Please enable JavaScript.
Coggle requires JavaScript to display documents.
A 30-year old man noted that he has had tea-coloured urine since the…
A 30-year old man noted that he has had tea-coloured urine since the evening before. He has not been feeling well for the past 5-6 days. He went to see his GP, who then referred him on to the Emergency Department in the hospital when he noted the patient was jaundiced.
urinary tract infection
acute onset dysuria ± fever is suspicious. Look at the dipstick for nitrite &leukocyte +ve, and UFEME for pyuria.
Benign trauma: e.g. preceding sports, sex, recent cystoscopy. Repeat the sample
Periurethral bleed: consider causes e.g. traumatic catheterization, tear of penile frenulum.
Obstructive jaundice
benign
gallstones (most common)
-
Mirizzi syndrome is the presence of a stone impacted in the cystic duct or the gallbladder neck, causing inflammation and external compression of the common hepatic duct and thus biliary obstruction
infection
A tear in the duct causes bile leakage and predisposes the patient to a localized infection. In turn, this accentuates scar formation and the ultimate development of a fibrous stricture.
Ascaris lumbricoides from intestines, obstructing the extrahepatic ducts
iver flukes (eg, Clonorchis sinensis, Fasciola hepatica - obstruct the smaller bile ducts within the liver, resulting in intraductal cholestasis
-
external compression
-
pancreas malignancy
Pancreatic cancer: a cancer in the body or tail of pancreas may present with chronic progressive epigastric pain radiating to the back. A head of pancreas tumor is more likely to present with obstructive jaundice
biliary tb
abdominal pain and elevated liver function test results, suggesting obstruction
infectious (cytomegalovirus, Cryptosporidium species, and microsporidia
-
-
yellowing of the skin and whites of the eyes; paler stools and darker urine; and intense itching. may also feel tired.
blood tests to examine the level of bilirubin, as well as ultrasound of the liver and bile ducts to find out the exact cause of the obstruction is. CT scans are also used to help examine what is causing the blockage
-
PE- bruising, spider angiomas, gynecomastia, testicular atrophy, and palmar erythema. An abdominal examination to assess liver size and tenderness is important. The presence or absence of ascites also should be noted.