黄疸级一系老麻醉救援心理陶小红ppt课件.pptVIP

Recognise jaundice Position：sclera, skin and tongue sleeves Pseudojaundice(假性黄疸): eat Carotene(胡罗卜素) food (Carotene,pumpkin(南瓜), tomato, orange) also can cause skin stained yellow, but bilirubin is not increased. Old people fat accumulation at bulbar conjunctiva(球结膜), yellow, uneven distribution Questions 1) Unconjugated hyperbilirubinemia usually results from a intra- or extrahepatic biliary obstruction. A. True B. False 2) Clinical features of cholecystitis include all of the following except: A. RUQ abdominal pain B. Radiation to R upper back C. Nausea, Vomiting D. + Murphy’s sign E. Fever 3) A marker of acute hepatocyte injury is: A. PT B. ALT C. Albumin D. Direct bilirubin E. Ammonia 1.A 13 years old male, chief complaints “Finding skin and sclera yellow and feeling right upper abdomen swell pain for 1 week” Blood test: TBil:80μmol/L, DBil:50μmol/L, ALT:1200U/L. B Ultrasound: normal. What are the possible diagnoses and your suggested examinations. Hepatocellular and Cholestetic jaundice. Hepatitis virus test, Urine test, or MRCP. Question Reference books Cecil mecidine 23rd edition. Davidson’ principles and practice of medicine. Harrisons principles of internal medicine.16th edition. * Jaundice does not occur before delivery because bilirubin producted by the breakdown of cells in the fetal spleen passes via the placenta to the maternal circulation. Serum albumin transports the fetal bilirubin to the maternal liver where and enzyme (glucuronyl transferase) converts it to excretable direct bilirubin. The liver of the neonate does not produce glucuronyl transferase and cannot convert bilirubin to an excretable form. Consequently, bilirubin accumulates and if not removed will collect in tissue causing jaundice and brain tissue Jaundice(黄疸)　 Department of Gastroenterology, First Affiliated Hospital of Chongqing Medical University XIAOHONG TAO (陶小红) Jaundice or icterus : What is jaundice ? Clinically it is the yellow discoloration o