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Z Year3 Gastro Conditions > Jaundice > Flashcards

Jaundice Flashcards

1
Q

What are reticuloendothelial cells?

A

macrophages which are responsible for the maintenance of the blood, through the destruction of old or abnormal cells

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2
Q

What is the role of reticuloendothelial cells?

A

take up red blood cells and metabolise the haemoglobin present into its individual components; haem and globin

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3
Q

What is globin broken down into?

A

amino acids which are subsequently recycled

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4
Q

What is haem broken down into?

A

iron and biliverdin, a process which is catalysed by haem oxygenase

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5
Q

What happens to the iron and bilverdin?

A
  1. iron gets recycled

2. biliverdin is reduced to create unconjugated bilirubin

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6
Q

What happens to the unconjugated bilirubin in the bloodstream?

A

binds to albumin to facilitate its transport to the liver

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7
Q

What happens to unconjugated bilirubin in the liver?

A

glucuronic acid is added to unconjugated bilirubin by the enzyme glucuronyl transferase forming conjuagted bilirubin

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8
Q

What happens to the conjugated bilirubin?

A
  • it is soluble

- excreted into the duodenum in bile.

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9
Q

What happens to the conjugated bilirubin in the colon?

A

colonic bacteria deconjugate bilirubin and convert it into urobilinogen

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10
Q

What happens to 80% of urobilingoen?

A
  1. oxidised by intestinal bacteria and converted to stercobilin and then excreted through faeces
  2. stercobilin which gives faeces their colour
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11
Q

What happens to 20% of urobilinogen?

A

reabsorbed into the bloodstream as part of the enterohepatic circulation and taken to liver and some to kidneys

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12
Q

What happens to the urobilingoen in the kidneys?

A

oxidised further into urobilin and then excreted into the urine

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13
Q

What are the pre-hepatic causes of jaundice?

A
  1. Haemolysis

2. Gilberts syndrome

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14
Q

What is gilberts syndrome?

A

UDPGT not effecting as usual at conjugating bilirubin (common)

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15
Q

What are the signs of pre-hepatic jaundice?

A

normal urine or dark in haemolysis

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16
Q

What type of bilirubin is there in pre-hepatic jaundice?

A

unconjugated

17
Q

What levels are raised in pre-hepatic jaundice?

A

only bilirubin

18
Q

What are the causes of hepatocellular jaundice?

A
  1. Hepatitis: viral, alcoholic, AI, drug
  2. Hepatocyte damage/hepatic picture
  3. Cirrhosis
19
Q

What do blood tests show in hepatocellular jaundice?

A

Raised AST/ALT

20
Q

What are causes of obstructive jaundice?

A
  1. Liver mass
  2. Gallstone
  3. PBC/PSC
  4. Pancreatic cancer
  5. Cholangiocarcinoma/GB cancer
  6. Drug (ileus)
21
Q

What type of bilirubin is common in obstructive jaundcie?

A

conjugated bilirubin

22
Q

What are the signs in obstructive/cholestasis jaundice?

A
  1. Dark urine (conj bilirubin going into urine)
  2. pale stools (lack of stercobilin)
  3. pruritus (bile salts into circulation)
23
Q

What are blood test results in obstructive jaundice?

A
  1. Raised ALP/GGT

2. Bile duct damage/obstructive picture

24
Q

Why does urine turn dark>

A

when conjugated bilirubin (which is dark) gets into it, i.e., when there is some form of hepatocellular or post-hepatic jaundice

25
Q

Why is there itching in obstructive jaundice?

A

bile salts produced in the liver are also blocked from entering the duodenum so they leak into the circulation and causing itching (pruritus), which make be accompanied by scratch marks

26
Q

What are symptoms of Gilbert’s?

A

healthy just turn jaundice in times of stress

27
Q

Where is bile produced?

A

hepatocytes in the liver

28
Q

Where is bile stored?

A

travels via hepatic ducts to gallbladder

29
Q

How does Bile enter the small intestine?

A

contractions of the gallbladder facilitate delivery of bile into the duodenum through the Ampulla of Vater

30
Q

What is the main function of bile?

A

emulsify fats to allow digestion and absorption – a lack of bile salts will therefore cause malabsorption of lipids which includes fat soluble vitamins such as ADEK

31
Q

What is the anatomical duct situation?

A
  1. left and right hepatic ducts fuse to form common hepatic duct
  2. common hepatic duct fuses with cystic duct (that comes from gallballder) to form the common bile dict
32
Q

What does the common bile duct fuse with?

A

fuses with the main pancreatic duct which carries other enzymes needed for digestion and this flows into duodenum

33
Q

What are causes of post-hepatic Jaundice?

A
  1. Gallstones
  2. Cholangitis
  3. Pancreatic cancer
  4. Bile duct cancer
  5. PBC/PSC

Z Year3 Gastro Conditions (48 decks)

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