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Biliary atresia — RACP Paediatrics MCQ

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HardNeonatologyBiliary atresiaRACP Paediatrics

A 23-day-old breastfed infant remains visibly jaundiced. Weight gain is adequate, but the parents describe pale stools and dark urine. Examination shows mild hepatomegaly. What is the most appropriate investigation?

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Correct answer: E — Measure fractionated serum bilirubin and liver function tests urgently

Persistent jaundice with pale stools and dark urine suggests conjugated hyperbilirubinaemia and possible biliary atresia. Fractionated bilirubin with liver enzymes is the urgent first step because early referral improves the chance of successful surgery. Breast milk jaundice does not cause pale stools or dark urine.

Reference: RCH Jaundice in early infancy guideline; RACP Knowledge Guides