Jaundice

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Jaundice – is it a disease?

Yellowish staining of the skin and sclerae

High levels of bilirubin in blood

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Category Definition

Pre-hepaticPathology occurs prior to the liver

Hepatic Pathology located within the liver

Post-hepatic

Pathology located after the conjugation of bilirubin in the liver

What causes jaundice?

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Neonatal jaundice Yellowish staining of the skin and whites of the newborn's

eyes (sclerae) by pigment of bile (bilirubin) Breakdown of red blood cells (which release bilirubin into

the blood) and immaturity of the newborn's liver (which cannot effectively metabolize bilirubin and prepare it for excretion into urine)

Normal neonatal jaundice appears between the 2nd and 5th days of life and clears with time

Kernicterus – brain damage - lifelong disability

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What problems does jaundice cause? Skin and sclerae - yellow Stool - light colour, clay coloured Dark urine Pain in abdomen Itching Trouble with sleeping Fatigue Swelling Ascites Mental confusion Coma Bleeding

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Which diseases cause jaundice? Increased production of bilirubin Acute liver inflammation Infiltrative liver diseases Bile duct inflammation Blockage of bile ducts Drugs Genetic disorders Developmental abnormalities of bile ducts Jaundice of pregnancy

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History Physical examination Blood tests - laboratory Ultrasonography CT MRI Liver biopsy ERCP Endoscopic ultrasound

Diagnosis

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Laboratory Tests

Bilirubin level in serum (total and direct)

Aminotransferase Alkaline phosphatase U/A for bilirubin and

urobilogen

Complete blood count Prothrombin time Other laboratory tests

pertinent to history Coombs test Electrophoresis of

hemoglobin Viral hepatitis panel

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Treatment

Treatment requires a precise diagnosis of the specific cause and should be directed to the specific problem

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