Icterus Flashcards

1
Q

What are your differentials for prehepatic hyperbilirubinemia?

A

(Prehepatic = excessive RBC destruction → immune-mediated, toxin, and post-transfusion)

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2
Q

You have a patient that has hyperbilirubinemia and is icteric, what on your CBC might indicate it is prehepatic?

A

(Anemia)

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3
Q

What are some of the causes of hepatic hyperbilirubinemia?

A

(Toxicity, hepatitis, cirrhosis (rare), end-stage portosystemic shunts, microvascular dysplasia, secondary injury (such as hepatic lipidosis), and congenital deficiencies (such as copper storage dz))

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4
Q

What are some of the causes of post-hepatic hyperbilirubinemia?

A

(Biliary obstruction → gallbladder mucocele, cholelithiasis, pancreatitis, and tumors)

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5
Q

You have a patient that is icteric so obviously you run blood work and note hyperbilirubinemia and elevated ALT and AST values, is it prehepatic, hepatic, or post-hepatic?

A

(Hepatic, this would have just given it away but would probably also see decreased pseudofunction analytes (glucose, BUN, cholesterol, albumin))

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6
Q

You have a patient that is icteric so obviously you run blood work and note hyperbilirubinemia and elevated ALP values, is it prehepatic, hepatic, or post-hepatic and what further diagnostics might be especially helpful in confirming it?

A

(Post-hepatic, and ultrasound is good for post hepatic as you can look for a distended common bile duct)

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