Obstructive jaundice Flashcards

1
Q

what is obstructive jaundice also known as

A

cholestatic jaundice

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2
Q

Define obstructive jaundice

A

when there is a mechanical blockage of bile flow from the liver to the duodenum, leading to the accumulation of conjugated bilirubin in the bloodstream.

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3
Q

Clinical features of obstructive jaundice

A
  • Jaundice: Yellow discoloration of the skin and sclera.
  • Dark Urine: Due to increased excretion of conjugated bilirubin.
  • Pale/Clay-Colored Stools: Due to the absence of stercobilin in the stool.
  • Pruritus: Accumulation of bile salts.
  • Abdominal Pain: Often in the right upper quadrant (RUQ) or epigastrium.
  • Weight Loss and Fat Malabsorption: Due to impaired bile salt secretion.
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4
Q

Causes of bbstructive jaundice can be divided into 3 categories

A
  1. Intraluminal causes
  2. Mural causes
  3. Extrinsic causes
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5
Q

Intraluminal Causes of Obstructive Jaundice

A
  • Gallstones (Choledocholithiasis) – Stones in the common bile duct (CBD).
  • Mirizzi Syndrome - gallstone becomes impacted in the cystic duct or Hartmann’s pouch of the gallbladder, causing external compression of the common hepatic duct (CHD) or common bile duct (CBD)
  • Biliary Sludge – Thickened bile causing partial obstruction.
  • Parasites – Ascaris or Clonorchis causing obstruction.
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6
Q

Mural Causes of Obstructive Jaundice

A
  • Cholangiocarcinoma – Cancer arising from the bile ducts.
  • Biliary Strictures – Benign or malignant strictures narrowing the bile ducts.
  • Primary Sclerosing Cholangitis (PSC) – Chronic inflammation and fibrosis of the bile ducts.
  • Post-surgical or Post-inflammatory Strictures – After cholecystectomy or bile duct injury.
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7
Q

Extrinsic Causes of Obstructive Jaundice

A
  • Pancreatic Cancer – Compression of the distal CBD by the tumor.
  • Periampullary Tumor – Tumors at the ampulla of Vater.
    Enlarged Lymph Nodes (e.g., Metastatic Disease) – Compression of the bile ducts.
  • Chronic Pancreatitis – Fibrosis causing biliary obstruction.
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8
Q

Tx for biliary strictures

A

ERCP with stenting

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9
Q

Obstructive picture of LFTs

A
  • sig. raise of ALP
  • slightly raised ALT/AST
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10
Q

Hepatic picture of LFTs

A
  • sig. raise of ALT/AST
  • slightly raise of ALP
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10
Q

what systems are ALP assoc with

A
  • Liver
  • Biliary
  • Bones
  • Placenta (pregnancy)
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11
Q

what is AST/ALT assoc. with

A

Hepatocellular injury (Liver cells damage)

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