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Liver and Friends > Jaundice > Flashcards

Jaundice Flashcards

1
Q

How are red blood cells converted to Unconjugated bilirubin @ Spleen

A

RBC -> HAEM and Globin
HAEM -> BILIVERDIN and Fe
BILIVERDIN -> UNCONJ. BILIRUBIN

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2
Q

How is Biliverdin converted to Unconj. Bilirubin

A

Biliverdin reductase

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3
Q

What is a RBC broken down into

A

Haem and Globin

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4
Q

What is haem broken down into

A

Biliverdin and Iron

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5
Q

Biliverdin reductase converts what to what

A

Biliverdin to unconj.Bilirubin

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6
Q

How does Unconj. Bilirubin travel to the liver

A

UCB binds to Albumin

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7
Q

Where is UCB converted to Con Biliribuin

A

Liver

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8
Q

How is UCB converted to Con B at the liver

A

UGT and Glucorinic Acid

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9
Q

Which enzyme is used to convert UCB to Con Bilirubin w/ the addition of Glucorininc acid

A

UGT

-UDP Glucoronyl Transferase

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10
Q

What does Con Bilirubin become at the colon

A

Urobilinogen by Colonic Flora

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11
Q

How does Con Bilirubin travel to Colon to become Urobilinogen

A

Via CBD

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12
Q

What are the two products of Urobilinogen at the colon

A

Stercobilin (Brown shit)

Urobilin (Yellow Piss)

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13
Q

What is jaundice also known as

A

Icterus

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14
Q

Why does jaundice present as yellowed skin and eyes

A

Accumulation of UCB and Con bilirubin

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15
Q

What are the three types of causes for jaundice

A 
Pre hepatic (Haemolytic anaemia)
Hepatic (Parenchymal disease)
Post Hepatic (Billiary obstruction)
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16
Q

Pre hepatic jaundice is due to raised…….

A

UCB due to RBC Breakdown (Haemolytic)

17
Q

Intrahepatic jaundice is due to raised……

A

UCB and Con Bilirubin

18
Q

Post hepatic Jaundice is due to raised…..

A

Con Bilirubin due to Biliary obstruction

19
Q

What are some anaemias responsible for Prehepatic jaundice

A

Haemolytic

  • SCD and Malaria
  • G6PDH deficiency
  • Autoimmune
  • Thalassemia
20
Q

What are some parenchymal diseases responsible for Intrahepatic Jaundice

A 
HCC
ALD/NAFLD
Hepatitis 
Rifampicin
Gilbert syndrome
21
Q

What is Gilbert Syndrome

A

Aut Recessive mutation of the UGT1A1 gene

-Defective UGT = Less Con Bilirubin

22
Q

In Gilbert syndrome less Con Bilirubin is produced why

A

Mutated UGT1A1 gene = Defective UGT

23
Q

What is the most common sign of Post hepatic Jaundice

A

Pale stool

Dark Urine

24
Q

What are some Biliary tree pathologies responsible for Post hepatic Jaundice

A 
Choleodocolithiasis (Stone in CBD)
Pancreatic cancer
Cholangiocarcinoma
Ampicillin
PBC and PSC
Mirizzi Syndrome
25
Q

What is Mirizzi syndrome

A

Gallstones in Gallbladder neck compressing the CBD

26
Q

Why is there dark urine and pale stools in post hepatic/obstructive jaundice

A

Increased Con Bilirubin in blood / less in Intestine

  • Sterocobilin (Pale)
  • Urobilin (Dark)
27
Q

What is the typical presentation of a patient with Gilbert syndrome

A

Young male with painless, sudden jaundice

28
Q

What is the Courvoisier sign in Jaundice

A

Painless jaundice w/ Palpable Gallbladder

-Most likely Pancreatic Cancer/Cholangiocarcinoma

29
Q

What is the Charcot’s triad

A

Fever
RUQ pain
Jaundice

30
Q

Bilary colic presents with what symptom found in the Charcot’s triad

A

RUQ pain

31
Q

What triad is present in a patient with Ascending cholangitis

A

Charcot (Fever RUQ Jaundice)

32
Q

How can you differentiate a patient with cholecystitis and Ascending Cholangitis

A

Cholecystitis has no jaundice

33
Q

What is the Reynold Pentad

A

Ascending Cholangitis

  • Fever
  • RUQ Pain
  • Jaundice
  • Confusion
  • Hypotension
34
Q

What is the Murphy sign

A

Tender RUQ

“breathe while pressing RUQ” Pain = Cholecystitis

35
Q

How can Jaundice be investogated

A

Blood and LFT
Urine Bilirubin/Urobilinogen
USS

36
Q

Urine bilirubin is raised in what instance

A

Post hepatic Jaundice

37
Q

Urobilinogen is raised and lowered in what instances

A 
Raised = Haemolysis
Low = Intra and Post Hepatic

Liver and Friends (27 decks)

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