Chapter 043 Jaundice (Part 1) pptx

... membrane transport. No specific bilirubin transporter has yet been identified (Chap. 297, Fig. 297 -1). After entering the hepatocyte, unconjugated bilirubin is bound to the cytosolic protein ligandin, ... to biliverdin. The differential diagnosis for yellowing of the skin is limited. In addition to jaundice, it includes carotenoderma, the use of the drug quinacrine, and excessive expos...

Ngày tải lên: 06/07/2014, 15:21

... advanced cirrhosis. Chapter 043. Jaundice (Part 5) History A complete medical history is perhaps the single most important part of the evaluation of the patient with unexplained jaundice. Important ... particular diagnosis. A history of arthralgias and myalgias predating jaundice suggests hepatitis, either viral or drug-related. Jaundice associated with the sudden onset o...

Ngày tải lên: 06/07/2014, 15:21

... Chapter 043. Jaundice (Part 9) Choledocholithiasis is the most common cause of extrahepatic cholestasis. ... quadrant discomfort with only minimal elevations of the enzyme tests to ascending cholangitis with jaundice, sepsis, and circulatory collapse. PSC may occur with clinically important strictures ... 800 IU/L), but the bilirubin is often near normal. These patients do not...

Ngày tải lên: 06/07/2014, 15:21

... glucuronides is impaired and the glucuronides are present in serum in increasing amounts. By Chapter 043. Jaundice (Part 2) Measurement of Serum Bilirubin The terms direct- and indirect-reacting ... backward leakage of the pigment. The initial steps in evaluating the patient with jaundice are to determine (1) whether the hyperbilirubinemia is predominantly conjugated or unc...

Ngày tải lên: 06/07/2014, 15:21

... Direct hyperbilirubinemia A. Inherited conditions 1. Dubin- Chapter 043. Jaundice (Part 3) Evaluation of the patient with jaundice. MRCP, magnetic resonance cholangiopancreatography; ALT, ... The differential diagnosis of an isolated unconjugated hyperbilirubinemia is limited (Table 43 -1). The critical determination is whether the patient is suffering from a hemolytic...

Ngày tải lên: 06/07/2014, 15:21

... conditions: Dubin-Johnson syndrome and Rotor's syndrome (Table 43 -1). Patients with both conditions present with asymptomatic jaundice, typically in the second generation of life. The defect ... nature. Elevation of Serum Bilirubin with Other Liver Test Abnormalities The remainder of this chapter will focus on the evaluation of the patient with a conjugated hyperbilirubinemia i...

Ngày tải lên: 06/07/2014, 15:21

... Wilson's disease Autoimmune hepatitis Chapter 043. Jaundice (Part 6) Hepatocellular Conditions Hepatocellular diseases that can cause jaundice include viral hepatitis, drug or environmental ... believed to occur primarily in young adults, should be considered in all adults if no other cause of jaundice is found. Autoimmune hepatitis is typically seen in young...

Ngày tải lên: 06/07/2014, 15:21

... Cholestasis of pregnancy I. Total parenteral nutrition J. Nonhepatobiliary sepsis Chapter 043. Jaundice (Part 7) Cholestatic Conditions When the pattern of the liver tests suggests a cholestatic ... disorder, the next step is to determine whether it is intra- or extrahepatic cholestasis (Fig. 43 -1). Distinguishing intrahepatic from extrahepatic cholestasis may be difficult....

Ngày tải lên: 06/07/2014, 15:21

... marrow transplantation. Vanishing bile duct syndrome also occurs in rare cases of Chapter 043. Jaundice (Part 8) Drugs may cause intrahepatic cholestasis, a variant of drug-induced hepatitis. ... the intensive care unit, the major considerations should be sepsis, shock liver, and TPN jaundice. Jaundice occurring after bone marrow transplantation is most likely due to venooc...

Ngày tải lên: 06/07/2014, 15:21

... neurons: primary sensory afferents, motor neurons, and sympathetic postganglionic neurons (Fig. 12 -1). The cell bodies of primary sensory afferents are located in the dorsal root ganglia in the ... afferents: the small-diameter myelinated A- delta (Aδ) and the unmyelinated (C fiber) axons (Fig. 12 -1). These fibers are present in nerves to the skin and to deep somatic and visceral struct...

Ngày tải lên: 06/07/2014, 08:20