This document discusses jaundice and hepatitis B. It defines jaundice as a yellowing of the skin and eyes caused by high bilirubin levels. It then discusses the pathophysiology of jaundice and how bilirubin is processed in the liver. Signs and symptoms include yellow skin and eyes. Diagnostic tests include liver function tests and imaging. Treatment depends on the underlying cause but may include medications, surgery, or liver transplant. The document also discusses hepatitis B as a viral infection attacking the liver that can cause acute or chronic disease.

1. JAUNDICE
AND
HEPATITIS B
By ifsha Akhlaq

2. JAUNDICE
 Yellowing of the skin and eyes condition occurs
when too much bilirubin is present in body.

3. EPIDEMIOLOGY
 In United states
 6.1% infants in 1986
 4.3 % in 2003
 2.9% in 1994 reported.
 In Turkey 10.5% reported.

4. PATHOPHYSIOLOGY
 Bilirubin is produced by breakdown of hemoglobin
into unconjugated bilirubin.
 Un conjugated bilirubin binds to albumin in the
blood and transport to liver.
 In liver the enzyme uridine diphosphogluconurate
glucuronasyltransferase (UGT) conjugated this
bilirubin with glucronic acid which is taken up by
hepatocytes.
 This conjugated bilirubin excreted in bile.
 In patients or neonates the conjugated bilirubin is
deconjugates and recycled into the circulation and
not excreted from body.

6. SIGNS & SYMPTOMS
 Yellow tinted skin and eye
 Whites of eye turn brown but in severe condition
 Dark urine
 Pale stool
 Excessive fatigue
 Vomiting

7. DIAGNOSTIC TEST
 CBCs
 Liver function test
 Imaging test
 Abdominal ultrasounds
 Computed tomography scans
 Magnetic resonance imaging
 Liver biopsies

8. TREATMENT
 Supportive care
 Jaundice caused by medication/drugs the antidote
is required.
 Steroids in which have autoimmune diseases with
jaundice.
 Diuretics and lactulose is used in jaundice with
cirrhosis.
 Antibiotics for infectious causes of jaundice.
 Blood transfusions may be required in individuals
who have anemia from hemolysis.
 Surgery is requiring for jaundice with gallstones.
 Jaundice with liver failure need liver transplant.

9. HEPATITIS B
 Hepatitis B is a viral infection that attacks the liver
and can cause both acute and chronic disease.

10. EPIDEMIOLOGY
 780,000 people die in a year due to hepatitis B.
 In Middle East and Indian subcontinent 2-5 %
chronically infected.
 Less than 1 % of the population of western Europe
and North American is chronically infected.

11. PATHOPHYSIOLOGY
 Blood become exposed to HBV the body cell
mediated immune response sending cytotoxic T
cells and naturally killer cells against the virus and
release inflammatory cytokines.
 As the hepatocytes are attacked and infiltrated by
the HBV. Because hepatocytes are continually
proliferating the virus is constantly being shed into
the blood which leads to the chronic illness.

12. SIGNS & SYMPTOMS
 Dark urine
 Joint pain
 Loss of appetite
 Fever
 Abdominal discomfort
 Weakness
 Yellow skin and eyes

13. DIAGNOSTIC TEST
 Hepatitis B surface antigen test
 Hepatitis B core antigen test
 Antibody Hepatitis B surface antigen test
 Liver function tests

14. TREATMENT
 Hepatitis B immune globulin Within 24hours in
contact with HBV
 Antiviral medication
 Liver transplant