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Pathologic neonatal jaundice from haemolysis — MCCQE Part 1 MCQ

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HardNeonatal DistressPathologic neonatal jaundice from haemolysisMCCQE Part 1

A 30-hour-old term newborn is visibly jaundiced to the abdomen and feeding poorly. The mother is blood group O negative and the baby is A positive. Total serum bilirubin plots above the phototherapy threshold for age, and direct antiglobulin test is positive. What is the most appropriate investigation?

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Correct answer: E — Assess bilirubin urgently and treat with phototherapy while evaluating haemolysis

Jaundice in the first 24–48 hours, poor feeding and positive DAT suggest haemolysis and risk of severe hyperbilirubinaemia; urgent bilirubin-based treatment with phototherapy is needed. Physiologic jaundice typically appears later and is less concerning. Breastfeeding support is important rather than routine permanent cessation.

Reference: CPS Position Statement—Hyperbilirubinaemia