JAUNDICE

Prepared by:

ALIA ZULAIKHA MOHD HANIF D11B037AHMAD SALLEHUDDIN MUKHTARRUDDIN D11A001

ABDUL MUHAIMIN ABD WAHAB D11A007AHMAD HANIF B. M AMIN D11B043

Introduction and normal condition of jaundice

By: Alia Zulaikha Mohd Hanif D11 B037

INTRODUCTION• Jaundice is not a dz by its own but reflects some other

underlying dz

• Jaundice (also known as icterus ) is a yellowish pigmentation of the skin, the conjunctival membranes over the sclerae, other mucous membrane caused by hyperbilirubinemia

• Often seen in liver dz such as hepatitis or liver cancer indicate obstruction of the biliary tract, for example by gallstones or pancreatic cancer, or less commonly be congenital in origin.

Darkening of urine due to excess breakdown of rbc

Jaundice of gums

Jaundice of the sclera of the eye

*concentration higher than 1.8 mg/dL (>30µmol/L) leads to jaundice

NORMAL CONDITION

• The average life span of a normal eryhtrocytes I20 days.

• The red cells are destroyed, and the hemoglobin is broken down.

• Hemoglobin, the part of red blood cells that carries oxygen, is broken down into a dark greenish yellow pigment called bilirubin

• Bilirubin is then carried in the bloodstream to liver and is excreted into intestine as a component of bile

• If bilirubin cannot be excreted into bile quickly enough, it builds up in the blood.

• Excess bilirubin is deposited in the skin, resulting in the yellowish discoloration called jaundice.

Causes and symptoms of jaundice

By: Abdul Muhaimin bin Abd Wahab D11 A007

CAUSES

• Pre-hepatic icterus– Too much bilirubin being produced and liver is unable

to process all of it. (Overproduction)– Due to excessive breakdown of RBCs (Anemia)

• Primary hepatic jaundice– Abnormal metabolism and excretion of bilirubin by

liver cells. (Failure hepatocyte uptake and failure to excrete)

– Liver disease that may contribute to other diseases.• Diabetes mellitus, cancer, acute toxic hepatitis,

cholangiohepatitis, cirrhosis of liver and fatty liver syndrome.

CAUSES

• Post-hepatic icterus– When the bile duct interferes with excretion of

bilirubin.– Causes bile duct obstruction, a rupturing bile duct,

pancreatic disease, cancer, inflammation of gallbladder and bile duct.

– Causing gallstone or tumor. (Blockage duct carrying bile from liver to small intestine)

SYMPTOMS• Yellow Colouring

– Primary symptom of jaundice.– In the whites of the eyes, in the skin at base of ears, along the gums

and in the skin of abdomen.• Lethargy

– Becomes lethargy, lose appetite and weight loss.– Looks emaciated and losing muscular body due to body begins to feed

off the muscles.• Digestive Problems

– Vomiting, diarrhea and stomach bloating.– Frequently urinate due to obsessively drink.– Serious condition: Poisoning, heartworm disease, liver infections and

cirrhosis, pancreatic, gall bladder and intestinal disease.

General Symptoms

• Skin and whites of eyes appear yellow• Urine dark (because of excessive bilirubin excreted through the

kidney)• Itching• Vomiting• Diarrhea• Lethargy• Excessive thirst• Loss of appetite• Difficulty in breathing• Abdominal distension• Excessive drinking and urinating

Diagnosis and treatment of jaundice

By: Ahmad Hanif bin M Amin D11B043

Diagnosis • Physical examination – yellow discoloration of the skin or

mucous membranes • Bloodwork – serum bilirubin• PCV – to rule out anemia• Abdominal and chest X-rays– To assess organ size and shape & presence of foreign objects

• Abdominal ultrasound – To assess size, shape and structure of abdominal organs,

especially liver– Bile duct obstruction

Treatment • No 1 for all & No specific treatment!!! It is directed to underlying disorder

• Some liver diseases respond to specific treatments, while the majority can only be managed symptomatically and supportively.

• Treatment of liver disease (jaundice) may include:

- fluid administration, electrolyte - antibiotics- antacids- non steroidal anti-inflammatory drugs (NSAIDs)- Carprofen Rimadyl, drugs to suppress scar tissue formation or to influence bile flow- vitamin K, vitamin E - fatty acid supplements

The end!!!