Jaundice

Beschreibung

FOCP- GI Mindmap am Jaundice, erstellt von greenfylde am 22/11/2013.
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Mindmap von greenfylde, aktualisiert more than 1 year ago
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Erstellt von greenfylde vor etwa 11 Jahre
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Zusammenfassung der Ressource

Jaundice
  1. Acute liver injury (including hepatitis)
    1. infective
      1. acute viral hepatitis (A,B,E), CMV, EBV
        1. jaundice commonly preceded by 1-2w prodrome
        2. autoimmune
          1. autoimmune hepatitis
          2. toxic
            1. paracetamol overdose, antiTB drugs, ecstasy, halothane
            2. metabolic
              1. Wilson's disease
              2. vascular
                1. shock/ishchemic hepatitis, Budd-Chiari syndrome
                2. other: acute fatty liver of preg, extensive malignant infiltration
                3. Cirrhosis
                  1. chronic liver inj from any cause
                    1. pathphys: hepatocell fail -> jaundice, coagulopathy, decreased albumin. portal hypertension -> esoph varices, hepatic encephalopathy.
                      1. portal hypertens + decreased albumin + generalised salt and water retention -> ascites
                    2. Hepatic tumors
                      1. malignant infiltration by py or metastatic tumors -> jaundice b/c replace liver parenchyma or hepatic duct obstruction
                        1. assoc feats: cachexia, malaise, RUQ pain, hepatomegaly
                        2. Biliary disease
                          1. jaundice due to biliary obstruction
                            1. py biliary cirrhosis, py sclerosing scholangitis, extrahepatic cholestasis- most often caused by gallstones, benign strictures, cholangiocarcinoma, pancreatic carcinoma
                            2. increased ALP + GGT
                              1. assoc: pale stools, dark urine, itch
                              2. No hepatobiliary disease
                                1. hemolytic disorders
                                  1. gilbert's syndrome (congen, 2-5% pop, decreased enzymatic activity so limits conjugation)
                                2. cause: increased hemolysis, decreased uptake/conjugation by liver, imparied biliary drainage (cholestasis)
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