Jaundice

Front 1

What is jaundice?

Back 1

Yellow discolouration that is secondary to hyperbilirubinaemia

Front 2

Where is jaundice best seen?

Back 2

The Sclera and mucus membranes of the mouth

Front 3

What is unconjugated bilirubin?

Back 3

Originate from splenic macrophages and bound to albumin.

It is NOT water soluble

Front 4

What is conjugated bilirubin?

Back 4

Bilirubin that was unconjugated, but has been attached to glucoronic acid.

The conjugation with the acid makes it water soluble, allowing it to enter the colon and breakdown fat.

Front 5

What causes Unconjugated Hyperbilirubinaemia?

Back 5

1) Excess unconjucated bilirubin production
Haemolysis or Extravasation

2) Impaired hepatic uptake

Portosystemic shunt, HF, some drugs

3) Impaired conjugation

Gilbert's Syndrome, Neonates,

Chronic Hepatits, Cirrhosis, Wilson's disease

Front 6

What causes Conjugated Hyperbilirubinaemia?

Back 6

1) Intrahepatic Cholestasis

• Viral Hepatitis, EtOH Hepatitis, Fatty Liver,
  
• PBC, Sepsis, Drugs, TPN, Infiltration (TB etc)
  

2) Extrahepatic Cholestasis (Biliary Obstruction)

• Choledocholithiasis, Cholangiocarcinoma,
  
• PSC, Acute/Chronic Pancreatitis, Strictures,
  
• Parasites, AIDS cholangiopathy
  

Front 7

How can jaundice by classified?

Back 7

1. Pre-hepatic
2. Hepatic
3. Post-Hepatic

Front 8

What are causes of Pre-hepatic jaundice?

Back 8

1. Haemolysis
2. Congenital hyperbilirubinaemia

Gilbert's, Dubin-Johnson, Criglar-Najar

Front 9

What are causes of Hepatic Jaundice?

Back 9

1. Viral Hepatitis
2. Alcoholic Liver Disease
3. Drug-induced
4. Metastatic Disease

Front 10

What are causes of Post-hepatic Jaundice?

Back 10

Most often: Biliary Obstruction

Carcinoma at head of pancreas

Choledochlithiases

biliary stricture

PSC

Chronic Pancreatitis

Mirizzi's syndrome