14. Jaundice

Question 1

Miss Watoomba is a 28-year old woman from Poland has has recently moved ot the UK. She has attended her GP because she has developed ‘yellow eyes’. As soon as she walks into your office you can see she is jaundiced. Jaundice is due to the excessive accumulation of bilirubin in tissues/ What is the normal metabolism of bilirubin?

Answer 1

Question 2

Clinicians often talk about jaundice being prehepatic, hepatic, or posthepatic in origin; obstructive; cholestatic; and conjugated or unconjuated. What does all of this terminology mean?

Answer 2

Question 3

What are your differential diagnoses for jaundice?
- Increased production of bilirubin?

Answer 3

Question 4

What are your differential diagnoses for jaundice?
- Decreased conjugation of bilirubin?

Answer 4

Question 5

What are your differential diagnoses for jaundice?
- Decreased excretion of bilirubin?

Answer 5

Question 6

History Taking - Jaundice
- Personal information?
- Presenting Complaint?
- Past Medical History?
- Medications?

Answer 6

Question 7

History Taking - Jaundice
- Family History?
- Social History?
- Concerns?

Answer 7

Question 8

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Question 9

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Question 10

Investigation of Jaundice - Initial Screen
- Bloods? (5)
- Urine? (2)

Answer 10

Question 11

Investigation of Jaundice - Second Line Investigations
- Bloods? (4)
- Imaging? (1)
- Further? (2)

Answer 11

Question 12

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Question 13

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Question 14

How should Miss Watroba’s acute Hepatitis B infection be managed?

Answer 14

Question 15

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Question 16

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Question 17

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Question 18

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Question 19

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Question 20

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Question 21

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Question 22

If a patient is clinically jaundiced, how high will their bilirubin levels be at a minimum?

Answer 22

Question 23

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Question 24

Which tumours could cause obstructive jaundice?

Answer 24

Question 25

Why does obstruction of the common bile duct result in steatorrheoa?

Answer 25

Question 26

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Question 27

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Question 28

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Question 29

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