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General Surgery > Jaundice > Flashcards

Jaundice Flashcards

1
Q

what bilirubin is present in the urine of prehepatic jaundice?

A

Urobilinogen

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2
Q

what bilirubin is present in the urine of hepatic jaundice?

A

Urobilinogen

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3
Q

what bilirubin is present in the urine of posthepatic jaundice?

A

No urobilinogen

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4
Q

what serum bilirubin is present in prehepatic jaundice?

A

Unconjugated bilirubin

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5
Q

what serum bilirubin is present in hepatic jaundice?

A

Conjugated and Unconjugated

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6
Q

what serum bilirubin is present in posthepatic jaundice?

A

Conjugated bilirubin

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7
Q

what are the levels of ALT and AST in prehepatic jaundice?

A

Normal

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8
Q

what are the levels of ALT and AST in hepatic jaundice?

A

Raised

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9
Q

what are the levels of ALT and AST in posthepatic jaundice?

A

Normal or moderately raised

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10
Q

what is the level of ALP in prehepatic jaundice?

A

Normal

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11
Q

what is the level of ALP in hepatic jaundice?

A

Normal or moderately raised

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12
Q

what is the level of ALP in posthepatic jaundice?

A

raised

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13
Q

what is the blood glucose level in prehepatic jaundice?

A

normal

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14
Q

what is the blood glucose level in hepatic jaundice?

A

low if liver failure

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15
Q

what is the blood glucose level in posthepatic jaundice?

A

raised in pancreatic tumour

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16
Q

what is the reticulocyte count in prehepatic jaundice?

A

raised in haemolysis

17
Q

what is the reticulocyte count in hepatic jaundice?

A

normal

18
Q

what is the reticulocyte count in posthepatic jaundice?

A

normal

19
Q

what is the haptoglobin level in prehepatic jaundice?

A

Low due to haemolysis

20
Q

what is the haptoglobin level in hepatic jaundice?

A

Normal or low if liver failure

21
Q

what is the haptoglobin level in posthepatic jaundice?

A

Normal

22
Q

what is the prothrombin time in prehepatic jaundice?

A

Normal

23
Q

what is the prothrombin time in hepatic jaundice?

A

Prolonged due to poor synthetic function

24
Q

what is the prothrombin time in posthepatic jaundice?

A

Prolonged due to vitamin K, malabsorption; corrects with vitamin K

25
Q

what will US show in prehepatic jaundice?

A

Normal

26
Q

what will US show in hepatic jaundice?

A

May be abnormal liver texture, e.g. cirrhosis

27
Q

what will US show in posthepatic jaundice?

A

dilated bile ducts

28
Q

what are the causes of prehepatic jaundice?

A

haemolysis (e.g. spherocytosis or incompatible blood transfusion)

29
Q

what is the pathophysiology of prehepatic jaundice?

A

Increased production of (unconjugated) bilirubin by the reticuloendothelial system exceeds the ability of the liver to conjugate; therefore, the unconjugated bilirubin accumulates in the blood. There is no increase in conjugated bilirubin in the blood, so none is found in the urine

30
Q

what are the causes of hepatic jaundice?

A

o Hepatitis – (A, B, C, E), leptospirosis, glandular fever (infectious mononucleosis)
o Cirrhosis
o Cholestasis from drugs – flucloxacillin, chlorpromazine
o Liver poisons – paracetamol overdose, chlorinated hydrocarbons,
o Liver tumours
o Sepsis

31
Q

what are the classification of causes of post hepatic jaundice?

A

location related to bile duct - within the lumen, within the wall, external compression

32
Q

what are the lumen obstructive causes of post hepatic jaundice?

A

gall stones

33
Q

what are wall pathology causes of post hepatic jaundice?

A

 Congenital atresia of the common bile duct
 Traumatic stricture
 Primary or secondary scleorisng cholangitis
 Tumour of the bile duct (cholangiocarcinoma)

34
Q

what are the external compression causes of post hepatic jaundice?

A

 Pancreas
 Tumour of the head of the pancreas
 Tumour of the ampulla of Vater
 Hilar lymphadenopathy

35
Q

what is the pathophysiology of hepatic jaundice?

A

In the presence of hepatocellular damage, the liver is unable to conjugate bilirubin efficiently, and less is excreted into the canaliculi. Thus, both unconjugated and conjugated bilirubin accumulate in the blood.

36
Q

what is the pathophysiology of posthepatic jaundice?

A

Obstruction prevents excretion of conjugated bilirubin

37
Q

what is the clinical features of post hepatic jaundice?

A

pale stools

dark urine

General Surgery (14 decks)

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