icr: jaundice Flashcards
cirhhosis causes
portal hypertension
final product of heme breakdown?
bilirubin
unconjugated bilirubin is water _____
insoluble — has to attach to albumin for transport
conjugation of bilirubin
unconjugated bilirubin is conjugated at the ER by the enzyme uridine diphosphate glucuronosyltransferase (UDP-GT)
after, bilirubin is water soluble
direct fraction =
conjugated bilirubin
indirect fraction =
u-bilirubin
PBC is more common in ___ and PSC in ___
females; males
pain radiating to the back indicates
pancreatic cancer or chronic pancreatitis
1-2 weeks before viral hepatitis you see
prodrome = anorexia, malaise, nausea, low grade fever, and arthritis
pruritis suggests
obstructive/cholestatic process
bilirubin binds to
elastin –> sclera is high in elastin so this causes scleral icterus
kayser Fleischer rings
copper deposit in lens of eye = wilsons disease
xanthoma
fat deposition = biliary sirrhosis
gynecomastia
chronic liver disease
caput medusa
superficial vein pattern near umbilicus –> portal hypertension
courvoisiers sign
distended gallbladder, nontender, and jaundice
NOT stones –> likely malignancy of gallbladder or pancreas
telangiectasia
spider veins –> cirrhosis or oral contraceptives can cause them
gilberts syndrome
AD, decreased activity of UDP-GT –> elevated u-bilirubin
evident jaundice in stress
crigler najjar
absence of UDP-GT –> fatal!
choledocolithiasis
stones in the common bile duct
PSC
primary sclerosing cholangitis inflammatory thickening/fibrosis of larger bile ducts immune system mediated young males associated with UC risk for cholangiocarcinoma
PBC
primary biliary sirrhosis autoimmune destruction of small bile ducts mid age females elevated alk phos \+AMA
ALT vs AST
AST is more sensitive for alcoholic cause
alk phos
indicated cholestatic process
