Jaundice

Question 1

When is jaundice clinically detectable?

Answer 1

Plasma bilirubin > 40

Question 2

What is prehepatic jaundice?

Answer 2

• Caused by haemolysis or congenital hyperbilirubinaemia
• Isolated raised bilirubin

Question 3

Describe a cause of congenital hyperbilirubinaemia?

Answer 3

• Gilbert’s syndrome
  
  • Autosomal dominant or recessive
  • Mild jaundice, especially when fasting

Question 4

Describe hepatocellular jaundice?

Answer 4

• Inability of the liver to convert bilirubin to bile
  
  • Due to parenchymal disease
• Concentrations of both unconjugated and conjugated bilirubin rise

Question 5

Describe Obstructive (cholestatic) jaundice?

Answer 5

• Can be caused by:
  
  • Failure of hepatocytes to initiate bile flow
  • Obstruction of the bile ducts
  • Obstruction of bile flow in the extrahepatic bile ducts
• Elevated conjugated bilirubin

Question 6

Clnical features of cholestatic jaundice?

Answer 6

• Itchy jaundice
• Dark urine, pale stools
• Malabsorption signs

Question 7

Investigation pathways of jaundice

Answer 7