Child health · UKMLA & AKT
Biliary atresia
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise biliary atresia — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Prolonged jaundice - persisting beyond 14 days (term) or 21 days (preterm); always conjugated (direct) hyperbilirubinaemia
- Pale/acholic stools - chalky white or putty-coloured due to absent bile pigment
- Dark urine - conjugated bilirubin is water-soluble and spills into urine
- Hepatomegaly - firm, enlarged liver due to cholestasis and early fibrosis
- Splenomegaly - develops as portal hypertension progresses
- Poor weight gain/failure to thrive - fat malabsorption due to absent bile delivery
Pale stools + dark urine in a jaundiced neonate = biliary atresia until proven otherwise. Any conjugated hyperbilirubinaemia at any age requires urgent investigation.
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