Jaundice Flashcards
(Conjugated/unconjugated) bilirubin is released to plasma bound to albumin
unconjugated
Bilirubin is conjugated by ____ to make water soluble and excreted through bile to ____
hepatocytes
small intestine
Which on of the following is NOT a cause of jaundice?
A. Overproduction by reticuloendothelial system
B. Failure of hepatocyte uptake
C. Failure to conjugate or excrete
D. Obstruction of biliary excretion into colon
D. excretion into intestine
All of the following are causes of increased CONJUGATED bilirubin EXCEPT: A. Acute hepatitis B. Common bile duct stones C. Intra/extravascular hemolysis D. Cancer E. Infiltrative disorders (TB, lymphoma)
C. Intra/extravascular hemolysis causes increase in unconjugated bilirubin due to increased production.
Impaired conjugation also leads to increased unconjugated bilirubin (neonatal jaundice, liver disorders)
Jaundice in healthy young person with fever and malaise, think ____
viral hepatitis
If symptoms have gradually developed, think ____
cirrhosis
Acute jaundice with abdominal pain, must exclude ____
biliary obstruction
Painless jaundice in older person with weight loss, think ____
obstruction from malignancy
Hepatomegaly with pedal edema, JVD, gallop, think ____
CHF
ALT and AST reflects ___
injury to hepatocytes
AST/ALT ratio > 2 suggests ___
alcoholic liver disease
If normal AST/ALT with jaundice, consider ____
hemolysis or inherited disorders
Alkaline phosphatase, GGT reflects ____
biliary processes
Inc alk phos > AST/ALT reflects ____
cholestasis
Decreased albumin or increased INR suggestive of ____
advanced liver disease
