Jaundice Flashcards
What are the commonest causes of drug induced jaundice?
Flucloxacillin and co-amoxiclav. Followed by paracetamol in overdose, nitrofurantoin, steroids, oral contraveptive pill, TB and malaria drugs.
What is the gold standard investigation for gallstones?
Ultrasound
Jaundice with normal stools and normal urine indicates?
Pre hepatic cause
Jaundice with normal stools but dark urine indicates?
Hepatic cause
Jaundice with pale stools and dark urine indicates?
Post-hepatic cause
What are clinical signs of hyperlipidaemia?
Xanthelasma and corneal arcus
What are some pre-hepatic causes of jaundice?
- Congenital red cell issues (sickle cell)
- Autoimmune haemolytic anaemia,
- Drugs,
- Infections (malaria)
- Transfusion reactions
What are some hepatic causes of jaundice?
- Cirrhosis,
- Malignancy,
- Viral hepatitis,
- Drugs,
- Enzymes
What are some post-hepatic causes of jaundice?
- Biliary tree obstruction,
- Primary biliary cirrhosis,
- Primary sclerosing cholangitis
What is Cholelithiasis?
Gall stones
What are the risk factors for gallstones?
5 F's - Fat - Forty - Female - Fertile - Family History (oestrogen causes more cholesterol to be secreted into bile)
What is biliary cholic?
Occurs when gallbladder neck becomes impacted by a gallstone. No inflammatory response but contraction of the gallbladder against occluded neck may cause pain. Pain precipitated by fatty foods.
What clinical symptoms are associated with cholangitis?
Cholangitis is infection of biliary tract. It presents with jaundice, fever and RUQ pain. (charcots triad)
What are the GI causes of clubbing?
- Hepatic cirrhosis,
- GI lymphoma,
- coeliac disease,
- Crohns disease,
- Ulcerative collitis
What are some causes of asterixis? (hepatic flap)
- Hepatic encephalopathy,
- Renal failure,
- Respiratory failure,
- Hypoglycaemia,
- Electrolyte abnormalities (hypokalaemia),
- Wilson’s disease,
- Urea cycle disorders
