Zusammenfassung der Ressource
Yellow eyes
- Liver
- Anatomy of the liver
- Liver function
- Blood reservoir
- Metabolic organ
- Carbohydrate metabolism
- Fat metabolism
- Protein metabolism
- Storage site
- Iron
- Vitamins
- Detoxification
- Drugs
- Elimination of ammonia
- Elimination of bilirubin
- Anatomy of the biliary system
- Physiology of the Extrahepatic system
- Bile
- Fat digestion by bile acids
- Large fat --> minute particles
- Aid in absorption of digested fat --> intestinal mucosal membrane
- Excretion of waste product from the blood including bilirubin & cholesterol
- Jaundice
- What is it ?
- A medical condition with yellowing of the skin or whites
of the eyes, arising from excess of the pigment bilirubin
and typically caused by obstruction of the bile duct, by
liver disease, or by excessive breakdown of red blood cells.
- Signs & Symptoms
- A yellow tinge to the skin and the
whites of the eyes, normally
starting at the head and
spreading down the body
- Pale stools
- Dark urine
- Itchiness
- Fatigue
- Abdominal pain
- Weight loss
- Vomiting
- Fever
- Types
- Pre-Hepatic
- Haemolytic anaemia
- Gilbert’s syndrome
- Criggler-Najjar syndrome
- Hepatocellular
- Alcoholic liver disease
- Viral hepatitis
- Epidemiology
- HAV -- Developing countries with poor sanitary conditions and hygienic practices
- HBC -- Western Pacific Region and the WHO African Region
- HCV -- Eastern Mediterranean and European Regions
- HDV -- Mediterranean, Middle East, Pakistan, Central and Northern Asia, Japan, Taiwan, Greenland and parts of Africa
- HEV -- Resource-poor areas with frequent water contamination
- What is it?
- Hepatitis means inflammation of the liver. Many illnesses and conditions can cause inflammation of
the liver, for example, drugs, alcohol, chemicals, and autoimmune diseases.
- Types
- Pathophysiology
- CD8 cells attack virally-infected hepatocytes and induce apoptosis
- So there is infiltration of lymphocytes ( CD8)
- Persistent inflammation : will lead to fibrosis : chronic hepatitis: post-necrotic cirrhosis
- Prognosis
- Lab investigations
- Liver Function Test
- Total Bilirubin
- CB
- UCB
- Serum Albumin
- Total Protein
- Serum Globulin
- Alanine Aminotransferase
- Alanine Phosphatase
- Gamma GT
- Prothrombin Time
- Urea, Electrolytes, and creatinine
- CBC/WBC
- Hepatitis serological markers:
- Complications
- Fulminant hepatitis
- Scarring of the liver (cirrhosis).
- Liver cancer
- Liver failure
- Kidney failure
- Vasulitis
- Management
- HBV
- Lamivudine
- A cytosine analogue- Nucleoside Reverse Transcriptase Inhibitor (NRTI)
- Side effects
- Headache, nausea, diarrhea, dizziness, myalgia, and malaise are rare
- Co-infection with HIV may increase the risk of pancreatitis
- Adefovir
- An analog of adenosine monophosphate
- Side effects
- Nephrotoxicity
- Lactic acidosis
- Entecavir
- An analog of guanosine monophosphate
- Side effects
- Potential adverse events are headache, fatigue, dizziness, nausea, rash, and fever.
- Lung adenomas and carcinomas in mice, hepatic adenomas and carcinomas in rats and mice,
vascular tumors in mice, and brain gliomas and skin fibromas in rats have been observed at varying
exposures.
- HCV
- Ribavirin
- A guanosine analogue
- Side effects
- Hemolytic anemia
- Boceprevir
- Telarprevir
- Direct acting anti-viral agents
- Daclatsevir
- Direct acting anti-viral agent
- Sofosbuvir
- Sofosbuvir is a nucleotide analog that inhibits the HCV NS5B RNA-dependent RNA polymerase in
patients infected with HCV genotype 1, 2, 3, or 4.
- Pegylated Interferon
- Their metabolism and excretion mainly by the kidneys, where they undergo rapid proteolysis during
tubular reabsorption, so detection in the systemic circulation is negligible
- Side effects
- fFu-like symptoms
- Bone depression
- Medication
- Hereditary haemochromatosis
- Autoimmune hepatitis
- Primary biliary cirrhosis
- Hepatocellular carcinoma
- Primary sclerosing cholangitis
- Post-Hepatic
- Intra-luminal causes, such as gallstones
- Mural causes, such as cholangiocarcinoma, strictures, or drug-induced cholestasis
- Extra-mural causes, such as pancreatic cancer or abdominal masses (e.g. lymphomas)
- Causes
- Hepatitis
- Alcohol-related liver disease
- Blocked bile ducts
- Pancreatic cancer
- Certain medicines
- Normal billirubin metabolism