Jaundice

Question 1

jaundice

Answer 1

refers to yellowish tint to the body tissues including a yellowness of the skin and deep tissues

• normal bilirubin - 0.5 mg/dl
• abnormal conditions can go as high as 40 mg/dl
• skin begins to appear jaundiced when the conc is 3 times (1.5 mg/dl)

causes
- rbc destruction thus increased bilirubin in blood (hemolytic)
- obstruction of bile ducts or
- damaged liver cells so that even the usual amounts of bilirubin cannot be excreted in gut
(obstructive)

hemolytic

• excretory funct of liver is not impaired but the rbcs are hemolyzed so rapidly that the hepatic cells simply cannot excrete bilirubin as quickly as it is formed
• thus plasma concentration of free bilirubin rises above normal levels
• likewise rate of formation of urobilinogen in the intestine is greatly increased and much of this is absorbed into the blood and later excreted
• obstructive
• obstruction of bile ducts (often occurs when a gallstone or cancer blocks the common bile duct)
• or by damage to the hepatic cells and their swelling resulting in a block of the intercellular biliary canaliculi (hepatocellular jaundice or hepatitis)
• the rate of formation of bilirubin is normal but the bilirubin formed cannot pass from the blood to the intestines.
• the unconjugated bilirubin still enters the liver and becomes conjugated in the usual way
• now this conjugated bilirubin is then returned to the blood probably by the rupture of the canaliculi
• thus, most of the bilirubin in the plasma becomes the conjugated bilirubin type rather than the unconjugated type.