Review Question - QID 105559

This infant's clinical picture is consistent with a diagnosis of neonatal jaundice. A rising serum total bilirubin at a rate of greater than 5 mg/dL/24hr is indicative of pathologic jaundice and warrants further investigation.

It is important to differentiate pathologic from physiologic neonatal jaundice, as there are numerous potential underlying causes to pathologic hyperbilirubinemia that, if present, must be identified so that further work-up and treatment can be initiated. Indications to pursue further evaluation of neonatal jaundice include: 1) conjugated bilirubin > 2 mg/dL or > 20% of total bilirubin, 2) jaundice in the first 24 to 36 hours, 3) bilirubin rate of rise > 5 mg/dL/24hrs, 4) total bilirubin > 12 mg/dL in a term infant, 5) jaundice persisting beyond 10-14 days of life, and 6) presence of any additional signs or symptoms indicative of underlying disease.

Incorrect Answers:
Answer 1: Pathologic jaundice is defined as total bilirubin level greater than 12 mg/dL in a term infant at any age of life.
Answer 2: Pathologic jaundice is defined as conjugated or direct serum bilirubin level greater than 2 mg/dL or greater than 20% of total serum bilirubin.
Answer 3: Pathologic jaundice is defined as the clinical presence of jaundice in the first 24-36 hours of life.
Answer 4: Pathologic jaundice is defined as persistence of jaundice beyond 10-14 days of life.