Jaundice Flashcards
What is the cause of jaundice?
High levels of bilirubin in the blood
What is bilirubin produced from?
Normal breakdown product of haem from destruction of RBCs
Where does conjugation of bilirubin take place?
Liver
Why is bilirubin conjugated?
To make it water soluble
What type of bilirubin is seen in pre-hepatic jaundice?
Unconjugated hyperbilirubinaemia
What is pre-hepatic jaundice?
Excessive RBC breakdown which overwhelms the livers ability to conjugate bilirubin
What is hepatocellular jaundice?
dysfunction of the hepatic cells.
• The liver loses the ability to conjugate bilirubin, but in cases where it also may become cirrhotic, it compresses the intra-hepatic portions of the biliary tree to cause a degree of obstruction.
What type of bilirubin is seen in hepatocellular jaundice?
• This leads to both unconjugated and conjugated bilirubin in the blood, termed a ‘mixed picture’.
What is post-hepatic jaundice?
• Post-hepatic jaundice refers to obstruction of biliary drainage.
Bilirubin can’t be excreted
What type of bilirubin is seen in post-hepatic jaundice?
Conjugated hyperbilirubinaemia
What are some causes of pre-hepatic jaundice? (3)
• Haemolytic anaemia
• Gilbert’s syndrome
• Criggler-Najjar syndrome
What are some causes of hepatocellular jaundice? (8)
• Alcoholic liver disease
• Viral hepatitis
• Iatrogenic, e.g. medication
• Hereditary haemochromatosis
• Autoimmune hepatitis
• Primary biliary cirrhosis
primary sclerosing cholangitis
HCC
What are some causes of post-hepatic jaundice? (3)
• Intra-luminal causes, such as gallstones
• Mural causes, such as cholangiocarcinoma, strictures, or drug-induced cholestasis
Extra-mural causes, such as pancreatic cancer or abdominal masses (e.g. lymphomas)
