Heme metabolism: synthesis, porphyrias, jaundice, bilirubin
Biochemistry · MBBS
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Study notes
A newborn on day 3 is yellow; bilirubin is high, and phototherapy starts. This is neonatal jaundice — the immature liver can't conjugate bilirubin from normal newborn red cell breakdown fast enough; unconjugated bilirubin rises. Blue phototherapy light converts skin bilirubin to excretable forms — no drugs needed. The danger is kernicterus: very high unconjugated bilirubin crosses into the brain, staining basal ganglia (cerebral palsy, deafness) — prevented by treating in time. Day 3 jaundice is physiology; day 1 jaundice is pathology (hemolysis — investigate).
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