A new mother and father are upset that their 2-day-old infant is ...

[lbcchick]

A new mother and father are upset that their 2-day-old infant is requiring phototherapy for hyperbilirubinemia.
 
  The pediatrician who has followed the infant since birth is explaining the multiplicity of factors that can contribute to high serum bilirubin levels in neonates.Which of the following factors would the physician be most likely to rule out as a contributor?
  A)
  The fact that the infant is being breast-fed
  B)
  Hypoxia
  C)
  Hepatic immaturity of the infant
  D)
  Transitioning of hemoglobin F (HbF) to hemoglobin A (HbA)

Question 2

A 44-year-old female patient presents to the emergency department with abnormal bleeding and abdominal pain that is later attributed to gallbladder disease.
 
 Which of the following diagnoses would the medical team be most justified in suspecting as a cause of the patient's bleeding?
 A) Excess calcium
 B) Vitamin K deficiency
 C) Hemophilia B
 D) Idiopathic immune thrombocytopenic purpura (ITP)

[zoeyesther]

Answer to Question 1

Ans:
D

Feedback:

Hemoglobin transition from HbF to HbA is not associated with hyperbilirubinemia. Breast-feeding, hypoxia, and immaturity of the young liver can contribute to hyperbilirubinemia.

Answer to Question 2

Ans: B

Feedback: Factors VII, IX, and X and prothrombin require the presence of vitamin K for normal activity. Vitamin K deficiency may result from impaired fat absorption caused by liver or gallbladder disease. Calcium, factors X and V, and platelet phospholipids combine to form prothrombin activator, which then converts prothrombin to thrombin. Excess calcium could result in increased formation of blood clots. Hemophilia B is a hereditary disorder. Half of the cases of ITP occur as an acute disorder in children; ITP in adults is a chronic disorder with insidious onset.