Jaundice Flashcards
What is the definition of jaundice?
What is the normal level of bilirubin in the body? What level causes clinical jaundice?
According to prof hill it is >70 for clinical signs of jaundice or 3x upper limit
Explain the production and excretion of bile.
What is meant by direct and indirect bilirubin? Which is fat soluble and which is water soluble?
How is each transported in the blood stream?
Indirect = Unconjugated = fat soluble = pre-hepatic mostly -> bound to albumin to be transported e.g. from spleen to liver
Direct = conjugated = water soluble = post-hepatic mostly -> hydrophilic => can move in the bloodstream freely (e.g. urobilinogen to kidneys)
Differentiate between pre, intra and post hepatic causes of jaundice in terms of LFTs.
|PRE
serum bilirubin only
|INTRA
serum bilirubin, AST, ALT, Lactate, gamma GT
|POST
Alk phos (significant increase), gamma GT (significant increase), Serum bilirubin
What are the causes of UNCONJUGATED jaundice?
This is separated into prehepatic and hepatic
Pre-hepatic = image (hemolysis section)
Hepatic = Crigler-Najjar + Gilbert
What are the causes of CONJUGATED jaundice?
Explain the pathophysiology and give causes of prehepatic jaundice.
Explain the pathophysiology and give causes of hepatocellular jaundice.
Explain the pathophysiology and give causes of post-hepatic jaundice. Include the symptoms expected.
Compare Gilbert’s Syndrome and Crigler Najjar Syndrome.
What question would you ask in a history on jaundice?
What is courvoisier’s law?
What exam findings will you be looking for in a case of jaundice?
What are some ddx for jaundice?
Why is it important to check the vitamin ADEK levels in jaundice?
What is the use of US abdo in jaundice?
What is the use of a contrast CT in the diagnosis of jaundice?
Why can a biopsy be useful in the diagnosis of jaundice?
What investigations would you order for any jaundice case?
What is the general management of jaundice?
What is the management of pruritus in the setting of hepatology?
What is the management of Haemolytic causes of jaundice?
What is the management of the hepatic causes of jaundice?
A patient has presented post liver transplant. What are the possible incision site scars that may indicate a liver transplant?
What is the management of the obstructive causes of jaundice?
Outline the full management of jaundice.
