MEQ 1

PAEDIATRICS

Mrs Mazibuko is 22 years old. She gave birth to a 3kg baby girl at
Discoverers Clinic 5 days ago. She was unbooked. The delivery was an
uncomplicated normal vaginal delivery. Apgars were 8 at 1 min, and 9
at 5 mins. Mom and baby were discharged 6 hours later.
At three days of age the mother noticed that her babys eyes were
yellow. She returned to the Clinic today because the eyes are still
yellow. The Clinic Sister confirmed that the neonate was jaundiced. A
blood test was done and the baby was referred to the nearest hospital
with the result.
(a) State five (5) other indications for referral to hospital. (5 marks)
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2
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3
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4
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5
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(b) Enumerate six (6) causes of intermediate neonatal jaundice. (6
marks)
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(c) State four (4) possible causes of early onset of jaundice. (4
marks)
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2
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3
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4
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(d) State six (6) investigations with justifications you would do in a
baby with early onset jaundice. (12 marks)
INVESTIGATIONS

JUSTIFICATIONS

(e) Enumerate five (5) causes of prolonged jaundice. (6 marks)

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2
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3
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5
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(f) Enumerate six (6) risk factors for bilirubin encelopathy. (6 marks)
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2
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3
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4
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5
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6
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(g) What are the four (4) long term effects of kernicterus? (4 marks)
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2
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3
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4
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(h) How does phototherapy work? Name four (4) factors that
determine the efficacy of phototherapy. (5 marks)
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(i) Enumerate five (5) complications of phototherapy. (5 marks)
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2
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4
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5
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(j) What observations need to be carried out on infants receiving
phototherapy?
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2 _____________________________________________________________
3 _____________________________________________________________
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5 _____________________________________________________________
(5 marks)
(k) How does breastfeeding failure leads to jaundice. (2 marks)
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