Causes Of Jaundice

Question 1

What is Jaundice?

Answer 1

• Clinical manifestation of increased Bilirubin in blood

- Yellow tint to sclera and skin

Question 2

How is Bilirubin made?

Answer 2

• At spleen, RBC split into Haem and Globin

- Haem-> Biliverdin-> Unconjugated Bilirubin (Then binds to albumin)

Question 3

The liver acts on Bilirubin conjugated to Albumin, to make it H2O soluble.

Where can the Bilirubin go?

Answer 3

1. Enters Enterohepatic circulation going round in circles as bile
2. Enter and stay in duodenum, becoming oxidised-> Stercobilin (Pigment that makes faeces brown)
3. Enters bloodstream-> Kidney then excreted in urine as Urobilinogen

Question 4

Compare the 3 classes of causes of jaundice

Answer 4

1. Pre-Hepatic: Too much Haem-> Unconjugated bilirubin
2. Hepatic: Reduced hepatocyte function
3. Post-Hepatic: Obstruction of bile ducts, more common form of jaundice, Conjugated bilirubin accumulates

Question 5

List 2 causes of Pre-Hepatic Jaundice

Answer 5

• Haemoglobinopathies (Increased RBC breakdown)

- Haemolysis

Question 6

Describe and list 2 causes of Hepatic Jaundice (reduced hepatocyte function)

Answer 6

1. Reduced hepatocyte function
2. Reduced conjugating ability-> Mix of Conjugated and Unconjugated bilirubin

• Chronic Liver disease
• Acute Liver damage

Question 7

How do stools and urine appear in Post-Hepatic Jaundice?

Why?

Answer 7

• Dark coloured urine
• Pale coloured stools
• Path to Gut is blocked so moe H2O-soluble conjugated Bilirubin goes to kidney to be excreted (as Urobilinogen)

Question 8

What are 4 causes of Post-Hepatic Jaundice?

Answer 8

• Gallstones in CBD
• Biliary Tree stricture (Scarring, narrowing etc)
• Enlargement of Head of Pancreas, which is painless (E.g Pancreatic Carcinoma)
• Intrahepatic duct obstruction (Inflammation, Oedema, Cirrhosis, Tumour)