All of the following are true about
Kernicterus EXCEPT:
a) Kernicterus is due to Unconjugated Hyperbilirubinemia
b) Yellowish staining of Basal Ganglia is seen
c) Prematurity is a risk factor
d) Not associated with increased morbidity
Correct Answer - D
Not associated with increased morbidity REF: Nelson 171h edition
page 687
KERNICTERUS OR BILIRUBIN ENCEPHALOPATHY:
Kernicterus, or bilirubin encephalopathy, is a neurologic syndrome
resulting from the deposition of unconjugated bilirubin in the basal
ganglia and brainstem nuclei.
The greatest risk associated with hyperbilirubinemia is the
development of kernicterus (bilirubin encephalopathy) at high
indirect serum bilirubin levels.
The level of serum bilirubin associated with kernicterus is dependent
in part on the cause of the jaundice. Kernicterus has developed
when bilirubin levels exceed 30 mg/dL, although the range is wide
(21-50 mg/dL).
Its onset is usually in the 1st wk of life, but it may_be delayed to the
2nd-3rd wk.
Kernicterus develops at lower bilirubin levels in preterm infants and
in the presence of asphyxia, intraventricular hemorrhage, hemolysis,
or drugs that displace bilirubin from albumin. The exact serum
bilirubin level that is harmful for VLBW infants is unclear. Kernicterus
does occur in patients with breast milk jaundice but is very
uncommon.
The surface of the brain is usually pale yellow. On cutting, certain
regions are characteristically stained yellow by unconjugated
bilirubin
Overt neurologic signs have a grave prognosis; 75% or more of such
infants die, and 80% of affected survivors have bilateral
choreoathetosis with involuntary muscle spasms. Mental retardation,
deafness, and spastic quadriplegia are common. Infants at risk
should have screening hearing tests.