Clinical/General Reading/PD/Man in the Pan

Majority of cases are normal and self-resolve; result of too much bilirubin from erythrocyte breakdown due to high red blood cell count of birth. Also, liver enzymes for conjugating bilirubin to make it polar and excretable not yet fully functional.

Anterior fontanelle (too depressed=dehydration, too elevated=increased intracranial pressure, think prob with choroid plexus or encephalitis or meningitis); skin for rashes/petechiae (petechiae's do not blanch), eyes for red reflex (if you see white pupil instead, or leucocoria, symptom of retinoblastoma), neck (pull flesh away), heart (50% of neonates have murmurs), palpate liver (usually 2 cm below costal margin), DISTAL PULSE (at femoral artery; HR usually 120-160), startle or Moro's reflex, check for DDH (developmental dysplasia of hip, after flexing knee push down and out, then abduct and pull up).

Diabetic ketoacidosis is a complication of diabetes that occurs when sugar (glucose) is not available as a fuel source by the body and fat is used instead. By-products of fat breakdown, called ketones, build up in the body. Usually seen with type I diabetes; very high glucose levels because no insulin available+increased glucose production by liver.

Type 1, known as juvenile diabetes, is not governed by lifestyle. It is an autoimmune disorder in which the body attacks the beta cells in the pancreas that produce the hormone insulin. Because people with Type 1 produce no insulin, they cannot survive without injecting it before each meal, and they must test their blood several times a day to check their glucose levels.