Jaundice Flashcards
Conjugated hyperbilirubinemia due to? Markers?
Hepatocellular disease (elevated AST and ALT) or biliary obstruction (alk phos)
Unconjugated hyperbilirubinemia? Causes?
Conjugated fraction <15% total
Hemolysis, Gilbert
Hemolysis/Gilbert: Bilirubin? Aminotransferases? Alk phos? Albumin? PT?
Indirect bilirubinemia, normal, normal, normal, normal
Acute hepatocellular necrosis: Bilirubin? Aminotransferases? Alk phos? Albumin? PT?
Bilirubinemia and bilirubinuria, ALT >AST >500, 5x normal)
Chronic hepatocellular disorders: Bilirubin? Aminotransferases? Alk phos? Albumin? PT?
Bilirubinemia and bilirubinuria, <3x normal values, decreased, prolonged and does not correct with vitamin K
Obstructive jaundice: Bilirubin? Aminotransferases? Alk phos? Albumin? PT?
Bilirubinemia and bilirubinuria, 4x normal elevation, normal, will correct with vitamin K
Infiltrative diseases or partial bile duct obstruction: Bilirubin? Aminotransferases? Alk phos? Albumin? PT?
Normal, normal, >4x normal, normal, normal
Patient with suspected biliary obstruction – test?
US
Extrahepatic dilatatiob without evidence of stones – test?
CT or ERCP
Strictures can result from?
1 PSC and PBC
2 surgery
3 pancreatitis
4 AIDS
PSC vs PBC: Age? Location? Associated conditions? Serologic markers? Complications?
Young males versus old females
Large intra/extra hepatic ducts versus small intrahepatic ducks
UC versus RA
None versus hentai mitochondrial antibody
Stricture/cholangitis/cholangiocarcinoma versus cirrhosis
Work up for patient with strictures but no history of surgery?
Look for cancer:
1 RUQ US to look at biliary tree
2 CT scan to visualize pancreas
3 FNA biopsy
Possible cure for pancreatic cancer?
Whipple procedure (pancreaticoduodenectomy)
