Jaundice
abbie glover
Created on October 14, 2024
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Transcript
Pre-Hepatic
Post-Hepatic
Info
Info
Hepatic
Info
Jaundice
Jaundice is a yellow discolouration of the skin and sclera due to a raised serum Bilirubin. Understanding bilirubin metabolism will help you understand Jaundice.
Excreted
Conjugated
Created
Jaundice
Build up of Bilirubin may occur due to problems with any part of this pathway and so we can break down the causes into pre-hepatic, hepatic and post hepatic. Thinking about the causes will help you understand what symptoms and signs to look for to narrow your differential diagnosis
The skin and sclera are both discoloured yellow. Jaundice may be more difficult to recognise in Black and Brown skin. Check out 'Mind the Gap: A handbook of clinical signs in Black and Brown skin' on the CARES 2 reading list
Breakdown product of Haemoglobin metabolism
travels to liver bound to albumin (unconjugated) conjugated in the liver
soluble conjugated bilirubin excreted in bile into duodenum >> in colon deconjugated by colon bacteria >>> urobilinogen >>> stercobilin >>> excreted in faeces (gives stool the brown colour)
e.g Haemolytic anaemias, Gilbert’s syndrome
e.g Viral hepatitis, Drug-induced hepatitis
e.g common bile duct stone, malignancy
Ask about: Risk factors e.g travel, drug, alcohol hx. Abdominal painFeverFatigueLook for: signs of chronic liver diseasee.g spider naevi, gynaecomastia, palmar erythema
Ask about: Fatigue, breathlessness (anaemia)Look for: Clinical sings of anaemia lymphadenopathysplenomegaly
Ask about: Abdominal pain Weight lossStool colour Look for: Abdominal tendernessMasses RUQ/Epigastrium