jaundice Flashcards
when does jaundice occur
when serum bilirubin is elevated
what does an increased breakdown of red cells lead to
increase in production of bilirubin
investigative results of haemolytic jaundice
- haemolysis
- elevated unconjugated bilirubin
- normal ALP
- normal albumin
what is Gilbert syndrome
familial uconjugated hyperbilirubinaemia
what is only treatment for congenital hyperbilirubinaemias
liver transplantation
what can acquired jaundice be split into
- extrahepatic
- intrahepatic
what is extrahepatic jaundice due to
large duct obstruction of bile flow at any point in the bililary tract
what does intrahepatic jaundice occur due to
failure of bile secretion
causes of intrahepatic jaundice
- hepatitis
- drugs
- alcoholic hepatitis
- cirrhosis
- autoimmune disease
- pregnancy
causes of extrahepatic jaundice
- duct stones
- carcinoma
- biliary stricture
- sclerosing cholangitis
- pancreatic pseudocyst t
what is seen clinically with jaundice
- pale stool
- dark urine
examples of causes in young people
- hepatitis
ask about drug and alcohol misuse
cause of jaundice in elderly
carcinoma
what does history of jaundice with prolonged weight loss in older patients suggest
malignancy
short history with illness of malaise suggest
hepatitis
outbreak of jaundice in community is
hep A
recent tattoo, IV drug user is
HBV and HCV
men having sex with men is
HCV
female sex worker is
HBV
jaundice with fever or rigors is
cholangitis or liver abscess
when is a smooth, tender liver seen
hepatitis
extrahepatic obstruction
what is knobbly, irregular liver suggest
metastases or cirrhosis
what does splenomegaly indicate
portal hypertension
when is the spleen tipped
viral hepatitis
when is ascites seen
cirrhosis
what does palpable gall bladder seen
carcinoma of pancreas
what does lympadenopathy suggest
lymphoma
what are cold sores seen with
herpes simplex virus hepatitis
what are 2 most useful tests to find cause of jaundice
- viral markers
- ultrasound examination
what does ultrasound demonstrate
- size of bile ducts
- level of obstruction
- cause of obstruction
how is pathological diagnosis made
fine-needle aspiration cytology
or
needle biopsy
what is liver biochemistry in hepatitis
AST and ALT are high
what is liver biochemistry in extrahepatic obstructtion
ALP is high
what is bilirubin like in haemolytic jaundice
raised
what does raised white cell count indicate
infection
