Jaundice

Question 1

What causes jaundice? (before production of bilirubin)

Answer 1

• Reabsorption of a large haematoma (clotted blood under the skin)
• Haemolytic anaemia (ed blood cells are destroyed faster than they can be made)

Question 2

What is unconjugated bilirubin?

Answer 2

• Breakdown product of haem

- It is not water-soluble, therefore requires conjugation for excretion in bile

Question 3

What enzyme converts unconjugated bilirubin into conjugated bilirubin, making it water-soluble?

Answer 3

UGT (UDP-glucuronosyltransferase)

Question 4

What causes jaundice? (during production of bilirubin)

Answer 4

• Viruses (Hep A, B, C and Epstein-Barr)
• Alcohol
• Autoimmune disorders
• Medications e.g. oral contraceptives, anabolic steroids

Question 5

What causes jaundice? (after production of bilirubin)

Answer 5

Blockage of the bile ducts:

• Gallstones
• Inflammation of the gallbladder
• Gall bladder cancer
• Pancreatic tumour

Question 6

How is jaundice diagnosed?

Answer 6

• Bruising of the skin
• Spider angiomas (abnormal collection of blood vessels near the surface of the skin)
• Palmar erythema (red coloration of the palms and fingertips)

Question 7

What would urinalysis that’s positive for bilirubin show?

Answer 7

Patient has conjugated jaundice