Hemolytic jaundice

The examiner will now refer you again to Mrs Horn and ask you tell me a little about the 2 other causes of jaundice that you have ruled out, tell me a bit about haemolytic jaundice

You tell the examiner that is excessive break down of red blood cells because as we discussed earlier on bilirubin the name we give to this yellow stuff cones largly from breakdown of red blood cells and that of haemoglobin, Haemolytic jaundice is always mild, patients are not deeply jaundice they have signs and symptoms of anaemia because that's what is causing the lesion. And if you were to check their liver function it would be entirely normal, the problem is that the liver is over loaded with break down of haemoglobin so that it tries to conjugate as much as it can, and succeeds, but some of it remains unconjugated. The spleen is often enlarged a condition we call splenomegaly.
And it turns out that if you were producing enormous amounts of bilirubin, due to red cell breakdown, the liver can not cope and therefore tries to excrete as much as possible, and it is a significant fact, that the patients who are haemolysing and producing lots of bilirubin, actually form gall stones which can obstruct the biliary tree, so you get grafted on signs and symptoms of obstructive jaundice.