Week 3 Pre-Learning: Jaundice

Question 1

What are some disorders of the liver? (4)

Answer 1

• Viral Hepatitis
• Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis
• Toxic and drug induced hepatitis
• Liver cirrhosis

Question 2

Jaundice is also called _____.

Answer 2

hyperbilirubinemia

Question 3

What is jaundice? (3)

Answer 3

• Symptoms resulting from elevated bilirubin
• causes yellow discoloration, which can be visible on the skin, sclera, and soft palate
• May also cause pruritis

Question 4

What are the 3 types of jaundice?

Answer 4

1. Prehepatic
2. Hepatic
3. Posthepatic

Question 5

What is prehaptic jaundice? (2)

Answer 5

• Results from increase in bilirubin before reaching the liver
• overproduction of unconjugated bilirubin

Question 6

Why does prehepatic jaundice occur? (3)

Answer 6

• usually from excessive hemolysis (break down of RBC)
• The liver cannot conjugate the bilirubin fast enough because of the increased load
• caused by conditions like hemolytic jaundice of the newborn, blood transfusion reaction

Question 7

Unconjugated bilirubin is not ___ soluble and cannot be ____ in the urine

Answer 7

• water soluble
• excreted

Question 8

In summary, Prehepatic jaundice is characterized by what 4 factors?

Answer 8

• Increased unconjugated bilirubin
• Decreased hematocrit
• Normal liver enzymes
• Urine will appear normal (amber)

Question 9

What is hepatic jaundice? (2)

Answer 9

• results from the liver’s inability to take up, conjugate, or excrete bilirubin
• damaged hepatocytes lead to leakage of bilirubin

Question 10

Why can a diseased liver result in both elevated conjugated and unconjugated bilirubin in hepatic jaundice? (2)

Answer 10

• hepatocytes struggle to conjugate bilirubin
• Conjugate bilirubin from the cells

Question 11

What is hepatic jaundice characterized by? (3)

Answer 11

• increased conjugated and unconjugated bilirubin
• Elevated liver enzymes
• Urine will be dark in color due to increased conjugated bilirubin (water soluble)

Question 12

What is posthepatic jaundice? (2)

Answer 12

• Caused by failure of bile to reach the duodenum
• Usually from cholestasis (obstruction of bile flow through the liver)

Question 13

Posthepatic jaundice can be caused from intrahepatic or extrahepatic causes. What are they? (2)

Answer 13

• Swelling or fibrosis of liver and bile ducts (intrahepatic)
• Common bile duct stone, gall stones, pancreatic cancer (extrahepatic)

Question 14

What is posthepatic jaundice characterized by? (6)

Answer 14

• Elevated conjugated
• Elevated blood cholesterol
• Dark colored urine (increased conjugated bilirubin)
• Pale colored feces; steatorrhea (decreased urobilinogen and stercobilin)
• Accumulation of bile salts in the blood and depositing in the skin (puritis)
• Vitamin K deficiency

Think about what happens if bile cannot be used by the gut