Jeepluv77 Posted March 8, 2009 Posted March 8, 2009 There are three groups of Hemorrhagic Disorder/Disease of the Newborn (HDN). How would you classify this patient? What about the other problem? The 3 groups are early, classic, and late onset. Early occurs within 24 hours of birth. We can rule that out. Classic within the first week of life, we can rule that out. Which leaves late. Late onset presents between 2 weeks and 2 months of age. Risk factors include Alpha1- antitrypsin deficiency, biliary atresia, exclusive breastfeeding, celiac disease, cystic fibrosis, diarrhea, and hepatitis. Since mom had no prenatal care it's safe to assume she was not screened for any of these and had no ultrasounds. We need to get a history on mom, a good physical exam focusing on palpation of abdomen on baby, possibly check mom's abdomen for liver abnormalities for undiagnosed hepatitis. Is/was she an iv drug user, alcoholic, etc? Even if she has stopped now, damage may have been done. Also, a family history for mom and dad both would not hurt in the absense of screening for celiac and cf.
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