MBBS viva · Paediatrics
Neonatal jaundice — viva (pathological flags, phototherapy, kernicterus)
Viva on neonatal jaundice: physiological vs pathological, haemolysis work-up, phototherapy/exchange, G6PD, kernicterus.
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NEET-PGINICET
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"A day-2 neonate is deeply jaundiced and sleepy. Approach."
Q1: Classification (2 min)
- Physiological vs pathological (onset <24 h, rapid rise, high peak, conjugated fraction, illness, prolonged >2 weeks).
- Unconjugated vs conjugated pathways.
Q2: Causes and work-up (2 min)
- Haemolysis (ABO/Rh, G6PD, spherocytosis), sepsis, bruising/cephalohematoma, dehydration/breastfeeding issues, hypothyroidism, metabolic, biliary atresia (conjugated/prolonged).
- TSB timed by hours of age, blood group/DCT, smear, retic, G6PD, septic screen if unwell.[1]
Q3: Treatment (3 min)
- Intensive phototherapy: mechanism, practical delivery, monitoring.
- IVIG in selected immune haemolysis.
- Exchange transfusion thresholds/encephalopathy.
- Continue feeding; treat cause.
Q4: Complications and counselling (1 min)
- Acute bilirubin encephalopathy → kernicterus (athetoid CP, deafness, gaze palsy, enamel dysplasia).
- Follow-up hearing screen; parental warning signs.
Key phrases
- "Plot bilirubin against hours of age."
- "Phototherapy now; exchange if encephalopathic or threshold failure."
- "G6PD is mandatory in endemic regions."
References1ShowHide
- [1]Kemper AR, et al. AAP 2022 hyperbilirubinemia guideline. Pediatrics, 2022.PMID 35927462