Jaundice

Jaundice

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

Resource summary

	Created by greenfylde about 11 years ago