Jaundice Flashcards
What is jaundice and what is it’s cause?
Yellowing of the skin, sclera and mucosa due to increased plasma bilirubin
What are the three types of jaundice?
Pre hepatic
Hepatocellular
Obstructive (post hepatic)
How is bilirubin formed?
The breakdown of haemoglobin
Is bilirubin water soluble?
No
How does the liver hepatocytes make bilirubin water soluble?
Conjugating it with glucaronic acid
What 2 things can happen to conjugated bilirubin in the gut?
Can be reabsorbed
Converted by gut organisms to the brown colour of faeces
What is the aetiology of pre hepatic jaundice?
Increased bilirubin production
Decreased liver uptake
What is different about pre hepatic jaundice compared with hepatocellular and obstructive?
The circulating bilirubin is unconjugated
- Unconjugated hyperbilirubinaemia
What are the causes of pre hepatic jaundice?
Physiological
- Neonates
Haemolysis
What is the aetiology of hepatocellular jaundice?
Hepatocyte damage
Name a few of the many causes of hepatocellular damage?
Viruses
Cirrhosis
Liver cancer
Hereditary haemochromatosis
Leptospirosis
What is the aetiology of obstructive jaundice?
Blocked bile duct
What are the symptoms of obstructive jaundice?
Dark urine
Pale stool
Pruritis
What are the main causes of obstructive jaundice?
Gallstones PSC PBC Cholangiocarcinoma Biliary atresia Pancreatic cancer Drugs
What is Courvisier’s law?
The prescence of obstructive painless jaundice with an enlarged, palpable gallbladder but NO PAIN suggests a cause that isn’t gallstones
