOS 251 Week 1 Case Study Questions and Correct Answers Approved and Certified 100% A++ $8.39   Add to cart

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BIOS 251 Week 1 Case Study Questions and Correct Answers Approved and Certified 100% A++

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(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...

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  • August 14, 2024
  • 17
  • 2024/2025
  • Exam (elaborations)
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  • Biology
  • Biology
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BIOS 251 Week 1 Case Study Questions and Correct

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

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