Causes of Jaundice

RBC L 120 days phagocytosis by macrophages in the reticuloendothelial system (macrophage syoten) in the spleen globin ↓ amino acids Heme Protoporphyrin ↓ uncojugated bilirubin (UCB) ↓ Not H2O soluble binds to albumin ↓ ↓ food taken to hepatocyle's gallbladder seveles bile stored as bile conjugated bilirubin has conjugated bilirubin gullbladder H₂O soluble I intestinal badkia bile duct Fe ↓ druined into urobilingen CUBA) bile canaliculi some reduced to stescobilin brown feaces reabsorbed into blood kidney spontaneous reducion to urobilin J yellow urine yellow sclera before skin ال as scleral hissue has elastin ↓ bilirubin bindo to it UCB Gxtravascular hemolytic anaemia, ineffective hematopoesis J broken by macrophages →146PD, mistmach transfusions, Rh mum Rnt dud pigmented gallstone list physiological jaundice of newburn If TTT UCB J busal ganglia ↓ kernicteres Ix Photo therapy ↓ light brain damage or death structural configurational charges in the bilirubin molecule absorbs light Breast milk Jaundice ↓ metabolile of progestrone UDP →↓bilirubin conjugation Genetic delects J Gibert is syndrome ↓ JUAT problematic esp it something that happers UGB e.g. infection, smess, starvation conjugahan a hemolysis Crigler Najjar syndrome vsually futal kernicterus ↓ NO JUT 17 UCB likelihood of deposition in the bruin Conjugated Bilirubin ↓ Dubin Johnson Syndrome cel in Hee transporter protien that moves conjugled bilirubin from hepatocytes into bile canaliculus abstructive jaundice something blocks bile floue ↓ eg gallstone, panceatic carcinomas, cholangiocarcinomas, parasites e.g. liver failure ↓ ↑ Pin bile ductal systems MRP2 when defective MRP 3 is upregulated bilirubin builds up in hepatocytes moves CB indo interstiol space & the BF instead of bile 2 caniculus CB in blood ↓ blood darke urine liver it self also gets very dark bile leuks between light-junchions that line the walls of the hepatocytes since wate soluble gelb inb urines ↓ dak viine ↑bile loss ↓ fat absanchion ↑ fat excretion ↓ Steatorrhea other bile contents can also leak out ind blood ↑ bile salts, bile acido cholestrol cas also leak out if deposit in skin ↓ skin itchiness ↓ cholestrolemia + xanthomes pruritus absorption of fat Conjugated + Unconjugated Bilirubin Viral Hepatitis infected hepatocytes die aff ↓ ↓ lining of the toile duds ability to conjugate bilirubin AUCB let bile leak ink the blood ↑ in blood CB } 1 CB in dood douler urine Biliary Amesia ↓ abstruction or deformity aloscence of lume no definitive Cause amloo Types congenital →ricuses, toxins, mutations CCFCI gene inflammation Cmore common J san afler birth involved in development of 2-R ombryonic αγίς inflammatio of bile ducts obstruction obstruchion to bile flove ↑ bile buildup ↓ bile pushes way between light jchon bekuan epithelial cello lining ducts lealks in the lblood 1 SCB yellowing of Skin + ques thaygh the most comman cause of neonatul jaundice overall, it is thee most common cause of jaundice that is surgically freetable early recognition improves elffectives of the surgery kasai procedue typical procedure damage bile duco untride the live ave surgically removed ↓ small intestine removed →ane end is directy attached to the liver wheеем bile comes out also where bile duct used to be ↓ bile directly drains inb omall inleshne other pact of small inkome is re-attached to ano the spot along the small inledine Though can eflective at be restablishing bile flow alot of newboons continue to have slowly progressing live disease LIVER stomach small intestines oflen need a liver transplant by 2 yrs of age Red flags * <24hrs * lasts for more than 2 wks * pale stoods ½ dark urine * poor feeding * par weight gain * trauma during birth or insmmental delivey