jaundice

Question 1

when does jaundice occur

Answer 1

when serum bilirubin is elevated

Question 2

what does an increased breakdown of red cells lead to

Answer 2

increase in production of bilirubin

Question 3

investigative results of haemolytic jaundice

Answer 3

• haemolysis
• elevated unconjugated bilirubin
• normal ALP
• normal albumin

Question 4

what is Gilbert syndrome

Answer 4

familial uconjugated hyperbilirubinaemia

Question 5

what is only treatment for congenital hyperbilirubinaemias

Answer 5

liver transplantation

Question 6

what can acquired jaundice be split into

Answer 6

• extrahepatic

- intrahepatic

Question 7

what is extrahepatic jaundice due to

Answer 7

large duct obstruction of bile flow at any point in the bililary tract

Question 8

what does intrahepatic jaundice occur due to

Answer 8

failure of bile secretion

Question 9

causes of intrahepatic jaundice

Answer 9

• hepatitis
• drugs
• alcoholic hepatitis
• cirrhosis
• autoimmune disease
• pregnancy

Question 10

causes of extrahepatic jaundice

Answer 10

• duct stones
• carcinoma
• biliary stricture
• sclerosing cholangitis
• pancreatic pseudocyst t

Question 11

what is seen clinically with jaundice

Answer 11

• pale stool

- dark urine

Question 12

examples of causes in young people

Answer 12

• hepatitis

ask about drug and alcohol misuse

Question 13

cause of jaundice in elderly

Answer 13

carcinoma

Question 14

what does history of jaundice with prolonged weight loss in older patients suggest

Answer 14

malignancy

Question 15

short history with illness of malaise suggest

Answer 15

hepatitis

Question 16

outbreak of jaundice in community is

Answer 16

hep A

Question 17

recent tattoo, IV drug user is

Answer 17

HBV and HCV

Question 18

men having sex with men is

Answer 18

HCV

Question 19

female sex worker is

Answer 19

HBV

Question 20

jaundice with fever or rigors is

Answer 20

cholangitis or liver abscess

Question 21

when is a smooth, tender liver seen

Answer 21

hepatitis

extrahepatic obstruction

Question 22

what is knobbly, irregular liver suggest

Answer 22

metastases or cirrhosis

Question 23

what does splenomegaly indicate

Answer 23

portal hypertension

Question 24

when is the spleen tipped

Answer 24

viral hepatitis

Question 25

when is ascites seen

Answer 25

cirrhosis

Question 26

what does palpable gall bladder seen

Answer 26

carcinoma of pancreas

Question 27

what does lympadenopathy suggest

Answer 27

lymphoma

Question 28

what are cold sores seen with

Answer 28

herpes simplex virus hepatitis

Question 29

what are 2 most useful tests to find cause of jaundice

Answer 29

• viral markers

- ultrasound examination

Question 30

what does ultrasound demonstrate

Answer 30

• size of bile ducts
• level of obstruction
• cause of obstruction

Question 31

how is pathological diagnosis made

Answer 31

fine-needle aspiration cytology
or
needle biopsy

Question 32

what is liver biochemistry in hepatitis

Answer 32

AST and ALT are high

Question 33

what is liver biochemistry in extrahepatic obstructtion

Answer 33

ALP is high

Question 34

what is bilirubin like in haemolytic jaundice

Answer 34

raised

Question 35

what does raised white cell count indicate

Answer 35

infection