What is the earliest sign of jaundice?
What specifically makes stool brown and urine yellow?
What happens to cause jaundice in extravascular hemolysis or ineffective erythropoeisis?
high levels of UCB overwhelm ability of liver to conjugate
What are the clinical manifestations of extravascular hemolysis/ineffective erythropoeisis?
dark urine - inc urobillinogen!
- inc risk for bilirubin gallstones due to inc UCB
Why does an ittybitty new baby get yellow?
transient low UGT activity
What are two reasons why premature infants are more susceptible to becoming bananna colored?
hepatic clearance less developed
turnover RBCs is more pronounced
in all seriousness, why is jaundice in a baby dangerous?
UCB is fat soluble and can deposit in BG
- can lead to neuro deficits and death
Whats the treatment for the sunshine colored babies
What is gilbert syndrome?
mildly low UGT activity
What are the clinical manifestations of gilbert?
jaundice during stress
What is crigler naijar?
EVIL VILLAIN that STOLE THE UGT
What is dubin johnson syndrome?
deficiency of bilirubin canalicular transport protein
-impaired transport into canaliculus
What is the pathology of dubin johnson syndrome?
black liver but no other problems -
no bitches no problemz (think that dubin johnson sounds like a black NBA supastar)
What are some things that can cause obstructive jaundice?
- pancreatic carcinoma
- liver fluke
What are some physical symptoms of biliary tract obstruction besides jaundice?
pruiritus - inc bile acids in skin xanthomas - hypercholesterolemia steatorrhea malabsorption of fat soluble vitamins dark urine
What is the pathological appearance of billiary duct obstruction?
liver is swollen and bile stains
- feathery degeneration
1. hydropic swelling
2. bile pigment
Which causes of jaundice cause inc UCB?
Gilbert and crijjar
Hemolysis and ineffective hematopoiesis
Viral hepatitis and cirrhosis -mixed
What causes CB jaundice
Biliary tract obstruction
Primary sclerosing cholangitis
Primary biliary cirrhosis
Hepatitis and cirrhosis - mixed