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JAUNDICE (HYPERBILIRUBINAEMIA) |
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unconjugated hyperbilirubinaemia: [no bilirubinuria; raised urinary urobilinogen; normal stools] |
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increased production of bilirubin: |
haemolysis [various causes] resorption of large haematoma |
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decreased hepatic uptake of bilirubin: |
drugs, eg. rifampicin genetic disorders, eg. Gilbert's syndrome |
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impaired conjugation: |
physiological in newly born genetic (Gilbert's syndrome, Crigler-Najjar syndrome) acquired (diffuse hepatocellular damage; but main component here is conjugated hyperbilirubinaemia) |
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conjugated hyperbilirubinaemia: [bilirubinuria present; with complete obstruction, stools are pale and no urinary urobilinogen is present] |
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hepatocellular: |
genetic (Dublin-Johnson and Rotor syndromes) drugs (various; different mechanisms) viral hepatitis (A, B, C, etc.) liver cirrhosis, eg. alcoholic cholestasis of pregnancy pericholangitis, eg. in ulcerative colitis leptospirosis 1� biliary cirrhosis metastases, including Hodgkin's disease |
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post-hepatic obstruction: |
cholelithiasis carcinoma of head of pancreas, cholangiocarcinoma strictures of bile duct sclerosing cholangitis pancreatic pseudocyst duodenal ulceration cholestatic jaundice of pregnancy worms (Ascaris lumbricoides) Caroli's disease |
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