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<p><b>New page</b></p><div>__NOTOC__<br />
A 3.8 kg one week-old full-term newborn boy arrives in the preoperative clinic<br />
in preparation for an eye exam under general anesthesia the next day. His family<br />
history is notable for being of southern Italian descent. During your examination,<br />
you note that he has jaundice to his umbilicus and scleral icterus. His exam is<br />
otherwise normal, including no hepatomegaly, aside from a soft<br />
cephalohematoma on the posterior scalp. Which of the following is the BEST<br />
response:<br />
<br />
a) You are not concerned about the jaundice because the mother is breast-feeding<br />
<br />
b) You opt for additional testing because of the family’s southern Italian heritage<br />
and the cephalohematoma<br />
<br />
c) The boy’s mother explains that he is making at least one wet diaper a day,<br />
reassuring you that he is well-hydrated<br />
<br />
d) No testing is necessary because the cephalohematoma is likely the cause of the<br />
jaundice<br />
<br />
e) This infant should be admitted for phototherapy, based on your examination<br />
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==Answer==<br />
Answer b. It is important to screen for G6PD in any infant of Mediterranean<br />
heritage. In addition, while cephalohematoma may increase the bilirubin value<br />
due to blood breakdown, this etiology does not decrease the risk to the infant of<br />
severe hyperbilirubinemia. CBC and total bilirubin as well as a G6PD screen<br />
should be performed.<br />
==Notes==<br />
<references /><br />
:This question originally printed in the [http://www.amazon.com/Justin-L.-Lockman/e/B00FLG5AEE/ref=ntt_dp_epwbk_0 Pediatric Anesthesiology Review Topics] kindle book series, and appears courtesy of Naerthwyn Press, LLC.<br />
==Keywords==<br />
:<br />
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