Answers
| Q1 | Glucose-6-phosphate dehydrogenase (G6PD) deficiency results in abnormal morphological structure of red blood cells |
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Answer: False. G6PD is an enzyme that maintains the stability of red blood cells (RBCs) and prevents haemolysis when the RBCs are subjected to oxidising stress |
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| Q2 | Severity of neonatal jaundice can be easily assessed by the intensity of yellowness of skin colour |
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Answer: False. Clinical assessment is often inaccurate especially in dark skin babies |
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| Q3 | Infants with mild neonatal jaundice can be treated by exposure to morning sunlight |
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Answer: False. This is not recommended as the short duration of treatment is unlikely to be adequate, sunlight may be harmful, and parents may have a false sense of security |
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| Q4 | Severe neonatal jaundice may result in cerebral palsy and mental retardation |
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Answer: True |
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| Q5 | Effectiveness of phototherapy is dependent on the intensity of the appropriate wave-length of light used |
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Answer: True. Effective wave-length is 425-475nm and effective irradiance is at least 4 uwatt/nm/cm2 . Irradiance must be much higher (even up to 30+ uwatt/nm/cm2) for intensive treatment |
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| Q6 | Baby R is 18 hours old. He is noted to be mildly jaundice. He is well otherwise and is due for discharge. G6PD screening is normal. He should be discharged and given follow-up in 1 weeks time. |
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Answer: False. All NNJ of onset within first 24 hours must be investigated. |
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| Q7 |
Baby R is discharged and at day 3 of life the visiting home nurse found him to be severely jaundiced. He is referred to hospital. Serum bilirubin level is 480 umol/L. Phototherapy must be started and an exchange transfusion must be organised immediately |
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Answer: True. The NNJ is likely to be due to haemolysis and ET is necessary to bring down this very high level quickly |
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| Q8 | A mother who is blood group B RH negative must be given Rhogam (Anti-D antibody) if cord blood of the baby is of blood group A Rh negative |
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Answer: False. Rho-gam is only needed if baby is Rh positive when mum is RH negative (ie incompatibility) |
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| Q9 | A baby with severe jaundice needs exchange transfusion (ET). He is A Rh positive and his mother is O Rh negative. Blood for ET must be A RH positive. |
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Answer: False. Transfusion of Rh positive blood in baby will aggravate the haemolysis due to maternal Rh antibody in the baby’s system |
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| Q10 |
Baby M is admitted to the ward for NNJ. He is 4 days old and is on exclusive breastfeeding. His serum bilirubin level is 310 umol/L and he is mildly dehydrated. The ideal management should include supplementation of breastfeeding with formula feeding via a bottle |
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Answer: False. If supplementation of formula is necessary it should be given by a cup or spoon to avoid ‘nipple-confusion’ |
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| Q11 |
Result of cord blood screening shows that Baby J is G6PD deficient. Instruction to mother must include avoidance of self-medication with drugs and herbs for both mother and baby. |
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Answer: True for both mother and child if baby is breast-fed. If medication is necessary a doctor should be consulted |
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| Q12 |
A 1 month old exclusively breastfed baby is detected to have mild to moderate jaundice. His stool is pale and urine is tea-coloured. He is looks well otherwise and his growth is normal. He is likely to have breastmilk jaundice and mother should be reassured. |
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Answer: False. This is obstructive or hepatocellular jaundice and needs to be investigated urgently. |
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