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Jaundice - Coggle Diagram
Jaundice
Unconjugated hyperbilirubinemia
Pattern of bilirubin elevation base on the presence of underlying liver diasease
Without liver disease
With coexisting liver disease
Overproduction of bilirubin
Hemolysis
Dyserythropoiesis
Extravasation
Is characterized by plasma elevation of predominantly unconjugated bilirubin due to the overproduction of bilirubin, impaired bilirubin uptake by the liver or abnormalities of bilirubin conjugation
Impared hepatic uptake
Medications (rifamycin antibiotics, probenecid) The drug induced defect usually resolves within 48 hours after discontinuation of the drug
Sinusoidal surface of hepatocytes, Gilbert syndrome
Congestive heart failure or portosystemic shunts reduce hepatic blood flow and the delivery of bilirubin yo hepatocytes, resulting unconjugated hyperbilirubinemia
Impared bilirubin conjugation
Reduce bilirubin conjugation as a result of a decreased or absent UDP - glucuronosyltransferase activity is found in conditions such as Crigler Najjar and Gilbert syndrome
Conjugated hyperbilirubinemia
In patients with conjugated hyperbilirubinemia, both bilirubin levels increase. Conjugated hyperbilirubinemia may be due to hepatocellular Diases, imparted canalicular excretion, defective rey-take of conjugated bilirubin or biliary obstruction
Inherited diseases
Diseases such as Dubin Johnson syndrome, Rotor syndrome, benign recurrente intrahepatic cholestasis BRIC
Extrahepatic cholestasic / biliary obstruction
In biliary obstruction, both bilirubin accumulate in serum. Obstruction of biliary flow causes retention of conjugated bilirubin within hepatocyte where resersal of glucoronidation may take place
Intrahepatic cholestasis
Other causes:
Hepatitis, primary biliary cholangitis, drugs and toxins, sepsis, infiltrative disorders, intrahepatic cholestasis of pregnancy, postoperative jaundice, organ transplantation
The normal concentration serum bilirubin is less than 1,2 mg/dl. Direct bilirubin: 0,0 - 0,3 md/dL. Indirect bilirubin: 0,2 - 0,8
Is often interchangeably with hyperbilirubinemia, which can be detected when the serum bilirubin is greater than 2 mg /dl