Jaundice and Biliary Cases Flashcards
1
Q
Describe jaundice.
A
- Abnormalities in bilirubin production, handling and excretion
- Yellow pigmentation of skin, clerae and mucosa
2
Q
Is bilirubin lipid-soluble?
A
YES
3
Q
Name some sources of bilirubin.
A
- Haemoglobin catabolism in erythrocytes
- Turnover of non-erythrocyte haem in form of haemoproteins
4
Q
Describe bilirubin metabolism.
A
- Haemoglobin and myogloin in muscles - at SPLEEN
- Unconjugated bilirubin - bound to albumin in plasma
- Bilirubin becomes conjugated - joins with glucuronides at hepatocytes
- Converts to stercobilinogen/urobilinogen in urine - AT INTESTINES
5
Q
What are the 3 clinical subgroups of jaundice?
A
- PRE-HEPATIC
- HEPATOCELLULAR
- POST-HEPATIC
6
Q
What should be done with bilirubin in patients with hyperbilirubinemia?
A
Determine predominant type of bilirubin
7
Q
What should be asked in a history of a patient with jaundice?
A
- Medication history
- Family history
- Recreational drug use - especially IV
- Contact with other people with jaundice or known hepatitis
- Foreign travel
- Occupation
- Vaccinations
- Associated symptoms
8
Q
What should be looked for in an examination of a patient with jaundice?
A
- Hepatic encephalopathy
- Asterixis
- Dark yellow urine
- Palpable gall bladder and liver/spleen
- Signs of previous biliary tree surgery
- Pale stools on DRE
9
Q
Describe urinalysis in a patient with jaundice.
A
- Darker due to presence of bilirubin and/or urobilinogen
- More severe jaundice = more intense colour
10
Q
What is the normal total bilirubin level in blood?
A
Less than 17 umol/litre
