Question & Answer in NB

Question ?

What factors suggest hemolytic disease as a cause of jaundice in the newborn ?


  Family history of hemolytic disease

  Bilirubin rise of > 0.5 mg /dl/hr

 Failure of phototherapy to lower serum bilirubin levels

  Ethnicity suggestive of inherited disease such : G6PD

Onset of jaundice before 24hrs of age

 Reticulocytosis > 8% at birth

 > 5% during 1st 2-3 days

 > 2% after 1st wk


Changes in peripheral smear: microspherocytosis,anisocytosis, target cells

 Significant decrease in hemoglobin

 Pallor & Hepato splenomegaly

Question ?

What are the complications of exchange transfusions in the newborn ?



  Hypo calcemia ( binding of ca by citrate )


  Hyper kalemia

 Hypo volemia

  Diminished oxygen delivery ( blood stored >5-7 days)

  Late: Anemia, Graft-versus-host disease

Question ?

 Is the ESR or CRP more helpful in the management of osteomyelitis ?


The ESR was significantly elevated on days 2-5

ESR slowly returned to normal within 3 wks of therapy


 CRP rises within 6-12 hrs of a triggering stimulus

  Returns to normal within a wk of therapy

  Secondary rise in either ESR or CRP could be a sign of recrudescence

Question ?

What is the presentation of Maxillary Osteomyelitis ?


Early edema & redness of the Cheeks 

Unilateral Nasal Discharge

Swelling of the eyelid with conjunctivitis 


Question ?

What radiographic study are helpful to make the diagnosis of DDH? (Developmental Dysplasia of the Hip )


 Ultrasound of the hip is the study of choice for suspected DDH in children younger than 4 months of age .

 The ossific nucleus of the femoral head is completely cartilaginous and therefore will not be seen on X ray

 After 4 months of age radiographs should be obtained .

Question ?

What are the Risk factors for DDH ?


First born status

Female sex

Breech presentation

Positive family history of DDH

About 2.5- 6.5 / 1000

Question ?  

How is the newborn hip exam performed  ?


The Exam consist of the  :



Galeazzi  maneuvers

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