Jaundice Flashcards
What is jaundice?
Yellowing of sclera and skin
What are the types of jaundice?
Pre-hepatic
Intra-hepatic
Post-hepatic
What is the cause of pre-hepatic jaundice?
Haemolytic anaemia
increased breakdown of red blood cells, haemaglobin, haem into unconjugated bilirubin
How does pre-hepatic jaundice affect bilirubin levels in the blood?
High unconjugated bilirubin in the blood
How jaundiced is a patient with pre-hepatic jaundice?
Mild jaundice, yellow tinge
How does pre-hepatic jaundice affect liver function?
Liver does more work
conjugates more bilirubin
excretes more conjugated bilirubin in bile
How does pre-hepatic jaundice affect urobilinogen? Why?
Increased urobilinogen in the gut, blood and urine
because more conjugated bilirubin in bile in gut
How does pre-hepatic jaundice affect urine? Why?
Normal urine
no conjugated bilirubin in the blood, none excreted into urine
How does pre-hepatic jaundice affect stercobilin? Why?
Increased stercobilin in the gut and faeces
because more urobilinogen in gut
How does pre-hepatic jaundice affect stools? Why?
Darker stools
increased stercobilin in the stools makes them darker
What is the cause of intra-hepatic jaundice?
Liver does not conjugate bilirubin, excrete conjugated bilirubin
How does intra-hepatic jaundice affect bilibrubin levels in the blood? Why?
Raised unconjugated bilirubin in the blood
raised conjugated bilirubin in the blood
back up into the blood
How jaundiced is a patient with intra-hepatic jaundice?
Moderate jaundice, orange tinge
How does intra-hepatic jaundice affect urobilinogen? Why?
Normal urobilinogen in gut, blood, urine
because some conjugated bilirubin enters the gut in bile
How does intra-hepatic jaundice affect urine? Why?
Darker urine
because conjugated bilirubin in the blood is excreted into the urine
is a brown colour
How does intra-hepatic jaundice affect stercobilin? Why?
Normal stercobilin in gut and faeces
because urobilinogen levels are normal
How does intra-hepatic jaundice affect stools? Why?
Normal
because normal stercobilin levels in the faeces
What is the cause of post-hepatic jaundice?
Biliary tree does not carry conjugated bilirubin in bile from the liver to the duodenum
How does post-hepatic jaundice affect bilirubin levels in the blood? Why?
Raised levels of conjugated bilirubin in the blood
because it backs up
How jaundiced is a patient with post-hepatic jaundice?
Severe jaundice, green tinge
How does post-hepatic jaundice affect urobilinogen?
Low levels of urobilinogen in the gut, blood, urine
because conjugated bilirubin isn’t entering the gut in bile
How does post-hepatic jaundice affect the urine? Why?
Darker urine
because conjugated bilirubin in the blood is excreted into the urine
is a brown colour
How does post-hepatic jaundice affect stercobilin?
Low levels of stercobilin in gut and faeces
because low levels of urobilinogen
How does post-hepatic jaundice affect stools?
Pale stools
because low levels of stercobilin in stools
What is a common symptom of post-hepatic jaundice? Why?
Pruritis
because bile salts back up in the blood, deposit in skin
What are some conditions that cause intra-hepatic jaundice?
Hepatitis
Cirrhosis
How are conjugated bilirubin levels in the urine measured?
Visibly by colour
Dipstick
How are urobilinogen levels in the urine measured?
Dipstick
What are some conditions that cause post-hepatic jaundice?
Biliary tree obstruction
