jaundice

Question 1

whis is raised in pre hepatic

Answer 1

unconjugated bilirubin

Question 1

prehepatic

Answer 1

increased breakdown of haemoglobin into haem and globin so liver cannot conjugate fast enough

Question 2

unconjugated biliruibn assoc

Answer 2

not water soluble

Question 3

complication of solubility of unconjugated bilirubin

Answer 3

means it cant enter the urine

Question 4

causes of prehepatic

Answer 4

gilberts, haemolytic anaemia, drugs; rifampicin

Question 5

hepatic

Answer 5

liver unable/ reduced capacity for forming unconjugated and conjugated bilirubin

Question 6

what is raised in hepatic

Answer 6

both conjugated and unconjugatedc

Question 7

causes of hepatic

Answer 7

• Viruses (hepatitis, CMV, EBV)
• Drugs, including paracetamol overdose, nitrofurantoin, halothane, valproate, statins, tuberculosis antibiotics
• Alcohol
• Cirrhosis
• Liver mass (abscess or malignancy)
• Haemochromatosis
• Autoimmune hepatitis
• Alpha-1 antitrypsin deficiency
• Budd-Chiari
• Wilson’s disease

Question 8

post hepatic

Answer 8

liver can conjugated bilirubin but cant excrete it

Question 9

what does post hepatic result in

Answer 9

rise in insoluble conjugated hyperbilirubin, which is then unable to pass into gut

Question 10

what does post hepatic cause

Answer 10

pale stools and dark urine

Question 11

post hepatic causes

Answer 11

• Primary biliary cirrhosis
• Primary sclerosing cholangitis
• Common bile duct gallstones or Mirrizi’s syndrome (CBD compression from a gallstone in the cystic duct)
• Drugs, including coamoxiclav, flucloxacillin, steroids, sulfonylureas
• Malignancy, such as head of the pancreas adenocarcinoma, cholangiocarcinoma
• Caroli’s disease
• Biliary atresia

Question 12

urobilinogen

Answer 12

a colorless pigment produced in the gut from the metabolism of bilirubin.

Question 13

bilirubin

Answer 13

a yellowish pigment that is made during the breakdown of red blood cells.