SlideShare a Scribd company logo
1 of 14
INVESTIGATIONS OF
    JAUNDICE
AIMS
• DETECT HEPATIC ABNORMALITY
• ASSESS SEVERITY OF DAMAGE
• DETECT PATTERN OF ABNORMALITY; HEPATIC
  OBSTRUCTIVE / CHOLESTATIC
• SPECIFIC CAUSE
• COMPLICATIONS
LIVER FUNCTION TESTS

•   Tests for Manufacture & excretion of bile
•   Serum enzyme assays
•   Tests for metabolic functions
•   Immunological Tests
•   USS
•   Liver Biopsy
URINE EXAMINATION
• BILE PIGMENTS – Conjugated Bilirubin
• BILE SALTS in urine in cholestasis
• UROBILINOGEN
            Increase in Hepatocellular d/s &
                   hemolytic d/s
            Absent in biliary obstruction
BIOCHEMICAL TESTS
• SERUM PROTEINS
       ALBUMIN LOWERED
       GLOBULIN INCREASED

• SERUM SODIUM – SEVERE LIVER DISEASE
  ( ADH PRODUCTION)

• SERUM UREA – REDUCED IN HEPATIC FAILURE
LIVER ENZYMES
• ALP - INC –OBSTRUCTIVE JAUNDICE
• AST/ SGOT - 5 -40 U/L
• ALT/SGPT -5-30 U/L
HAEMATOLOGICAL TESTS
• ANAEMIA
   NORMO NORMO –GI HAEMORRHAGE
   HMA-IRON DEF

• LEUCOPENIA - PORTAL HT, HYPERSPLENISM

• LEUCOCYTOSIS- cholangitis, hepatic abscess

• THROMBOCYTOPENIA- cirrhosis, c/c liver d/s
COAGULATION TESTS

PT-
Prolonged obstructive jaundice
Defective vit K absorption
PT prolonged
Immunological tests
• CHRONIC LIVER DISEASE SCREEN
• To confirm viral etiology
     Hep B surface Ag
     Hep C Ab
          Liver auto ab- nuclear, smooth
             muscle,      mitochondrial
• Immunoglobulin        Ceruloplasmin
• Ferritin               alpha 1 antitrypsin
RADIOLOGICAL IMAGING
• X ray – liver abscess, biliary calculi,calcificatn

• Barium swallow – esophageal varices

• CONTRAST Radiography- biliary tree and gall bladder

• ULTRASOUND- Non invasive

• Gall stones, Biliary obstruction,splenomegaly,hepatic
  trs cyst abscess
Continued
• Doppler US –Blood flow in portal veins ,hepatic
  artery , hepatic veins

• CT & MRI

• CT- Small focal lesions can be detected

• MRI- confirm etiology of primary n
  secondary liver trs
CHOLANGIOGRAPHY


• Can be undertaken by MRCP, ERCP or PTC

• MRCP – Diagnostic test of choice
         Provides images of biliary tree
NON INVASIVE MARKERS OF HEPATIC
             FIBROSIS

• Differentiates severe fibrosis from mild
  scarring
• Alternative – fibroscan test
LIVER BIOPSY
• Confirm severity of liver damage & provide
  etiological information

• Serological markers- procollagen type peptide
  &metalloproteinases

• Relatively safe

• Complications – Abdominal or shoulder pain
                 Bleeding biliary peritonitis

More Related Content

What's hot

Malabsorption syndrome
Malabsorption syndromeMalabsorption syndrome
Malabsorption syndromeNikhil Gupta
 
Hemorrhoids
Hemorrhoids Hemorrhoids
Hemorrhoids vidyaveer
 
CASE PRESENTATION ON JAUNDICE
CASE PRESENTATION ON JAUNDICECASE PRESENTATION ON JAUNDICE
CASE PRESENTATION ON JAUNDICERahman Khan
 
Liver function tests and interpretation
Liver function tests and interpretation Liver function tests and interpretation
Liver function tests and interpretation subramaniam sethupathy
 
Anemia Case Presentation
Anemia Case PresentationAnemia Case Presentation
Anemia Case PresentationZain Khan
 
Pernicious anemia
Pernicious anemia Pernicious anemia
Pernicious anemia Sijo A
 
chronic kidney disease case presentation
chronic kidney disease case presentationchronic kidney disease case presentation
chronic kidney disease case presentationKamal Sharma
 
chronic liver disease
chronic liver diseasechronic liver disease
chronic liver diseaseSamia Farhin
 
Case presentation
Case presentationCase presentation
Case presentationsalehsalman
 
Case Presentation: Hypertension (A case on refusal of Evidence Based Medicine)
Case Presentation: Hypertension (A case on refusal of Evidence Based Medicine)Case Presentation: Hypertension (A case on refusal of Evidence Based Medicine)
Case Presentation: Hypertension (A case on refusal of Evidence Based Medicine)Dr. Aryan (Anish Dhakal)
 
Anemia Causes, Types, Symptoms, Diet, and Treatment
Anemia Causes, Types, Symptoms, Diet, and Treatment Anemia Causes, Types, Symptoms, Diet, and Treatment
Anemia Causes, Types, Symptoms, Diet, and Treatment Dr Medical
 
‫ Jaundice
‫  Jaundice‫  Jaundice
‫ JaundiceafrahDH
 
Liver cirrhosis
Liver cirrhosisLiver cirrhosis
Liver cirrhosisEkta Patel
 
Approach to a pationt with pallor
Approach to a pationt with pallorApproach to a pationt with pallor
Approach to a pationt with pallorDOCTOR WHO
 

What's hot (20)

Malabsorption syndrome
Malabsorption syndromeMalabsorption syndrome
Malabsorption syndrome
 
Hemorrhoids
Hemorrhoids Hemorrhoids
Hemorrhoids
 
CASE PRESENTATION ON JAUNDICE
CASE PRESENTATION ON JAUNDICECASE PRESENTATION ON JAUNDICE
CASE PRESENTATION ON JAUNDICE
 
Liver function tests and interpretation
Liver function tests and interpretation Liver function tests and interpretation
Liver function tests and interpretation
 
Jaundice
JaundiceJaundice
Jaundice
 
Anemia Case Presentation
Anemia Case PresentationAnemia Case Presentation
Anemia Case Presentation
 
Liver cirrhosis
Liver cirrhosisLiver cirrhosis
Liver cirrhosis
 
Pernicious anemia
Pernicious anemia Pernicious anemia
Pernicious anemia
 
chronic kidney disease case presentation
chronic kidney disease case presentationchronic kidney disease case presentation
chronic kidney disease case presentation
 
chronic liver disease
chronic liver diseasechronic liver disease
chronic liver disease
 
Case presentation
Case presentationCase presentation
Case presentation
 
Case Presentation: Hypertension (A case on refusal of Evidence Based Medicine)
Case Presentation: Hypertension (A case on refusal of Evidence Based Medicine)Case Presentation: Hypertension (A case on refusal of Evidence Based Medicine)
Case Presentation: Hypertension (A case on refusal of Evidence Based Medicine)
 
Hypokalemia
HypokalemiaHypokalemia
Hypokalemia
 
Anemia Causes, Types, Symptoms, Diet, and Treatment
Anemia Causes, Types, Symptoms, Diet, and Treatment Anemia Causes, Types, Symptoms, Diet, and Treatment
Anemia Causes, Types, Symptoms, Diet, and Treatment
 
‫ Jaundice
‫  Jaundice‫  Jaundice
‫ Jaundice
 
Liver cirrhosis
Liver cirrhosisLiver cirrhosis
Liver cirrhosis
 
Umbilical hernia
Umbilical herniaUmbilical hernia
Umbilical hernia
 
Beri beri
Beri beriBeri beri
Beri beri
 
Approach to a pationt with pallor
Approach to a pationt with pallorApproach to a pationt with pallor
Approach to a pationt with pallor
 
Hyperthyroidism
HyperthyroidismHyperthyroidism
Hyperthyroidism
 

Viewers also liked

Investigations in jaundice
Investigations in jaundiceInvestigations in jaundice
Investigations in jaundiceNikhil Bansal
 
Jaundice presentation
Jaundice presentationJaundice presentation
Jaundice presentationmbishara
 
Clinical approach to jaundice
Clinical approach to jaundiceClinical approach to jaundice
Clinical approach to jaundiceKarthika Ramadoss
 
All about Jaundice
All about JaundiceAll about Jaundice
All about Jaundiceozhin araz
 
Definition & types of jaundice
Definition & types of jaundiceDefinition & types of jaundice
Definition & types of jaundiceFahad AlHulaibi
 
Obstructive jaundice
Obstructive jaundiceObstructive jaundice
Obstructive jaundiceFazal Hussain
 
investigations and management of obstructive jaundice secondary to stone disease
investigations and management of obstructive jaundice secondary to stone diseaseinvestigations and management of obstructive jaundice secondary to stone disease
investigations and management of obstructive jaundice secondary to stone diseaseErum Khateeb
 
Differential Diagnosis of Icterus/Jaundice
Differential Diagnosis of Icterus/JaundiceDifferential Diagnosis of Icterus/Jaundice
Differential Diagnosis of Icterus/JaundiceDr.Sudeesh Shetty
 
clinical approach to jaundice in adults
clinical approach to jaundice in adultsclinical approach to jaundice in adults
clinical approach to jaundice in adultsReem Alyahya
 
Bilrubin & jaundice: causes,pathogenesis,classification & clinical features
Bilrubin & jaundice: causes,pathogenesis,classification & clinical featuresBilrubin & jaundice: causes,pathogenesis,classification & clinical features
Bilrubin & jaundice: causes,pathogenesis,classification & clinical featuresMohammad Manzoor
 
Diabetes mellitus - (Part-3) -- Laboratory diagnosis and management
Diabetes mellitus - (Part-3) -- Laboratory diagnosis and managementDiabetes mellitus - (Part-3) -- Laboratory diagnosis and management
Diabetes mellitus - (Part-3) -- Laboratory diagnosis and managementNamrata Chhabra
 
Examination in palpitation
Examination in palpitationExamination in palpitation
Examination in palpitationAbino David
 
Diabetes mellitus part-1
Diabetes mellitus part-1Diabetes mellitus part-1
Diabetes mellitus part-1Namrata Chhabra
 
Approach To A Patient With Jaundice
Approach To A Patient With JaundiceApproach To A Patient With Jaundice
Approach To A Patient With JaundiceTanuj Bhatia
 
An approach to jaundice
An approach to jaundiceAn approach to jaundice
An approach to jaundiceKathiravan Ar
 
Metabolic effects of diabetes mellitus
Metabolic effects of diabetes mellitusMetabolic effects of diabetes mellitus
Metabolic effects of diabetes mellitusthamir22
 

Viewers also liked (20)

Investigations in jaundice
Investigations in jaundiceInvestigations in jaundice
Investigations in jaundice
 
Jaundice
JaundiceJaundice
Jaundice
 
Jaundice presentation
Jaundice presentationJaundice presentation
Jaundice presentation
 
Clinical approach to jaundice
Clinical approach to jaundiceClinical approach to jaundice
Clinical approach to jaundice
 
All about Jaundice
All about JaundiceAll about Jaundice
All about Jaundice
 
Definition & types of jaundice
Definition & types of jaundiceDefinition & types of jaundice
Definition & types of jaundice
 
Obstructive jaundice
Obstructive jaundiceObstructive jaundice
Obstructive jaundice
 
investigations and management of obstructive jaundice secondary to stone disease
investigations and management of obstructive jaundice secondary to stone diseaseinvestigations and management of obstructive jaundice secondary to stone disease
investigations and management of obstructive jaundice secondary to stone disease
 
Differential Diagnosis of Icterus/Jaundice
Differential Diagnosis of Icterus/JaundiceDifferential Diagnosis of Icterus/Jaundice
Differential Diagnosis of Icterus/Jaundice
 
clinical approach to jaundice in adults
clinical approach to jaundice in adultsclinical approach to jaundice in adults
clinical approach to jaundice in adults
 
Jaundice
JaundiceJaundice
Jaundice
 
Bilrubin & jaundice: causes,pathogenesis,classification & clinical features
Bilrubin & jaundice: causes,pathogenesis,classification & clinical featuresBilrubin & jaundice: causes,pathogenesis,classification & clinical features
Bilrubin & jaundice: causes,pathogenesis,classification & clinical features
 
laboratory investigations
 laboratory  investigations laboratory  investigations
laboratory investigations
 
Diabetes mellitus - (Part-3) -- Laboratory diagnosis and management
Diabetes mellitus - (Part-3) -- Laboratory diagnosis and managementDiabetes mellitus - (Part-3) -- Laboratory diagnosis and management
Diabetes mellitus - (Part-3) -- Laboratory diagnosis and management
 
Examination in palpitation
Examination in palpitationExamination in palpitation
Examination in palpitation
 
Diabetes mellitus - 2
Diabetes mellitus - 2Diabetes mellitus - 2
Diabetes mellitus - 2
 
Diabetes mellitus part-1
Diabetes mellitus part-1Diabetes mellitus part-1
Diabetes mellitus part-1
 
Approach To A Patient With Jaundice
Approach To A Patient With JaundiceApproach To A Patient With Jaundice
Approach To A Patient With Jaundice
 
An approach to jaundice
An approach to jaundiceAn approach to jaundice
An approach to jaundice
 
Metabolic effects of diabetes mellitus
Metabolic effects of diabetes mellitusMetabolic effects of diabetes mellitus
Metabolic effects of diabetes mellitus
 

Similar to Investigations of jaundice

M. Altman presentation 3 ch. 9 urinary system abbreviations
M. Altman presentation 3 ch. 9 urinary system abbreviationsM. Altman presentation 3 ch. 9 urinary system abbreviations
M. Altman presentation 3 ch. 9 urinary system abbreviationsmarlowe altman
 
Laboratory Interpretation K K
Laboratory Interpretation  K KLaboratory Interpretation  K K
Laboratory Interpretation K KSupattra Yongsiri
 
Investigation in a case of obstructive jaundice and
Investigation in a case of obstructive jaundice andInvestigation in a case of obstructive jaundice and
Investigation in a case of obstructive jaundice andYouttam Laudari
 
URINALYSIS CHEM PATH.pptx
URINALYSIS CHEM PATH.pptxURINALYSIS CHEM PATH.pptx
URINALYSIS CHEM PATH.pptxXavier875943
 
Approach to a case of Obstructive jaundice
Approach to a case of Obstructive jaundiceApproach to a case of Obstructive jaundice
Approach to a case of Obstructive jaundiceSupreet Kumar
 
Hepato&spleenomegaly
Hepato&spleenomegalyHepato&spleenomegaly
Hepato&spleenomegalySubash Arun
 
Evaluation of dysphagia and diseases of the esophagus
Evaluation of dysphagia and diseases of the esophagusEvaluation of dysphagia and diseases of the esophagus
Evaluation of dysphagia and diseases of the esophagusDr Krishna Koirala
 
20. evaluation of dysphagia and diseases of the esophagus kk
20. evaluation of dysphagia and diseases of the esophagus kk20. evaluation of dysphagia and diseases of the esophagus kk
20. evaluation of dysphagia and diseases of the esophagus kkkrishnakoirala4
 
Budd chiari syndrome
Budd chiari syndromeBudd chiari syndrome
Budd chiari syndromeTikal Kansara
 

Similar to Investigations of jaundice (20)

M. Altman presentation 3 ch. 9 urinary system abbreviations
M. Altman presentation 3 ch. 9 urinary system abbreviationsM. Altman presentation 3 ch. 9 urinary system abbreviations
M. Altman presentation 3 ch. 9 urinary system abbreviations
 
JAUNDICE.pptx
JAUNDICE.pptxJAUNDICE.pptx
JAUNDICE.pptx
 
JAUNDICE.pptx
JAUNDICE.pptxJAUNDICE.pptx
JAUNDICE.pptx
 
Liver biopsy interpretation
Liver biopsy interpretationLiver biopsy interpretation
Liver biopsy interpretation
 
Laboratory Interpretation K K
Laboratory Interpretation  K KLaboratory Interpretation  K K
Laboratory Interpretation K K
 
Approach to jaundice
Approach to jaundiceApproach to jaundice
Approach to jaundice
 
Pancreatic diseases
Pancreatic diseasesPancreatic diseases
Pancreatic diseases
 
Liver function test
Liver function testLiver function test
Liver function test
 
Investigation in a case of obstructive jaundice and
Investigation in a case of obstructive jaundice andInvestigation in a case of obstructive jaundice and
Investigation in a case of obstructive jaundice and
 
LIVER PATHOLOGY
LIVER PATHOLOGYLIVER PATHOLOGY
LIVER PATHOLOGY
 
URINALYSIS CHEM PATH.pptx
URINALYSIS CHEM PATH.pptxURINALYSIS CHEM PATH.pptx
URINALYSIS CHEM PATH.pptx
 
Approach to a case of Obstructive jaundice
Approach to a case of Obstructive jaundiceApproach to a case of Obstructive jaundice
Approach to a case of Obstructive jaundice
 
Hepato&spleenomegaly
Hepato&spleenomegalyHepato&spleenomegaly
Hepato&spleenomegaly
 
Approach to lft
Approach to lftApproach to lft
Approach to lft
 
Ascites and SBP
Ascites and SBPAscites and SBP
Ascites and SBP
 
Chronic Diarrhea.pptx
Chronic Diarrhea.pptxChronic Diarrhea.pptx
Chronic Diarrhea.pptx
 
Evaluation of dysphagia and diseases of the esophagus
Evaluation of dysphagia and diseases of the esophagusEvaluation of dysphagia and diseases of the esophagus
Evaluation of dysphagia and diseases of the esophagus
 
20. evaluation of dysphagia and diseases of the esophagus kk
20. evaluation of dysphagia and diseases of the esophagus kk20. evaluation of dysphagia and diseases of the esophagus kk
20. evaluation of dysphagia and diseases of the esophagus kk
 
Budd chiari syndrome
Budd chiari syndromeBudd chiari syndrome
Budd chiari syndrome
 
Cirrhosis ppt
Cirrhosis ppt Cirrhosis ppt
Cirrhosis ppt
 

More from Abino David

Clinical features of intestinal obstruction
Clinical features of intestinal obstructionClinical features of intestinal obstruction
Clinical features of intestinal obstructionAbino David
 
Aetiology of intestinal obstruction
Aetiology of intestinal obstructionAetiology of intestinal obstruction
Aetiology of intestinal obstructionAbino David
 
Management of abortion
Management of abortionManagement of abortion
Management of abortionAbino David
 
Induction of labour
Induction of labourInduction of labour
Induction of labourAbino David
 
Valvular heart disease
Valvular heart diseaseValvular heart disease
Valvular heart diseaseAbino David
 
Growth anomalies of the female genital tract
Growth anomalies of the female genital tractGrowth anomalies of the female genital tract
Growth anomalies of the female genital tractAbino David
 
CONGENITAL TALIPES EQUINO VARUS
CONGENITAL TALIPES EQUINO VARUSCONGENITAL TALIPES EQUINO VARUS
CONGENITAL TALIPES EQUINO VARUSAbino David
 
Relation between fetus & pelvis
Relation between fetus & pelvisRelation between fetus & pelvis
Relation between fetus & pelvisAbino David
 
Caesarean section
Caesarean sectionCaesarean section
Caesarean sectionAbino David
 
Paracetamol and sedative overdosage
Paracetamol and sedative overdosageParacetamol and sedative overdosage
Paracetamol and sedative overdosageAbino David
 
Compartment syndrome
Compartment syndromeCompartment syndrome
Compartment syndromeAbino David
 
ABERRATION IN NORMAL DEVELOPMENT AND INVOLUTION
 ABERRATION IN NORMAL DEVELOPMENT AND INVOLUTION ABERRATION IN NORMAL DEVELOPMENT AND INVOLUTION
ABERRATION IN NORMAL DEVELOPMENT AND INVOLUTIONAbino David
 
Acute limb ischemia
Acute limb ischemiaAcute limb ischemia
Acute limb ischemiaAbino David
 

More from Abino David (20)

Clinical features of intestinal obstruction
Clinical features of intestinal obstructionClinical features of intestinal obstruction
Clinical features of intestinal obstruction
 
Aetiology of intestinal obstruction
Aetiology of intestinal obstructionAetiology of intestinal obstruction
Aetiology of intestinal obstruction
 
Management of abortion
Management of abortionManagement of abortion
Management of abortion
 
Induction of labour
Induction of labourInduction of labour
Induction of labour
 
Valvular heart disease
Valvular heart diseaseValvular heart disease
Valvular heart disease
 
Growth anomalies of the female genital tract
Growth anomalies of the female genital tractGrowth anomalies of the female genital tract
Growth anomalies of the female genital tract
 
CONGENITAL TALIPES EQUINO VARUS
CONGENITAL TALIPES EQUINO VARUSCONGENITAL TALIPES EQUINO VARUS
CONGENITAL TALIPES EQUINO VARUS
 
Relation between fetus & pelvis
Relation between fetus & pelvisRelation between fetus & pelvis
Relation between fetus & pelvis
 
Caesarean section
Caesarean sectionCaesarean section
Caesarean section
 
Paracetamol and sedative overdosage
Paracetamol and sedative overdosageParacetamol and sedative overdosage
Paracetamol and sedative overdosage
 
Compartment syndrome
Compartment syndromeCompartment syndrome
Compartment syndrome
 
Varicocele
VaricoceleVaricocele
Varicocele
 
Spermatocoele
SpermatocoeleSpermatocoele
Spermatocoele
 
Neuro fibroma
Neuro fibromaNeuro fibroma
Neuro fibroma
 
Hydrocele
HydroceleHydrocele
Hydrocele
 
Fibroadenoma
FibroadenomaFibroadenoma
Fibroadenoma
 
Dermoid cyst
Dermoid cystDermoid cyst
Dermoid cyst
 
Lipoma
LipomaLipoma
Lipoma
 
ABERRATION IN NORMAL DEVELOPMENT AND INVOLUTION
 ABERRATION IN NORMAL DEVELOPMENT AND INVOLUTION ABERRATION IN NORMAL DEVELOPMENT AND INVOLUTION
ABERRATION IN NORMAL DEVELOPMENT AND INVOLUTION
 
Acute limb ischemia
Acute limb ischemiaAcute limb ischemia
Acute limb ischemia
 

Recently uploaded

Giftedness: Understanding Everyday Neurobiology for Self-Knowledge
Giftedness: Understanding Everyday Neurobiology for Self-KnowledgeGiftedness: Understanding Everyday Neurobiology for Self-Knowledge
Giftedness: Understanding Everyday Neurobiology for Self-Knowledgeassessoriafabianodea
 
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...MehranMouzam
 
PHYSIOTHERAPY IN HEART TRANSPLANTATION..
PHYSIOTHERAPY IN HEART TRANSPLANTATION..PHYSIOTHERAPY IN HEART TRANSPLANTATION..
PHYSIOTHERAPY IN HEART TRANSPLANTATION..AneriPatwari
 
SGK HÓA SINH NĂNG LƯỢNG SINH HỌC 2006.pdf
SGK HÓA SINH NĂNG LƯỢNG SINH HỌC 2006.pdfSGK HÓA SINH NĂNG LƯỢNG SINH HỌC 2006.pdf
SGK HÓA SINH NĂNG LƯỢNG SINH HỌC 2006.pdfHongBiThi1
 
Systemic Lupus Erythematosus -SLE PT2.ppt
Systemic  Lupus  Erythematosus -SLE PT2.pptSystemic  Lupus  Erythematosus -SLE PT2.ppt
Systemic Lupus Erythematosus -SLE PT2.pptraviapr7
 
Introduction to Sports Injuries by- Dr. Anjali Rai
Introduction to Sports Injuries by- Dr. Anjali RaiIntroduction to Sports Injuries by- Dr. Anjali Rai
Introduction to Sports Injuries by- Dr. Anjali RaiGoogle
 
Screening for colorectal cancer AAU.pptx
Screening for colorectal cancer AAU.pptxScreening for colorectal cancer AAU.pptx
Screening for colorectal cancer AAU.pptxtadehabte
 
Chronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptx
Chronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptxChronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptx
Chronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptxSasikiranMarri
 
PULMONARY EDEMA AND ITS MANAGEMENT.pdf
PULMONARY EDEMA AND  ITS  MANAGEMENT.pdfPULMONARY EDEMA AND  ITS  MANAGEMENT.pdf
PULMONARY EDEMA AND ITS MANAGEMENT.pdfDolisha Warbi
 
History and Development of Pharmacovigilence.pdf
History and Development of Pharmacovigilence.pdfHistory and Development of Pharmacovigilence.pdf
History and Development of Pharmacovigilence.pdfSasikiranMarri
 
Valproic Acid. (VPA). Antiseizure medication
Valproic Acid.  (VPA). Antiseizure medicationValproic Acid.  (VPA). Antiseizure medication
Valproic Acid. (VPA). Antiseizure medicationMohamadAlhes
 
ANEMIA IN PREGNANCY by Dr. Akebom Kidanemariam
ANEMIA IN PREGNANCY by Dr. Akebom KidanemariamANEMIA IN PREGNANCY by Dr. Akebom Kidanemariam
ANEMIA IN PREGNANCY by Dr. Akebom KidanemariamAkebom Gebremichael
 
Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)Mohamed Rizk Khodair
 
Rheumatoid arthritis - Musculoskeletal disorders.ppt
Rheumatoid arthritis - Musculoskeletal disorders.pptRheumatoid arthritis - Musculoskeletal disorders.ppt
Rheumatoid arthritis - Musculoskeletal disorders.pptraviapr7
 
Basic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdfBasic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdfDivya Kanojiya
 
CEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand University
CEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand UniversityCEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand University
CEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand UniversityHarshChauhan475104
 
SHOCK (Medical SURGICAL BASED EDITION)).pptx
SHOCK (Medical SURGICAL BASED EDITION)).pptxSHOCK (Medical SURGICAL BASED EDITION)).pptx
SHOCK (Medical SURGICAL BASED EDITION)).pptxAbhishek943418
 
epilepsy and status epilepticus for undergraduate.pptx
epilepsy and status epilepticus  for undergraduate.pptxepilepsy and status epilepticus  for undergraduate.pptx
epilepsy and status epilepticus for undergraduate.pptxMohamed Rizk Khodair
 
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...Badalona Serveis Assistencials
 
Myelin Oligodendrocyte Glycoprotein antibody associated disease (MOGAD)
Myelin Oligodendrocyte Glycoprotein antibody associated disease (MOGAD)Myelin Oligodendrocyte Glycoprotein antibody associated disease (MOGAD)
Myelin Oligodendrocyte Glycoprotein antibody associated disease (MOGAD)MohamadAlhes
 

Recently uploaded (20)

Giftedness: Understanding Everyday Neurobiology for Self-Knowledge
Giftedness: Understanding Everyday Neurobiology for Self-KnowledgeGiftedness: Understanding Everyday Neurobiology for Self-Knowledge
Giftedness: Understanding Everyday Neurobiology for Self-Knowledge
 
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
 
PHYSIOTHERAPY IN HEART TRANSPLANTATION..
PHYSIOTHERAPY IN HEART TRANSPLANTATION..PHYSIOTHERAPY IN HEART TRANSPLANTATION..
PHYSIOTHERAPY IN HEART TRANSPLANTATION..
 
SGK HÓA SINH NĂNG LƯỢNG SINH HỌC 2006.pdf
SGK HÓA SINH NĂNG LƯỢNG SINH HỌC 2006.pdfSGK HÓA SINH NĂNG LƯỢNG SINH HỌC 2006.pdf
SGK HÓA SINH NĂNG LƯỢNG SINH HỌC 2006.pdf
 
Systemic Lupus Erythematosus -SLE PT2.ppt
Systemic  Lupus  Erythematosus -SLE PT2.pptSystemic  Lupus  Erythematosus -SLE PT2.ppt
Systemic Lupus Erythematosus -SLE PT2.ppt
 
Introduction to Sports Injuries by- Dr. Anjali Rai
Introduction to Sports Injuries by- Dr. Anjali RaiIntroduction to Sports Injuries by- Dr. Anjali Rai
Introduction to Sports Injuries by- Dr. Anjali Rai
 
Screening for colorectal cancer AAU.pptx
Screening for colorectal cancer AAU.pptxScreening for colorectal cancer AAU.pptx
Screening for colorectal cancer AAU.pptx
 
Chronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptx
Chronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptxChronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptx
Chronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptx
 
PULMONARY EDEMA AND ITS MANAGEMENT.pdf
PULMONARY EDEMA AND  ITS  MANAGEMENT.pdfPULMONARY EDEMA AND  ITS  MANAGEMENT.pdf
PULMONARY EDEMA AND ITS MANAGEMENT.pdf
 
History and Development of Pharmacovigilence.pdf
History and Development of Pharmacovigilence.pdfHistory and Development of Pharmacovigilence.pdf
History and Development of Pharmacovigilence.pdf
 
Valproic Acid. (VPA). Antiseizure medication
Valproic Acid.  (VPA). Antiseizure medicationValproic Acid.  (VPA). Antiseizure medication
Valproic Acid. (VPA). Antiseizure medication
 
ANEMIA IN PREGNANCY by Dr. Akebom Kidanemariam
ANEMIA IN PREGNANCY by Dr. Akebom KidanemariamANEMIA IN PREGNANCY by Dr. Akebom Kidanemariam
ANEMIA IN PREGNANCY by Dr. Akebom Kidanemariam
 
Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)
 
Rheumatoid arthritis - Musculoskeletal disorders.ppt
Rheumatoid arthritis - Musculoskeletal disorders.pptRheumatoid arthritis - Musculoskeletal disorders.ppt
Rheumatoid arthritis - Musculoskeletal disorders.ppt
 
Basic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdfBasic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdf
 
CEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand University
CEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand UniversityCEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand University
CEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand University
 
SHOCK (Medical SURGICAL BASED EDITION)).pptx
SHOCK (Medical SURGICAL BASED EDITION)).pptxSHOCK (Medical SURGICAL BASED EDITION)).pptx
SHOCK (Medical SURGICAL BASED EDITION)).pptx
 
epilepsy and status epilepticus for undergraduate.pptx
epilepsy and status epilepticus  for undergraduate.pptxepilepsy and status epilepticus  for undergraduate.pptx
epilepsy and status epilepticus for undergraduate.pptx
 
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
 
Myelin Oligodendrocyte Glycoprotein antibody associated disease (MOGAD)
Myelin Oligodendrocyte Glycoprotein antibody associated disease (MOGAD)Myelin Oligodendrocyte Glycoprotein antibody associated disease (MOGAD)
Myelin Oligodendrocyte Glycoprotein antibody associated disease (MOGAD)
 

Investigations of jaundice

  • 1. INVESTIGATIONS OF JAUNDICE
  • 2. AIMS • DETECT HEPATIC ABNORMALITY • ASSESS SEVERITY OF DAMAGE • DETECT PATTERN OF ABNORMALITY; HEPATIC OBSTRUCTIVE / CHOLESTATIC • SPECIFIC CAUSE • COMPLICATIONS
  • 3. LIVER FUNCTION TESTS • Tests for Manufacture & excretion of bile • Serum enzyme assays • Tests for metabolic functions • Immunological Tests • USS • Liver Biopsy
  • 4. URINE EXAMINATION • BILE PIGMENTS – Conjugated Bilirubin • BILE SALTS in urine in cholestasis • UROBILINOGEN Increase in Hepatocellular d/s & hemolytic d/s Absent in biliary obstruction
  • 5. BIOCHEMICAL TESTS • SERUM PROTEINS ALBUMIN LOWERED GLOBULIN INCREASED • SERUM SODIUM – SEVERE LIVER DISEASE ( ADH PRODUCTION) • SERUM UREA – REDUCED IN HEPATIC FAILURE
  • 6. LIVER ENZYMES • ALP - INC –OBSTRUCTIVE JAUNDICE • AST/ SGOT - 5 -40 U/L • ALT/SGPT -5-30 U/L
  • 7. HAEMATOLOGICAL TESTS • ANAEMIA NORMO NORMO –GI HAEMORRHAGE HMA-IRON DEF • LEUCOPENIA - PORTAL HT, HYPERSPLENISM • LEUCOCYTOSIS- cholangitis, hepatic abscess • THROMBOCYTOPENIA- cirrhosis, c/c liver d/s
  • 8. COAGULATION TESTS PT- Prolonged obstructive jaundice Defective vit K absorption PT prolonged
  • 9. Immunological tests • CHRONIC LIVER DISEASE SCREEN • To confirm viral etiology Hep B surface Ag Hep C Ab Liver auto ab- nuclear, smooth muscle, mitochondrial • Immunoglobulin Ceruloplasmin • Ferritin alpha 1 antitrypsin
  • 10. RADIOLOGICAL IMAGING • X ray – liver abscess, biliary calculi,calcificatn • Barium swallow – esophageal varices • CONTRAST Radiography- biliary tree and gall bladder • ULTRASOUND- Non invasive • Gall stones, Biliary obstruction,splenomegaly,hepatic trs cyst abscess
  • 11. Continued • Doppler US –Blood flow in portal veins ,hepatic artery , hepatic veins • CT & MRI • CT- Small focal lesions can be detected • MRI- confirm etiology of primary n secondary liver trs
  • 12. CHOLANGIOGRAPHY • Can be undertaken by MRCP, ERCP or PTC • MRCP – Diagnostic test of choice Provides images of biliary tree
  • 13. NON INVASIVE MARKERS OF HEPATIC FIBROSIS • Differentiates severe fibrosis from mild scarring • Alternative – fibroscan test
  • 14. LIVER BIOPSY • Confirm severity of liver damage & provide etiological information • Serological markers- procollagen type peptide &metalloproteinases • Relatively safe • Complications – Abdominal or shoulder pain Bleeding biliary peritonitis