Jaundice | Cheat Sheet

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

154

Pages:

3
Author:

Mariam A. A.

Jaundice Definitions Jaundice: yellow discolouration Cholestasis: impaired production, secretion or outflow of bile Types and Causes Prehepatic Unconjugated hyperbilirubinemia Most commonly due to haemolysis Mechanism Causes G6PD deficiency RBC structural defects e.g. sickle cell anaemia, hereditary spherocytosis Haemolysis Autoimmune haemolytic anaemia Haemolytic transfusion Thalassemia Ineffective erythropoiesis Pernicious anaemia Sideroblastic anaemia Increased bilirubin production Massive blood transfusions Rifampin Side effects from medications Protease inhibitors Intrahepatic May be conjugated or unconjugated hyperbilirubinemia Unconjugated Conjugated Mixed Dublin-Johnson syndrome TB Gilbert’s syndrome Sarcoidosis Viral hepatitis TPN Crigler-Najjar syndrome Liver disease e.g. alcohol associated hepatitis, MASH, cirrhosis et, Willison disease, Intrahepatic biliary diseases e.g. primary autoimmune hepatitis etc. biliary cholangitis, primary sclerosing cholangitis Malaria Post-Hepatic Conjugated hyperbilirubinemia Caused by extrahepatic cholestasis from biliary obstruction Mechanism Causes Cholangiocarcinoma Pancreatic cancer Liver cancer Malignancy Gallbladder cancer Ampullary cancer Liver metastasis Cholelithiasis Choledocholithiasis Gallbladder and gallstones Cholangitis Postoperative bile leaks or biliary strictures Primary sclerosing cholangitis Inflammatory processes Acute and chronic pancreatitis AIDS cholangiopathy Infection Liver flukes Ascariasis Clinical features Jaundice Scleral icterus -> when levels are more than 2-3 mg/dL Skin discoloration -> when levels are more than 4-5 mg/dL RUQ pain Unconjugated Features of anaemia Pallor, fatigue and exertional dyspnoea Conjugated – it is water soluble -> so can get into urine and faeces Pale and clay coloured stools -> acholic Dark urine Chronic obstruction -> bile backflow -> inflammation and hepatomegaly Pruritus Features of fat malabsorption Weight loss Steatorrhea Features of acute liver failure Anorexia, fatigue, nausea and abdominal pain Perform a GIT exam Look for features of liver disease e.g. hepatomegaly Perform a hematology exam Look for features of anaemia