Which of the following features in a jaundiced neonate indicates PATHOLOGICAL rather than physiological jaundice?
- A Visible jaundice first appearing on day 3 of life in a term baby
- B Peak bilirubin of 10 mg/dL on day 4 with exclusively unconjugated fraction
- C Total serum bilirubin rising at a rate of more than 5 mg/dL per day ✓
- D Jaundice fading completely by day 10 in a term infant
Correct answer: C. Total serum bilirubin rising at a rate of more than 5 mg/dL per day
Explanation
Physiological jaundice appears after 24 hours, rises less than 5 mg/dL per day, peaks below about 12 mg/dL in term infants, remains unconjugated, and resolves by 2 weeks. A rate of rise exceeding 5 mg/dL per day signals haemolysis or another pathological process and mandates evaluation. Options A, B and D all fall within accepted physiological limits, so they cannot distinguish pathological from physiological jaundice.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.