Easy and simple

1. DR. ADIL FARUQI
(MD KYRGYZSTAN)

2.  IT IS NOT A DIAGNOSIS, IT IS JUST A SIGN
 Jaundice is a condition in which the skin, whites of the eyes
and mucous membranes
turn yellow because of a
high level of bilirubin , a
yellow-orange bile pigment.
 SERUM BILIRUBIN
EXCEEDS >2mg/dl
OR >50mmol/l

4. 1. PRE-HEPATIC JAUNDICE (before the production of
bilirubin)
2. HEPATIC-JAUNDICE (during production of
bilirubin)
3. POST-HEPATIC JAUNDICE (after the production of
bilirubin)

5. • HEMOLYTIC ANEMIAS
 THALASSEMIA
 SICKLE CELL ANEMIA
 ERYTHROBLASTOSIS FETALIS
 G-6PD ANEMIA
• DRUGS
 ANTI-MALARIAL
 DAPSONES
 NITROFURANTOIN

6. • Decrease uptake
 Congenital : Gilbert Syndrome
 Acquired : Drugs (Rifampacin)
• Conjugation Impaired
 Congenital : Criggler-Najjar
 Acquired : Drugs(Chloramphenicol),Physiological Jaundice, Breast
Milk Jaundice
• Release in Billiary Channel
 Congenital : Dubin-Johnson
 Acquired : Drugs(Isoniazid,Rifampacin,Statins,Halothane, Sodium
Valporate)

7. • Drugs
 STEROIDS
 FLUCILAXILIN
 SULFONYL UREAS
 PROCLORAPRAZINE
• GALL STONES
• INFECTION OF BILE DUCT(SEVERE CHOLANGITIS)
• TUMORS
• LYMPHODENOPATHY OF PORTA HEPATIS

8.  GENETIC DFFECT LEADING TO UNCONJUGATED
HYPERBILIRUBINEMIA.
 THERE IS PARTIAL DEFFICIENCY OF CHANNELS
FOR BILIRUBIN TO ENTER INTO HEPATOCYTE
 USUALLY ASYMPTOMATIC
 OFF & ON JAUNDICE DEVELOPMENT

9.  AUTOSOMAL RECESSIVE ENZYME DEFECT
 ABSENT GLUCURONOSYLTRANSFERASE
 DIE BEFORE AGE OF 2 yrs
 LEADS IN KERNICTERUS(BILIRUBIN DEPOSITION
IN BRAIN)
 TREATMENT IS PLASMAPHERESIS AND
PHOTOTHERAPY

10.  A GENETIC DEFECT IN WHICH DEFICIENCY OF
EXIT CHANNELS OF BILIRUBIN EXIST
 COLOR OF LIVER BECOMES BLACK DUE TO
DEPOSITION OF PIGMENT WHICH RESEMBLES
MELANIN
 IT IS BENIGN CONDITION

11.  IF PREGNANT WOMAN IS GIVEN
CHLORAMPHENICOL THEN IT WILL CROSS
PLACENTA AND IRREVERSILY INHINIT
GLUCUROSYLTRANSFERASE ENZYME AND BABY
WILL BORN WITH SEVERE HYPERBILIRUBINEMIA
AND COLOR OF BABY WILL BE GREY
 BABY GOING TO DIE WITHIN 48 hrs

12.  GLUCUSYLTRANSFERASE TAKE ONE WEEK TO
BECOME MATURE IN TERM BABIES AND TAKE
TWO WEEKS IN PRETERM BABIES
 APPEAR ON SECOND DAY OF LIFE
 RESOLVES WITHOUT TREATMENT WITHIN 1-2
WEEKS
 TREATMENT IF WE NEED THEN PHOTOTHERAPY
WILL BE NEEDED

13.  THERE ARE SOME PROTEINS IN MOTHER WHICH
INHIBIT GLUCUROSYLTRANSFERASE
 IT IS NOT INDICATED TO QUIT MILK

14.  PRE-HEPATIC
 JAUNDICE + ANEMIA(HEMOLYSIS)
 ABNORMAL WEIGHT LOSS
 DARK URINE AND PALE SKIN
 HEPATIC(HEPATITIS)
 JAUNDICE
 FEVER,MALAISE,ANOREXIA
 PAIN/TENDERNESS IN RHC
 HEPATOMEGALY
 NAUSEA/VOMITING
 POST-HEPATIC
 JAUNDICE + PRURITUS(DEPOSITION OF BILE SALTS IN SKIN)
 CLAY COLORED STOOLS
 DEVELOPMENT OF XANTHOMAS

15.  Doctors diagnose jaundice by checking for signs of liver disease
such as:
 Bruising of the skin
 Spider angiomas (abnormal collection of blood vessels near the
surface of the skin)
 Palmar erythema (red coloration of the palms and fingertips)
 Urinalysis (urine testing) that is positive for bilirubin shows that
the patient has conjugated jaundice. The findings of urinalysis
should be confirmed by serum testing. The serum testing will
include a complete blood count (CBC) and bilirubin levels.
 Your doctor will also do an exam to determine the size and
tenderness of your liver. He or she may use imaging
(ultrasonography and computer tomographic (CT)
scanning) and liver biopsy (taking a sample of the liver) to
further confirm diagnosis.

16.  Anemia-induced jaundice may be treated by boosting
the amount of iron in the blood by either taking iron
supplements or eating more iron-rich foods. ...
 Hepatitis-induced jaundice requires antiviral or
steroid medications.
 Doctors can treat obstruction-induced jaundice by
surgically removing the obstruction.

17.  REFERENCE IS INTERNET , USMLE FIRST AID, DIMS
NOTES
 This information is very useful in passing PMDC
Examination
FOR FURTHER CONTACT
adilfaruqi222@gmail.com