Jaundice

Jaundice

1. Definition

   • a yellowish discoloration of the skin, mucous membranes and of the white of the eyes caused by elevated levels of the chemical bilirubin in the blood (hyperbilirubinemia)
     • Distruction of RBCs and reading the
       • Haem
         • Synthesis
         • Degradation
           • Lead to formation of
             • Bilirubin
               • Bilirubin formation
                 • Transportation
                   • hepatic uptake
                     • conjugation
                       • biliary excretion

2. Types

   • Pre hepatic
     • Transfusion reactions
     • sickle cell anemia
     • autoimmune diseases
   • Post hepatic
     • Gallstones
     • tumors
   • Hepatic
     • cancer
     • cirrhosis
     • congenital disorders
       • Crigler najjar syndrome
       • Gilbert’s syndrome
       • Dubin Johnson syndrome
     • Anatomy of the hepatobilliary system
   • Obstructive
   • Hemolytic

3. Sign and symptoms

   • Kernicterus
     • abdominal pain
       • dark urine
         • what causes change in the color to
           • Red or pink
             • hemorrhage
           • Orange
             • sulfasalazine
           • Blue or green
             • cobalt
           • loudy or murky
             • kidney stones

4. Viral Hepatitis

   • Types
     • A,B,C,D,E
   • hazardous occupations related to disease transmitted by blood transfusion
     • surgeons
     • dentists
     • nurses
   • Sign and symptoms
     • fever and malaise
     • painful hepatomegaly
     • serum sickness prodrome
     • vasculitis
     • urticaria, polyarthritis
   • Phases
     • prodrome
     • jaundice
     • recovery
   • Epidemiology
     • HCV = 1% in the Arabian gulf region
   • Investigations
     • Blood Tests
       • Gamma GT
       • Alkaline phosphatase
       • Liver function tests
   • management and prevention
     • Treatment
       • Lamivudine
       • Adefovir
       • Entecavir
       • Pegylated interferons
     • Vaccination
     • Prophylaxis
       • Pre-exposure prophylaxis
       • Post-exposure prophylaxis
   • Prognosis
     • A and E generally resolve
     • Fulminant hepatitis rare
       • Pregnancy

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