Jaundice Flashcards
Pre-Hepatic Causes
Haemolysis
- Hereditary Spherocytosis - G6PD deficiency - Malaria
Thalassaemia
- B major - Trait
Hepatic: Unconjugated Causes
CCF
Hypothyroid
Gilbert’s Syndrome
Crigler-Najjar
Hepatic: Conjugated Causes
Wilson's Disease Hepatitis A, B, C Alcohol HCC or liver mets Budd chiari
Post-Hepatic Causes
Gallstones Cholangitis Primary Sclerosing Cholangitis Biliary Atresia Lymphadenopathy Cholangiocarcinoma Pancreatic Ca Duodenal Ca
Iatrogenic Causes
Pre: antimalarials (haemolysis)
Hepatic: statins, paracetamol, valproate
Post: Cholestasis - fluclox, co-amox, OCP, sulphonylureas
Pre-hepatic
- Urine Results
Urine
- Urobilogen ++
- Blood + (haemolytic)
Pre-Hepatic
- LFT Results
Unconjugated bilirubin
AST ++
LDH ++
Hepatic
- Urine Results
Urobilinogen ++
Bilirubin +
Hepatic
- LFT Results
Conjugated Bilirubin ++
AST and ALT +++
ALP +, GGT+ (alcohol)
Function:
low albumin, prolonged PTT
Post Hepatic
- Urine Results
Bilirubin +++
Post-Hepatic
- LFT Results
Conjugated Bilirubin +
ALP +++
ALT+, AST+, GGT+
RED FLAGS
Painless Jaundice = Pancreatic Ca
Weight loss, fevers, RUQ pain, splenomegaly, ascites
Social Hx
Travel, IVDU, malaria exposure
Alcohol, smoking
Fatty foods (gallstones)
High meat diet
Family Hx
Haemolysis/Bleeding Thrombophilia (budd chiari) Diabetes Thyroid/Autoimmune disease Bowel Ca: HPNCC, FAP
System R/V
Change in Bowel habit: IBD
Pale stools, dark urine = obstructive
Fevers, N&V
