Pathology Cheat Sheet
Classify the Jaundice Pattern
Jaundice and hepatitis for NEET-PG: unconjugated vs conjugated bilirubin, Gilbert syndrome, Councilman bodies, ground-glass hepatocytes, and HBV serology.
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Classify the Jaundice Pattern
Jaundice and hepatitis for NEET-PG: unconjugated vs conjugated bilirubin, Gilbert syndrome, Councilman bodies, ground-glass hepatocytes, and HBV serology.
Bilirubin metabolism and the classification of jaundice, and the pathology and serology of viral hepatitis.
High-yield lines
- Unconjugated bilirubin is fat-soluble and albumin-bound, whereas conjugated bilirubin is water-soluble and excreted in bile.
- Prehepatic jaundice from haemolysis causes unconjugated hyperbilirubinaemia without bilirubinuria.
- Hepatocellular jaundice causes a mixed rise in bilirubin with raised transaminases.
- Posthepatic obstructive jaundice causes conjugated hyperbilirubinaemia with pale stools, dark urine, and raised alkaline phosphatase.
- Gilbert syndrome is a mild inherited defect of UGT1A1 causing unconjugated hyperbilirubinaemia with fasting.
- Crigler-Najjar syndrome is severe UGT1A1 deficiency causing marked unconjugated hyperbilirubinaemia.
- Hepatitis A and E are transmitted enterically and cause acute self-limited hepatitis, with hepatitis E dangerous in pregnancy.
- Hepatitis B and C are transmitted parenterally and can cause chronic hepatitis, cirrhosis, and hepatocellular carcinoma.
- Councilman bodies are apoptotic hepatocytes seen in viral hepatitis.
- Ground-glass hepatocytes indicate chronic hepatitis B surface antigen accumulation.
- HBsAg indicates active hepatitis B infection, and anti-HBs indicates immunity or recovery.
- IgM anti-HBc indicates acute or recent hepatitis B infection, useful during the window period.
Mapped competency codes
- PA25.1
- PA25.3
- PA25.6
Continue into the full chapter
This summary maps to PA25-hepatobiliary-system.
Frequently Asked Questions
How is jaundice classified by bilirubin type?
Prehepatic haemolytic jaundice causes unconjugated hyperbilirubinaemia, hepatocellular jaundice causes a mixed pattern, and obstructive jaundice causes conjugated hyperbilirubinaemia with pale stools and dark urine.
What are Councilman bodies?
Apoptotic hepatocytes appearing as shrunken eosinophilic bodies, characteristic of viral hepatitis.
Which hepatitis viruses cause chronic infection?
Hepatitis B and hepatitis C, which are parenterally transmitted and can progress to cirrhosis and hepatocellular carcinoma.
What does IgM anti-HBc indicate?
Acute or recent hepatitis B infection, and it is especially useful for diagnosis during the window period when HBsAg has cleared but anti-HBs has not yet appeared.
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