Podcast
Questions and Answers
What is the definition of jaundice?
What is the definition of jaundice?
- Yellow discoloration of the skin, eyes, and mucous membrane due to elevation of bilirubin levels (correct)
- Blue discoloration of the skin due to lack of oxygen
- Red discoloration of the skin due to increased iron levels
- Green discoloration of the skin due to copper accumulation
At what bilirubin level do jaundice symptoms become noticeable?
At what bilirubin level do jaundice symptoms become noticeable?
- 1.0 to 2.0 mg/dL
- 2.0 to 3.0 mg/dL
- 3.0 to 5.0 mg/dL (correct)
- 5.0 to 7.0 mg/dL
Which type of jaundice is caused by excessive breakdown of red blood cells?
Which type of jaundice is caused by excessive breakdown of red blood cells?
- Post-hepatic
- Pre-hepatic (correct)
- Hepatic
- Cholestatic
What is another term for pre-hepatic jaundice?
What is another term for pre-hepatic jaundice?
What distinguishes pre-hepatic jaundice from other types regarding bilirubin levels?
What distinguishes pre-hepatic jaundice from other types regarding bilirubin levels?
What is a clinical sign of cholestasis?
What is a clinical sign of cholestasis?
Which of the following is a type of pathological cholestasis?
Which of the following is a type of pathological cholestasis?
Which of the following tests can suggest cholestasis?
Which of the following tests can suggest cholestasis?
What is involved in biochemical cholestasis?
What is involved in biochemical cholestasis?
Which of the following is a treatment option for cholestasis?
Which of the following is a treatment option for cholestasis?
Which of these mechanisms does NOT relate to cholestasis?
Which of these mechanisms does NOT relate to cholestasis?
Which condition is characterized by an increase in both conjugated and unconjugated bilirubin?
Which condition is characterized by an increase in both conjugated and unconjugated bilirubin?
What is a common cause of posthepatic jaundice?
What is a common cause of posthepatic jaundice?
Which syndrome is a hepatic cause of jaundice that results in elevations in conjugated bilirubin?
Which syndrome is a hepatic cause of jaundice that results in elevations in conjugated bilirubin?
Which type of jaundice involves clay-colored stool?
Which type of jaundice involves clay-colored stool?
When does neonatal jaundice typically appear?
When does neonatal jaundice typically appear?
Which diagnostic method is NOT typically used for diagnosing jaundice?
Which diagnostic method is NOT typically used for diagnosing jaundice?
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Study Notes
Jaundice
- Yellow discoloration of skin, eyes, and mucous membrane due to elevated bilirubin levels
- Bilirubin levels must reach 3.0-5.0 mg/dL to cause jaundice
Types of Jaundice
- Pre-hepatic (Hemolytic Jaundice)
- Caused by excessive breakdown of RBCs
- Production of unconjugated bilirubin more than liver can handle
- Rarely exceeds 5.0 mg/dL
- Also known as unconjugated hyperbilirubinemia
- Hepatic Jaundice
- Caused by intrinsic liver defect or disease
- Disorders of bilirubin metabolism and transport defects
- Both conjugated and unconjugated bilirubin increase
- Post-hepatic (Obstructive, Cholestatic) Jaundice
- Results from biliary obstructive disease
- Physical obstructions (gallstones or tumors) prevent flow of conjugated bilirubin into bile canaliculi
- Conjugated hyperbilirubinemia
- Clay color stool
Physiological Jaundice
- Neonatal Jaundice
- Appears 2-5 days after birth
- Excessive destruction of RBCs and hepatic inability
Diagnosis
- History
- Physical examination
- Blood tests
- Liver biopsy
Cholestasis
- Impaired bile formation (hepatocytes)
- Impaired bile flow (bile ducts/ductules)
- Consequences: build up in blood of substances normally excreted in bile (bilirubin, bile acids)
Consequences of Cholestasis
- Biochemical Cholestasis
- Increased serum bilirubin
- Increased serum alkaline phosphatase
- Clinical Cholestasis
- Jaundice
- Dark urine/clay-colored feces
- Pruritus
- Pathological Cholestasis
- Bile plugs in dilated canaliculi
- Increased bile pigment in hepatocytes
- Bile lakes
- Biliary infection
Treatment
- Phototherapy
- Exposure of skin to white light for photo-isomerization of bilirubin to water-soluble form that can be excreted
Screening Tests
- Color change in skin/sclerae/stool/urine
- Laboratory biochemical tests (Alk Phos, Bilirubin)
Diagnostic Tests
- Liver biopsy
- Indirect visualization of dilated bile ducts and/or masses compressing bile ducts/stones (CT, U/S)
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