6. Jaundice

Question 1

What is jaundice?

Answer 1

Increased bilirubin in blood

Yellow sclera and skin

Question 2

What is bilirubin bound to in the blood?

Answer 2

Albumin

Question 3

Where is bilirubin conjugated?

Answer 3

Liver

Question 4

Where can bilirubin end up?

Answer 4

In bile
Travel into duodenum then stay in gut, then oxidised to stercobilin (brown in faeces)
In bloodstream to kidney then excreted as urobilinogen

Question 5

What are the 3 broad causes of jaundice?

Answer 5

Pre-hepatic
Hepatic
Post-hepatic

Question 6

What are the pre-hepatic causes of jaundice?

Answer 6

Too much haem so liver cannot keep up, unconjugated bilirubin in blood builds up

• haemoglobinopathies
• haemolysis

Question 7

What are the hepatic causes of jaundice?

Answer 7

Decreased hepatocyte function, mix of conjugated and unconjugated bilirubin as some of liver still working

• chronic liver disease
• acute liver damage

Question 8

What are the causes of post-hepatic jaundice?

Answer 8

Any obstructive condition to bile ducts, raised conjugated bilirubin therefore water soluble, more travels to kidney so darker urine and pale stools

• gallstones (common bile duct)
• biliary stricture
• pancreatic carcinoma (head of pancreas)

Question 9

What is intraheptaic obstruction?

Answer 9

Both hepatic and post-hepatic jaundice 
E.g.
- inflammation/oedema
- tumour (compression locally)
- cirrhosis