Neonatal jaundice physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
Notoriously inaccurate [[rules of thumb]] have been applied to the [[physical exam]] of the jaundiced infant. Some include estimation of serum [[bilirubin]] based on appearance. One such rule of thumb includes infants whose jaundice is restricted to the face and part of the trunk above the [[Navel|umbilicus]], have the [[bilirubin]] less than 204 umol/l (12 mg/dL) (less dangerous level). Infants whose palms and soles are yellow, have serum bilirubin level over 255 umol/l (15 mg/dL) (more serious level) | Notoriously inaccurate [[rules of thumb]] have been applied to the [[physical exam]] of the jaundiced infant. Some include estimation of serum [[bilirubin]] based on appearance. One such rule of thumb includes infants whose jaundice is restricted to the face and part of the trunk above the [[Navel|umbilicus]], have the [[bilirubin]] less than 204 umol/l (12 mg/dL) (less dangerous level). Infants whose palms and soles are yellow, have serum bilirubin level over 255 umol/l (15 mg/dL) (more serious level) | ||
* Complete physical exam including evidence of: | |||
*:* [[Ddx:Hepatomegaly|Hepatomegaly]] | |||
*:* [[Ddx:Splenomegaly|Splenomegaly]] | |||
*:* Palpable gallbladder | |||
*:* Signs of chronic liver disease | |||
=== Skin === | |||
* Jaundice is visible in conjunctiva, skin and mucosa when the serum bilirubin level rises above 2 mg/dL | |||
=== Eyes === | |||
* Jaundice is usually best seen in the periphery of the ocular conjunctiva | |||
=== Abdomen === | |||
* Hepatomegaly may be present | |||
=== Neurologic === | |||
* A flap may be present | |||
==References== | ==References== | ||
Revision as of 21:33, 8 January 2018
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Overview
Physical Examination
Notoriously inaccurate rules of thumb have been applied to the physical exam of the jaundiced infant. Some include estimation of serum bilirubin based on appearance. One such rule of thumb includes infants whose jaundice is restricted to the face and part of the trunk above the umbilicus, have the bilirubin less than 204 umol/l (12 mg/dL) (less dangerous level). Infants whose palms and soles are yellow, have serum bilirubin level over 255 umol/l (15 mg/dL) (more serious level)
- Complete physical exam including evidence of:
- Hepatomegaly
- Splenomegaly
- Palpable gallbladder
- Signs of chronic liver disease
Skin
- Jaundice is visible in conjunctiva, skin and mucosa when the serum bilirubin level rises above 2 mg/dL
Eyes
- Jaundice is usually best seen in the periphery of the ocular conjunctiva
Abdomen
- Hepatomegaly may be present
Neurologic
- A flap may be present