jaundice (Daiyan watch osmosis for this too) Flashcards
what is jaundice
raised serum bilirubin presenting as yellowing of the skin, sclera and mucous membranes
what is unconjugated bilirubin also known as
pre heptatic
what is conjugated bilirubin also known as
cholestatic
3 types of jaundice
pre hepatic
hepatic
post hepatic
prehepatic jaundice would appear as
normal urine
normal stools
no itching
normal liver tests
hepatic and post hepatic jaundice would present as
dark urine
pale stools
may be itchy
abnormal liver tests
Investigations for jaunduce
-liver enzymes
- biliary obstruction
what would liver enzyme test show for jaundice
very high AST/ ALT
risk factors for gallstones
fat female forty fertile
types of gall stones
intrahepatic bile duct stones
gall bladder stones
extrahepatic bile duct stones
presentation of gall bladder gall stones
biliary pain
cholecysticis
maybe obstructive jaundice
no pancreatitis or choloangitis
presentation of bile duct gall stones
biliary pain
no cholecystitis
obstructive jaundice
cholangitits and pancreatitis
management of gallbladder stones
Laparoscopic cholecystectomy
- Bile acid dissolution therapy (<1/3 success)
management of bile duct stones
- ERCP with sphincterotomy and: removal (basket or balloon) crushing (mechanical, laser..) placement
- Surgery (large stones)
Causes of ascites
chronic liver disease
+/- PORTAL VEIN thrombosis
hepatoma
TB
pathogenesis of ascites
increased intrahepatic resistance
most common complication of liver disease
Ascites
hepatocellular jaundice results from…?
an inability of the liver to excrete and or conjugate bilirubin as a result of liver tissue damage
Cholestatic Jaundice is a result of
obstruction in the bile duct
describe the normal pathway of bilirubin pathway
RBC broken down int haem and globin
Haem further broken into Fe and PTP
PTP is converted to unconjugated b - FAT SOLUBLE
albumin binds to take this to the liver
Glucoronyl transfers converts this to conjugated b
stored in gall bladder via bile duct
