25. Clinical approach to patients with icterus (jaundice) Flashcards

(32 cards)

1
Q

Jaundice definition

A

the yellow staining of serum or tissues by an excessive amount of bile pigment or bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Origin of Jaundice

A

Pre hepatic
hepatic
post hepatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what needs to be present in order for Jaundice to occur

A

there needs to be a large, persistent increase in bile pigment production
or
major impairment of its excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

^ Br

A

detectable by lab tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

^^ Br

A

Plasma appears yellow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

^^^Br

A

Jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

causes of Prehepatic Jaundice

A

Babesia
IMHA
Toxicosis - snake, onion/ garlic, paracetamol, Zn
Bacteria - mycoplasma haemofelis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Clinical signs of Prehepatic Jaundice

A

Hypercholic faeces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lab D of Prehepatic Jaundice

A

Decreased; PCV
Increased ; Hb, Reticulocytes, Br I in serum, BrII in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Influence of haemolysis in Prehepatic Jaundice

A

increase Hb degradation –> ^Br
Decreased RBCs –> hypoxia –> cholestasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hepatic Jaundice

A

decreased uptake and conjugation due to hepatic disease
decreased excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

causes of Hepatic Jaundice

A
  • Severe/acute hepatitis
  • Plants
  • Abnormal conjugation
  • Neoplasia
  • Abnormal excretion
  • Bacteria
  • Intrahepatic cholestasis
  • Parasites
  • Extrahepatic infection
  • Sepsis
  • Cholangiohepatitis
  • Mycotoxins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clinical signs of Hepatic Jaundice

A

hypercholic faeces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lab D of Hepatic Jaundice

A

Increased ; Br, ALT, ALP, GGT, AST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Post Hepatic Jaundice

A

obstruction of biliary duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Cause of Post Hepatic Jaundice

A

Stones in biliary tract
duodenal foreign body
pancreatitis

17
Q

Clinical signs of Post Hepatic Jaundice

18
Q

Lab D of Post Hepatic Jaundice

A

Increased; Br, ALP, GGT, AST

19
Q

Normal serum total bilirubin in dogs

20
Q

Normal serum total bilirubin in cats

21
Q

why might bilirubinaemia be normal for dogs

A

canine renal tubules have a low resorptive threshold for bilirubin & process Br to a limited extent

22
Q

Parameters to measure for Bilirubin

A

Blood total Br
Blood total Br I
Blood total Br II
Faecal stercobilinogen
Urine Br
Urine UBG

23
Q

Prehepatic Jaundice Lab values from serum

A

Increased ; BrI, BrII, Free Hb, UBG, Urea, Retiulocytes

24
Q

Prehepatic Jaundice Lab values from urine

A

Increased ; Br, UBG, Hb

25
Prehepatic Jaundice Lab values from faeces
Increased stercobilinogen
26
hepatic Jaundice Lab values from serum
increased Br I, BrII, UBG, BA
27
hepatic Jaundice Lab values from urine
Increased ; Br Decreased UBG No Hb
28
hepatic Jaundice Lab values in faeces
No stercobilinigen
29
posthepatic Jaundice Lab values in faeces
No stercobilinigen
30
posthepatic Jaundice Lab values in serum
Increased ; BrII, BA no UBG
31
posthepatic Jaundice Lab values in urine
Increased Br Decreased UBG no Hb
32
Treatment of Jaundice
treat cause IVFT, Electrolytes, antiemetics, gastroprotectants AB plasma, vit K Antiox UDCA