Why doesn't kernicterus occur in the adult?

[DermViser]

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This is, like, the third thread in two days that you've hit on her in her own language. When you gonna seal the deal, brah?

No, I just like basic science.

 

[evilbooyaa]

This is, like, the third thread in two days that you've hit on her in her own language. When you gonna seal the deal, brah?

You mean English? There was nothing 'medical' in his response, lol.

 

[DermViser]

I think you need to calm down. Maybe some people learned about kernicterus before they learned about infant development and the idea of the BBB not being fully formed didn't cross their minds. I mean you were clearly trying to be haughty. Theres no reason to look down on someone for asking a question even if its a basic one.

From the way you posted, you made it seem like he asked the difference between a red blood cell and a white blood cell.

It still doesn't matter. I opened the thread to post about about the BB barrier but saw it was already answered, but I was still ticked off by the seemingly haughty response by Anastomoses. Such condescending attitude is repulsive and destroys dialogue and general education. There are seemingly obvious things we don't know. It is not as if the person asked an ultra-basic question. And for anyone with an investigative mind, you might appreciate the possiblity that we might later find that BB barrier may not be even correct. I have had people ask seemingly basic questions only to find out there was far deeper reasoning that the majority just glossed over.

Anastomoses should get over herself.

Sorry, I know it's been a while, but with all due respect, Anastomoses response was hardly haughty, condescending, or whatever other epithet you wish to throw her way. The necrobump for a question in 2003, was obviously someone with an MD/PhD who wished to show how smart he was bc of his kernicterus research on a question that was ALREADY ANSWERED. Even in the most basic of USMLE board review books, kernicterus and it's association with the BBB is ALWAYS mentioned. One does not need to have learned about infant development. This is a basic science factoid from Biochemistry that is repeated ad nauseum and is the "easy" question on Step 1. To say we may find out it's wrong in future years is a complete cop out.

She is correct when she says:

I don't have to get over myself. But let's not talk about me. Address my comments or my inaccuracies - don't bring in your personal issues and start in on what you don't like about my personality. You don't think the question was basic? Okay. I could be wrong. To me it was the equivalent of saying "what is kernicterus?".
2. neonate BBB junctions + neonate inability to conjugate bilirubin are currently the standard knowledge w/bluelight phototherapy to treat. What you could theoretically find out in 10 years really has no bearing on any of this, head in the clouds much?

 

[Ismet]

Sorry, I know it's been a while, but with all due respect, Anastomoses response was hardly haughty, condescending, or whatever other epithet you wish to throw her way. The necrobump for a question in 2003, was obviously someone with an MD/PhD who wished to show how smart he was bc of his kernicterus research on a question that was ALREADY ANSWERED. Even in the most basic of USMLE board review books, kernicterus and it's association with the BBB is ALWAYS mentioned. One does not need to have learned about infant development. This is a basic science factoid from Biochemistry that is repeated ad nauseum and is the "easy" question on Step 1. To say we may find out it's wrong in future years is a complete cop out.

She is correct when she says:

Did you have to bump something from 2 months ago to white knight defend Anastomo?

 

[DermViser]

Did you have to bump something from 2 months ago to white knight defend Anastomo?

Great gif selection. Even he knows....

No, but seriously I thought their responses to her were out-of-bounds and accusatory.

 

[Ladiabla07]

I came across this thread because I myself was looking up the "basic" question of why adults don't get kernicterus. And while pointing out it's a basic question might have boosted your ego for knowing the answer, belittling someone else's genuine interesting in finding out an answer to a question they have is really petty. Also, yelling out "Blood brain barrier, duh!" doesn't actually answer the question because infants do, in fact, have blood brain barriers (albeit less developed) and, more importantly, unconjugated bilirubin is lipid soluble and therefore theoretically can cross the blood brain barrier anyway (which is what had me confused.) What hadn't occurred to me, and what may be equally as basic as 'blood brain barrier' and yet not mentioned anywhere in this thread (which is why I'm posting this,) is that UCB bound to albumin* cannot cross the blood brain barrier and since albumin is significantly less in newborns, they have more unbound UCB that can cross their weaker blood brain barrier, while adults have albumin which prevents UCB from crossing the more developed BBB. So, in theory, adults with hypoalbuminemia or anything that causes disturbance in the binding of albumin to bilirubin (low pH, drugs that compete for albumin binding, etc) puts adults with high levels of UCB at risk for developing kernicterus as well.

 

[VisionaryTics]

I came across this thread because I myself was looking up the "basic" question of why adults don't get kernicterus. And while pointing out it's a basic question might have boosted your ego for knowing the answer, belittling someone else's genuine interesting in finding out an answer to a question they have is really petty. Also, yelling out "Blood brain barrier, duh!" doesn't actually answer the question because infants do, in fact, have blood brain barriers (albeit less developed) and, more importantly, unconjugated bilirubin is lipid soluble and therefore theoretically can cross the blood brain barrier anyway (which is what had me confused.) What hadn't occurred to me, and what may be equally as basic as 'blood brain barrier' and yet not mentioned anywhere in this thread (which is why I'm posting this,) is that UCB bound to albumin* cannot cross the blood brain barrier and since albumin is significantly less in newborns, they have more unbound UCB that can cross their weaker blood brain barrier, while adults have albumin which prevents UCB from crossing the more developed BBB. So, in theory, adults with hypoalbuminemia or anything that causes disturbance in the binding of albumin to bilirubin (low pH, drugs that compete for albumin binding, etc) puts adults with high levels of UCB at risk for developing kernicterus as well.

You waited 4.5 years and necrobumped a thread from 7 months ago...to post this?

 

[Kaustikos]

You waited 4.5 years and necrobumped a thread from 7 months ago...to post this?

Right? If we're looking to necrobump something awesome... Do the Winged Scapula is awesome.

 

[Ladiabla07]

You waited 4.5 years and necrobumped a thread from 7 months ago...to post this?

Not at all. I commented on it when I came across it because for some reason this 4.5 year old thread is the first thing that comes up when you google adults and kernicterus. Sorry the problem didn't arise for me 4.5 years ago when it would have been timely for me to post a response.