Jaundice Flashcards
What is jaundice
skin, whites of the eyes and mucous membranes turn yellow because of a high level of bilirubin
Normal values of serum bilirubin and its bilirubins
0.3-1 mg/dl
* Conjugated - 0.1 - 0.3
* Unconjugated - 0.2-0,7
What is bilirubin
Byproduct of the breakdown of hemoglobin
Unconjugated bilirubin
From the blood -> liver
Not soluble, Transported by albumin
Conjugated bilirubin
From the liver -> small intestine
Soluble
Metabolite that gives color to feces and urine
Urobilinogen
Causes of Hyperbilirubinemia from unconjugated bilirubin (2)
- There is increased production
- Decreased hepatic uptake / glucuronide conjugation - No transportation
Why is there Decreased hepatic uptake of indirect bilirubin (3)
○ Gilbert’s syndrome: deficiency of enzyme
○ Thalassemia: abnormal form of erythrocyte
○Drugs: damage the liver and hepatocyte works on something else
Causes of Hyperbilirubinemia from conjugated bilirubin (2)
- Hepatocellular disease: hepatocytes don’t work and don’t mix anything
- Cholestatic: there is a stone on the ducts
Why is there Hepatocellular disease? (4)
○ Viral: hepatitis - VHA - VHE
○ Alcohol
○ Drugs
○ Toxins
Hepatitis of fecal/oral route
A and E
Hepatitis of parenteral route
B, C and D
Why is there intrahepatic cholestatic jaundice? (2)
§ Primary biliary cirrhosis - you don’t find cause of jaundice
§ Non-hepatobiliary sepsis - portal vein may conduct sepsis from another place
Why is there extrahepatic cholestatic jaundice? (4)
§ Postoperative - something went wrong
§ Stones - pushes the duct from the inside
§ Primary sclerosing cholangitis
§ Tumor - pushes the duct from the outside
Charcot’s triad
Pain
Fever
Jaundice
