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Haemolytic neonatal jaundice — MCCQE Part 1 MCQ

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HardNeonatal DistressHaemolytic neonatal jaundiceMCCQE Part 1

A term newborn is jaundiced at 20 hours of age. The baby is breastfeeding, has lost 5% of birthweight, and appears well. Maternal blood group is O positive; infant blood group is A positive and direct antiglobulin test is positive. What is the most appropriate investigation?

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Correct answer: A — Measure serum bilirubin and plot against age in hours

Jaundice in the first 24 hours is pathologic until proven otherwise and requires prompt bilirubin measurement plotted by age in hours, especially with ABO incompatibility and positive DAT. Reassurance or delayed assessment risks kernicterus. Biliary atresia usually presents with persistent conjugated jaundice and pale stools later. Iron therapy is irrelevant.

Reference: https://mcc.ca/objectives/medical-experts/