Jaundice

Question 1

What’s Jaundice?
What’s Cholestasis?

Answer 1

-yellowish discoloration of the sclerae , skin and mucus
membranes due to increased serum bilirubin.
-impaired production, secretion, or outflow of bile

Question 2

Causes?

Answer 2

➢Haemolysis; sickle cell disease, favism .

➢Obstruction or cholestasis; (dark urine, pale stool)
• Intrahepatic ; hepatitis , primary biliary cirrhosis.
• Extrahepatic ; gall stone, cancer pancreas.

➢Hepatocellular disease; hepatitis, cirrhosis , cancer, metabolic (Gilbert).

Question 3

What to ask?

Answer 3

• Dark urine? Pale stools? (Obstructive jaundice)
• skin itching (pruritus)?
• fever? (Cholangitis)
• change in appetite or weight? (Malignancy)
• vomiting of blood or passage of dark stools? (hepatocellular disease)
• recent contact with patients with jaundice or liver problems?
• travelled overseas to areas where hepatitis A is endemic? • Occupation; contact with hepatic toxins, health care workers.

Question 4

What’s Pruritus?

Answer 4

itching of the skin;
• Cholestatic liver disease; can cause pruritus that tends to be worse over the extremities.