Causes of Jaundice

Question 1

What is the etiology, laboratory findings, clinical features of extravascular hemolysis/ ineffective erythropoiesis? What does it increase the risk for?

Answer 1

High levels of unconjugated Bilirubin overwhelm the conjugating ability of the liver. Increased unconjugated bilirubin. Dark urine due to increased urine urobilinogen. Increased risk for pigmented bilirubin gallstones.

Question 2

What is the etiology, laboratory findings, clinical features of

Answer 2

a

Question 3

What is the etiology, laboratory findings, clinical features of

Answer 3

a

Question 4

What is the etiology, laboratory findings, clinical features of Crigler-Najjar syndrome?

Answer 4

Absence of UDP glucuronosyltransferases (UGT) . Increased unconjugated bilirubin. Jaundice during stress (sever infection)

Question 5

What is the etiology, laboratory findings, clinical features of Dubin-Johnson syndrome?

Answer 5

Deficiency of bilirubin canalicular transport protein. Autosomal recessive. Increased conjugated bilirubin. Liver is dark. Rotor syndrome is the same but the liver is not dark.

Question 6

What is the etiology, laboratory findings, clinical features of biliary tract obstruction?

Answer 6

Associated with gallstones, pancreatic carcinoma, cholangiocarcinoma, parasites and liver fluke (Clonorchis sinensis). Increased conjugated bilirubin, decerased urine urobilinogen and increased alkaline phosphatase. Dark urine (due to bilirubinuria) and pale stool. Pruritis due to increased plasma bile acids. Hypercholesterolemia with xanthomas. Steatorrhea with malabsorption of fat soluble vitamins.

Question 7

What is the etiology, laboratory findings, clinical features of viral hepatitis?

Answer 7

Inflammation disrupts hepatocytes and small bile ductules. Increase in both conjugated and unconjugated Bilirubin. Dark urine due to increased bilirubin. Urine urobilinogen is normal or decreased.

Question 8

What is the etiology, laboratory findings, clinical features of physiologic jaundice of the newborn? How is it treated?

Answer 8

Newborn liver has transiently low UDP glucuronosyltransferases (UGT). Increased unconjugated bilirubin. UCB is fat soluble and can deposit in the basal ganglia (kernicterus) leading o neurological deficits and death. Treatment is phototherapy (makes UCB water soluble)

Question 9

What is the etiology, laboratory findings, clinical features of Gilbert syndrome.

Answer 9

Mildly low UDP glucuronosyltransferases (UGT) activity. Autosomal recessive. Increased unconjugated bilirubin (UCB). Jaundice during stress (sever infection)

Question 10

What is the etiology, laboratory findings, clinical features of Crigler-Najjar syndrome?

Answer 10

Absence of UDP glucuronosyltransferases (UGT) . Increased unconjugated bilirubin. Kernicterus; usual fatal.

Question 11

What is the etiology, laboratory findings, clinical features of Dubin-Johnson syndrome? Rotor syndrome?

Answer 11

Deficiency of bilirubin canalicular transport protein. Autosomal recessive. Increased conjugated bilirubin. Liver is dark. Rotor syndrome is the same but the liver is not dark.