Notes in 25 Jaundice

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Published	07/30/2024	Bilirubin comes from {{c1::heme}} in hemoglobin, which is from the destruction of old RBCs
Published	07/30/2024	Two main sources of bilirubin {{c1::RBC breakdown in spleen Ineffective erythropoiesis}}
Published	07/30/2024	{{c1::Reticuloendothelial cells}}, primarily in the spleen and liver form bilirubin
Published	07/30/2024	First reaction of bilirubin production is from oxidation by {{c1::heme oxygenase}} microsomal enzyme
Published	07/30/2024	Bilirubin formation First reaction enzyme: {{c2::heme oxygenase}}Second reaction enzyme: {{c1::biliverdin reductase}}
Published	07/30/2024	QC. Bilirubin 1. Soluble in water2. Insoluble in water{{c1::B}}
Published	07/30/2024	QC. Unconjugated bilirubin1. Bound to albumin 2. Unbound to albumin {{c1::A}}
Published	07/30/2024	Conjugation to {{c1::glucuronic acid}} makes bilirubin soluble in endoplasmic reticulum of hepatocytes by the enzyme {{c2::Uridine diphosphate-glucuro…
Published	07/30/2024	Conjugated bilirubin is transferred into the canalicular bile by the enzyme {{c1::Multidrug resistance protein 2}}
Published	07/30/2024	Conjugated bilirubin in the small intestine is reduced to {{c2::urobilinogen}} by gut flora and {{c1::80%-90%::%}} is excreted in feces
Published	07/30/2024	Bacterial {{c1::β-glucuronidases::enzyme}} hydrolyze conjugated bilirubin to unconjugated bilirubin
Published	07/30/2024	QC. Formation of bilirubin1. reticuloendothelial cells2. hepatocyte cells{{c1::A}}
Published	07/30/2024	QC. Conjugation of bilirubin1. reticuloendothelial cells2. hepatocyte cells{{c1::B}}
Published	07/30/2024	[VR]1. Defective UDPGT2. Unconjugated bilirubin {{c1::A}}
Published	07/30/2024	VR1. Defective UDPGT2. Conjugated bilirubin {{c1::B}}
Published	07/30/2024	[QC] Conjugated hyperbilirubinemia 1. Defective UDPGT2. Defective MRP2{{c1::B}}
Published	07/30/2024	Hemolytic anemia leads to increased bilirubin turnover and {{c1::unconjugated::Conjugated or Unconjugated}} hyperbilirubinemia
Published	07/30/2024	Required serum bilirubin levels to obtain scleral icterus {{c1::> 3 mg/dL}}
Published	07/30/2024	{{c1::Sclera}} is the first area to assess for jaundice
Published	07/30/2024	{{c1::Elastin}} component of the sclera has high affinity for bilirubin
Published	07/30/2024	QC. Indirect bilirubin 1. Unconjugated bilirubin 2. Conjugated bilirubin{{c1::A}}
Published	07/30/2024	QC. Direct bilirubin 1. Unconjugated bilirubin 2. Conjugated bilirubin{{c1::B}}
Published	07/30/2024	QC. Serum level concentration 1. Indirect bilirubin 2. Direct bilirubin {{c1::A}}
Published	07/30/2024	What is delta bilirubin/biliprotein?{{c1::Conjugated bilirubin that is COVALENTLY linked to albumin and detected as B2}}
Published	07/30/2024	Half-life of delta bilirubin {{c1::12-14 days}}
Published	07/30/2024	Exposure to {{c1::phenols::environmental exposure}} or {{c1::quinacrine}} can cause yellowish coloration of skin
Published	07/30/2024	Two syndromes associated with elevated B2{{c1::Dubin-Johnson SyndromeRotor Syndrome}}
Published	07/30/2024	Two syndromes associated with elevated B1{{c1::Crigler-Najjar syndromeGilbert’s syndrome}}
Published	07/30/2024	Biliary pain is a severe {{c1::visceral::Somatic or Visceral}} pain in {{c2::epigastric region/RUQ::abdominal region}} that radiates to the back
Published	07/30/2024	If you see fever and hyperbilirubinemia, think of…{{c1::Cholangitis Liver abscessViral Hepatitis::3}}
Published	07/30/2024	Hepato-biliary pathology associated with GI bleeding and hyperbilirubinemia{{c1::Ampullary CALiver cirrhosis::2}}
Published	07/30/2024	Two important preliminary laboratory tests to assess for px with jaundice{{c1::Isolated elevation of bilirubinBilirubin and other liver tests elevated…
Published	07/30/2024	For alcoholic hepatitis, the temporal relationship should be within {{c1::2}} months of last alcohol intake.
Published	07/30/2024	Transfusions before {{c1::1986}} have a risk for HBV
Published	07/30/2024	There is a Hepatitis infection with HCV risk in blood transfusions before {{c1::1992}}
Published	07/30/2024	Signs of portal hypertension {{c1::AscitesSplenomegalyLeg EdemaCaput Medusae}}
Published	07/30/2024	Stigmata of chronic liver disease{{c1::Spider angiomaPalmar erythemaGynecomastiaParotid gland enlargementTesticular atrophyLoss of body hairDuputren’s…
Published	07/30/2024	Familiarize with different laboratory tests for liver function {{c1::}}
Published	07/30/2024	Give drugs that inhibit uptake of unconjugated bilirubin {{c1::RifampinProbenecidRibavirin}}
Published	07/30/2024	Syndrome associated with DEC UDPGT activity {{c1::Gilbert’s syndromeCrigler Najjar type 1 and 2}}
Published	07/30/2024	QC. Dubin Johnson Syndrome 1. MRP-2 Transporter Defect2. OATP1B1 and OATP1B3 Defct{{c1::A}}
Published	07/30/2024	QC. Rotor Syndrome 1. MRP-2 Transporter Defect2. OATP1B1 and OATP1B3 Defct{{c1::B}}
Published	07/30/2024	QC. Zero ability to conjugate bilirubin1. Type I Crigler-Najjar2. Type II Crigler-Najjar{{c1::A}}
Published	07/30/2024	QC. Poor prognosis 1. Type 1 Crigler-Najjar2. Type 2 Crigler-Najjar{{c1::A}}
Published	07/30/2024	Genes affected in ff. syndromes Gilbert: {{c2::UGT1A1}}Type 1 Crigler-Najjar: {{c2::UGT1A1}}Type 2 Crigler-Najjar: {{c2::UGT1A1}}Dubin Johnson: {…
Published	07/30/2024	CBA. ALT:ALP ratio> 5 ratioA. Hepatocellular (hepatitis)B. CholestaticC. Mixed Cholestatic and Hepatocellular{{c1::A}}
Published	07/30/2024	CBA. ALT:ALP ratio< 2 ratioA. Hepatocellular (hepatitis)B. CholestaticC. Mixed Cholestatic and Hepatocellular{{c1::B}}
Published	07/30/2024	Normal Values: ALT:ALP ratioCholestatic: {{c1::2}}Mixed Cholestatic-Hepatocellular: {{c1::2-5}}Hepatocellular: {{c1::5}}
Published	07/30/2024	Drug related to hepatocellular (hepatitis) liver injury {{c1::IsoniazidParacetamol}}
Published	07/30/2024	Drug related to cholestatic liver injury {{c1::Rifampicin}}
Published	07/30/2024	AST/ALT ratio in alcoholic hepatitis {{c1::AST/ALT ratio 2:1, AST, 3000U/L}}
Published	07/30/2024	QC. Viral hepatitis1. Elevated ALT2. Elevated AST{{c1::A}}
Published	07/30/2024	Liver pathology associated with hypoalbuminemia {{c1::Chronic liver diseaseCirrhosis}}
Published	07/30/2024	{{c1::Wilson's disease}} - Rare condition that causes copper levels to build up in several organs (liver, brain, eyes)
Published	07/30/2024	Intrahepatic cholestasis. Drug related to cholestatic hepatitis{{c1::ChlorpromazineErythromycin::2}}
Published	07/30/2024	Intrahepatic cholestasis. Drug related to chronic cholestasis{{c1::ChlorpromazineProchlorperazine}}
Published	07/30/2024	Primary biliary cholangitis in intrahepatic cholestasis Etiology:{{c1::Antimitochondrial antibodies}}
Published	07/30/2024	Causes of Primary Sclerosing Cholangitis{{c1::IBD}}
Published	07/30/2024	Familiarize with metastatic and benign causes of extrahepatic cholestasis {{c1::}}
Published	07/30/2024	Diagnostic and therapeutic method for biliary stones{{c1::Endoscopic Retrograde Cholangiopancreatography (ERCP)}}
Published	07/30/2024	Procedure of choice for diagnostic purposes of biliary stones{{c1::Magnetic Resonance CholangiopancreatographyEndoscopic UTZ}}
Published	07/30/2024	Top of the line diagnostic and therapeutic method for draining bile {{c1::Percutaneous Transhepatic Cholangiography (PTC)Percutaneous Transhepati…
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