Jaundice..

2day i've saw a jaundice patient..let's explain wat jaundice is..

jaundice is where yellow pigementation in skin ,mucosae or sclera due to high albumin level(<35micro mol/L)

Physiology of Bilirubin
so..Bilirubin is a substance that produce after the process of heamolysis,break down of the RBC.
so..our liver will takes up bilirubin.
after that it will go through Left/R hepatic duct to common HD then to the gall bladder.
then the biluribin is use to produce bile which make to emulsify fats.
then bile can go kidney and pass down by urine or will be reabsorb in kidney.
once the substance being reabsorbed it's call urobilinogen.
1st pathway :
liver cell take up bilirubin and biliverdin --- bile ducts--- gall bladder--- duodenum---gut--urine
2nd pathway:
reabsorb from gut ---urobilinogen

Types of jaundice:
clasified by site of problem

A.) Pre-hepatic jaundice


causes : -haemolytic disease
            -genetic hyperalbuminaemia

Mechanism going:
causes--- heamolysis increases--- high RBC--- high bilirubin

symptoms:

• Pale-lemon yellow color
• splenomegaly (due to high RBC destruction)
• stools normal 
• urobilinogen
• reticulocyte

B.) Hepatic jaundice

Causes : 
hepatocellular/liver cell failure, intrahepatic obstruction

mechanism : 
causes--- cannot take up bilirubin--accumulation of bilirubin

symptoms :

• normal lvl bilirubin
• infect, primary liver cancer,poisons ,drugs
• swelling of hepatocytes-- obstruction of small bile ducts/canaliculi. intrahepatic obstructive

C.) Post-hepatic jaundice

causes: 

• obstruction of bile ducts .(bile stones)
• pressure on bile ducts from outside.

symptoms :

• pale stools
• dark urine
• high serum cholesterol
• itching

Table of diagnostic tests^[9]

Function test	Pre-hepatic Jaundice	Hepatic Jaundice	Post-hepatic Jaundice
Total bilirubin	Normal / Increased	Increased
Conjugated bilirubin	Normal	Increased	Increased
Unconjugated bilirubin	Normal / Increased	Increased	Normal
Urobilinogen	Normal / Increased	Increased	Decreased / Negative
Urine Color	Normal	Dark (urobilinogen + conjugated bilirubin)	Dark (conjugated bilirubin)
Stool Color	Normal	Normal/Pale	Pale
Alkaline phosphatase levels	Normal	Increased
Alanine transferase and Aspartate transferase levels		Increased
Conjugated Bilirubin in Urine	Not Present	Present

thr's few more types of jaundice..like physiological..new born baby..
tiredddd...sleep 1st~will share 2moro..