BIOMED
Pathophysiology
Everything be alphabetical here (except for Homeostasis at the bottom) 😘
(& Mental Health, Lmao)
There are a lot of neonatal conditions covered, seen in high level NICU/NCCU Units.
-
Table of Contents:
1 | Ageing
2 | Canc...
Jaundice When a disruption in the excretion of bilirubin is present, bilirubin accumulates in body tissues and causes what we can 'Jaundice.' This is a yellowing of the skin that is actually somewhat plainly comparable to as yellow as this 🟨 in Caucasian people. It can be more difficult to identify in darker skin tones, however the whites of the eyes are always an easy place to detect the first signs of jaundice in a a patient, as Jaundice is usually first detectable in the whites of the eyes, before it appears in the skin.
Bilirubin - What is it & what is the breakdown process? Bilirubin is the product derived from process of the body destroying red blood cells (RBC).
Oops! This image does not follow our content guidelines. To continue publishing, please remove it or upload a different image.
The haemoglobin molecule is broken down into glob in, a protein, a haem and the iron portion of the molecule. This leads to biliverdin in which is converted into the fat soluble bilirubin and is released. This form of fat soluble bilirubin is called unconjugated bilirubin.
Physiology Bilirubin usually binds with albumin and is then transported to the liver to be converted to a water soluble bilirubin known as conjugated bilirubin, and will be excreted in the bile.
Pathophysiology When this process is interrupted, we get an accumulation of systemic bilirubin which has the potential to have devastating affects on the body.
Haemolytic Jaundice In this instance, we see the break down of BRC exceeding the rate that the liver can process the byproducts, and thus results in a high a high blood level of unconjugated bilirubin.
Hepatic jaundice We also have hepatic jaundice, which occurs when a hepatocyte (liver cell) is impaired. When the hepatocyte can't do it's job properly, the process of converting unconjugated to conjugated bilirubin and excreting this is disrupted, and thus we see blood levels of both unconjugated and conjugated bilirubin elevated.
In this case, we may potentially see dark urine, as the kidneys end up excreting the water soluble conjugated bilirubin , and stools may potentially appear normal to clay coloured.
Obstructive Jaundice Here, we see that there is an obstruction in the bile flow in the biliary system. When the biliary system (gall bladder & bile ducts) have an obstruction, we see elevated levels of conjugated bilirubin, as the process has already taken place, however the obstruction interferes with the excretion process. In this instance, we are likely to see stools that are light / clay coloured as there is a lack of bile pigments, and like previously mentioned, the urine appears dark, as the kidneys compensate and excrete the conjugated bilirubin.
Jaundice in Infants: * Physiological Jaundice is common, occurring in 60-80% of preterm babies * occurs around 3-5 days of life
Liver metabolises bilirubin & every baby is born with an immature liver * Baby has a high haem blood component in the womb, but when they start breathing air, they don't need it. So they begin to break foes the RBC's and this rises the levels * bilirubin attaches to fat, and BF colostrum helps bind bilirubin to excrete. Formula doesn't do this * being in biliblankets/under lights its like a day at the beach. They will get dehydrates and their temp needs to be taken regularly and accurately.
