BNBM 6144 Basic Medical Science 11 – Jaundice & LFT Analysis

You are required to write an essay addressing the below:

A. Elaborate the disorders where jaundice appears as a clinical symptom.

• Discuss at least three major categories of disorders (pre-hepatic, hepatic, and post-hepatic).
• Explain the underlying pathophysiological mechanisms contributing to bilirubin accumulation and provide relevant examples.

B.  Describe the types of jaundice with their respective bilirubin levels.

• Define each type: pre-hepatic, hepatic, and post-hepatic.
• Explain normal and abnormal serum bilirubin ranges.
• Compare conjugated and unconjugated bilirubin levels in each type.

C. Explain how liver function test (LFT) assist in distinguishing between different types of jaundice.

• Discuss the significance of key LFT parameters.
• Interpret how specific LFT patterns indicate hepatic versus obstructive pathology and provide examples from clinical aspects.

Experts Answer on Above Questions on Jaundice and LFT

Disorders where jaundice appears

Pre hepatic. The excessive red-cell destruction results in the production of bilirubin that exceeds the liver’s conjugating capacity Such as haemolytic anaemia, Malaria etc.

Hepatic – The impaired bilirubin processing results in reduction in uptake, conjugation or excretion Such as viral hepatitis, liver disease etc.

Post-hepatic – The conjugated bilirubin does not reach the intestine because of bile flow obstruction and it leads to reflux into the blood such as pancreatic head tumour, gallstones.

Types of Jaundice and bilirubin

Pre-hepatic jaundice – It is unconjugated bilirubin because haemolysis increases the production of bilirubin.

Hepatic Jaundice – There can be a rise in both unconjugated and conjugated bilirubin because damaged hepatocytes cannot efficiently process bilirubin.

Post hepatic/obstructive jaundice – It is conjugated bilirubin because bile cannot flow normally into the intestine.

Normal total bilirubin – It is approximately 0.3 to 1.2 milligram per dl and there are chances of differences in laboratory references. When the bilirubin reaches 2-3 mg/dL, Jaundice is clinically visible.

How LFT distinguish Jaundice

ALT and AST – Marked elevations favour hepatocellular injury such as hepatitis.

ALP and GGT – High levels favour cholestasis or biliary obstructions.

Bilirubin – Indirect elevation supports pre hepatic haemolysis.

Albumin and PT/INR – It helps in assessing hepatic synthetic function.

Interpretation – Very high ALT/AST and comparatively smaller ALP elevation indicates hepatocellular jaundice and marked ALP/GGT With direct hyperbilirubinemia Indicates obstructive jaundice.

Want Detailed Answers with References?

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