Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 3 > Jaundice (oxford clin cases) > Flashcards

Jaundice (oxford clin cases) Flashcards

(60 cards)

Start Studying
1
Q

What causes jaundice?

A

A build up of bilirubin in tissues

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

Where are RBCs broken down?

A

Spleen mainly

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

What breaks down RBCs

A

Macrophages

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

What are RBCs broken down into? (and what part of the RBC is broken down to give these products?)

A

Heamoglobin is broken down into:
Unconjugated bilirubin
Iron

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

How does unconjugated bilirubin circulate?

A

Bound to albumin

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

Where does unconjugated bilirubin go?

A

From the spleen to the liver

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

What happens to unconjugated bilirubin in the liver?

A

It is conjugated

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

What is conjugated bilirubin called? What are its characteristics?

A

Glucuronate, it is water soluble

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

Where is bilirubin secreted into from the liver?

A

Bile cancliculi (duct)

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

What happens to bilirubin in the gut?

A

It is metabolized by bacteria into urobilinogen and stercobilinogen which give faeces their colour

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

What will happen to urine if there is complete obstruction of the bile duct?

A

There will be no trace of urobilinogen in the urine

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

What are the 3 ways bilirubin can cause jaundice?

A

Problems with bilirubin production
Problems with bilirubin conjugation
Problems with bilirubin excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is prehepatic jaundice?

A

Jaundice due to excess bilirubin production eg increased breakdown of RBC in vessels or spleen

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

What is hepatic jaundice?

A

Jaundice due to failures in the liver eg reduced uptake by hepatocytes, reduced conjugation of bilirubin by enzymes or damage to hepatocytes

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

What is post hepatic jaundice?

A

Problems with bile flow

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

What is obstructive jaundice?

A

Jaundice due to lack of bile flow into the gut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What will faeces and urine look like in obstructive jaundice?

A

Faeces will be pale due to lack of sterco/uro bilinogen amd urine will be dark in colour due to conjugated bilirubin in them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is cholestatic jaundice?

A

Jaundice due to bilirubin not flowing out of the common bile duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the 2 types of haemolysis?

A

Intra and extra vascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What will intravascular haemolysis present with? Explain why

A

Dark urine due to free haemoglobin being excreted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are congenital causes of intravascular haemolysis?

A

G6PDH deficiency
PK deficiency
Sickle cell
Thalassaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are accquired causes of intravascular haemolysis?

A 
Heart valve replacement
Blood transfusion mismatch
DIC
Malaria
Medication
HELPP syndrome in pregnant women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are congenital causes of extravascular haemolysis

A

Hereditary spherocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are acquired causes of extravascular haemolysis

A

Autoimmune spherocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What will be seen on blood film in someone with intravascular haemolysis?
Schistocytes (fragmented blood cells)
26
What will be seen on blood film in someone with extravascular haemolysis?
Spherocytes
27
What are some congenital enzyme problems that may reduce conjugation of bulirubin
Gilbert's syndrome (common) | Crigler-Naj-jar syndrome (rare)
28
What acronym is used to remember acquired cuases of decreased bilirubin excretion?
``` INVITED MD Infection- viral/bacterial hepatitis etc Neoplasia- tumors of the liver, pancreas, bile duct Vascular- budd chiari syndrome (thrombosis in the hepatic vein) Inflammation Trauma- gallstones, stricture Endocrine- due to hormones in pregnancy Degenerative Metabolic Drugs ```
29
What symptoms alongside jaundice would steer you towards a diagnosis of hepatits?
Right upper quadrant pain Itching Nausea and vomitting
30
What does fever and diarhoea alongside jaundice make you think could be the cause?
Infection of the liver
31
What symptoms alongside jaundice would you suspect if there is an obstruction to bile outflow?
Steatorrhea Dark urine Itching
32
What symptoms alongside jaundice would you suspect if they have haemochromatosis?
Bronzed skin and diabetes mellitus signs
33
What are the 4 mechanisms by which medications can cause haemolysis?
Intravascular haemolysis Extravascular haemolysis Cholestasis Hepatitis
34
What should you ask about/ look for in past medical history when a patient has jaundice?
``` History of gallstones Pregnancy Medication they're on Liver disease (infection, alcohol) Haemophilia Recent blood transfusion Ulcerative colitis Emphysema Psychosis ```
35
What should you ask about/look for in family history when a patient has jaundice?
``` Wilson's Gilbert's syndrome Haemophilia Sickle cell Thalassaemia ```
36
What should you ask about/look for in social history when a patient has jaundice?
``` IV drug use Unprotected sex/multiple partners Foreign travel Alcohol consumption Tattoos ```
37
What is meant when a patient is described as jaundiced?
They have yellow skin
38
What is the medical name for yellow eyes?
Icteric
39
What may be seen on inspection when a patient has chronic liver disease?
``` Spider naevi Palmar erythema Clubbing Bruising Gynaecomastia ```
40
What is seen in the eyes that indicates Wilson's disease?
Green rings (kayser-fleischer)
41
What does right upper quadrant tenderness suggest when a patient has jaundice?
Hepatitis | Gallbladder disease
42
When should you do a blood film to investigate jaundice?
If FBC shows anaemia | If serum unconjugated bilirubin is raised
43
When should you do viral serology/ASMA/ANA to investigate jaundice?
If liver enzymes are raised
44
When should you do ultrasound of the biliary tree if the patient has jaundice?
Raised gallbladder enzymes Positive urine bilirubin Positive serum amylase
45
What are the 2 main liver enzymes vs 2 main gallbladder enzymes?
``` Liver= ALT, AST Gallbladder= ALP, GGT ```
46
What investigation should be done if you suspect hepatocyte damage and what will results be?
Check liver enzymes, they will be raised
47
What does AST>ALT suggest?
Excessive alcohol intake
48
What does ALT>AST suggest?
Viral hepatitis
49
What are causes of AST/ALT in the thousands?
Viral hep Paracetamol overdose Ischaemic hep
50
What will serum bilirubin be if the problem is obstruction of bile flow? Why?
Conjugated bilirubin >20% of total bilirubin because this shows the liver is conjugating the bilirubin that goes through it
51
Where is ALP released from?
Damaged biliary epithelial cells and the placenta
52
Where is GGT released from?
Biliary epithelial cells
53
What does high ALP and high GGT suggest?
Bile duct pathology | Could also be hepatitis
54
What does high ALP but normal GGT suggest?
High bone turnover (mets in bone or hyperparathyroidsm) or pregnancy
55
What does high GGT alone suggest?
Recent alcohol consumption
56
What type of jaundice manifests as dark urine?
Posthepatic jaundice
57
What does bilirubin in the urine suggest?
Posthepatic obstruction- the bilirubin has to be excreted via an alternate route
58
Why is there no urobilinogen in the urine of patients with posthepatic jaundice?
Because bilirubin cannot reach the gut so it isn't broken down into urobilinogen and excreted in the urine
59
What might you look at in investigations if you suspect jaundice is due to haemolysis?
Haptoglobins- will be depleted Lactate dehydrogenase- will be raised Direct antiglobulin test (DAT)- if you suspect haemolysis Blood film
60
What disease increases risk of PSC?
Ulcerative colitis

Year 3 (104 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions