Jaundice Flashcards
Cause
Altered metabolism of bilirubin due to increased circulating bilirubin
3 phases of metabolism pathway of bilirubin
Pre-hepatic
Hepatic
Post-hepatic
Pre-hepatic stage of bilirubin metabolism pathway
Haem from broken down haemoglobin is converted into bilirubin in the spleen then released into the circulation
Hepatic stage of bilirubin metabolism pathway
Hepatocytes take up and conjugate bilirubin then excrete it into the biliary system
Post-hepatic stage of bilirubin metabolism pathway
Conjugated bilirubin transported in biliary system to the small intestines, is broken down in the small intestines and then re-absorbed by enterocytes and taken back to liver
Pre-hepatic jaundice cause
Increased haemoglobin release from red blood cells (haemolysis)
Hepatic jaundice cause
Cholestasis
Intra-hepatic duct obstruction
Cholestasis
Accumulation of bile within hepatocytes or bile canaliculi
Causes of cholestasis
Viral hepatitis
Alcoholic hepatitis
Liver failure
Drugs
Cause of intra-hepatic duct obstruction
Primary biliary cholangitis
Primary sclerosing cholangitis
Tumours of liver
Different liver tumours
Hepatocellular carcinoma
Cholangiocarcinoma
Metastatic
Primary biliary cholangitis
Organ-specific autoimmune disease
Measurements in serum for identifying primary biliary cholangitis
Anti-microbial auto-anitbodies
Raised alkaline phosphatase
Pathology of primary biliary cholangitis
Granulomatous inflammation of bile ducts - loss of intra-hepatic bile ducts - cirrhosis
Primary sclerosis cholangitis
Chronic inflammation and fibrous obliteration of intra-hepatic bile ducts
