August 31, 2015 - Jaundice *

Question 1

Mechanisms of Jaundice

Answer 1

1. Increased production of bilirubin
2. Decreased uptake of bilirubin by liver cells
3. Decreased ability to conjugate
4. Decreased excretion of bilirubin into the bile

Question 2

Stercobilin

Answer 2

Turns stool brown.

Question 3

Urobilin

Answer 3

Turns urine yellow.

Question 4

Physiologic Jaundice of the Newborn

Answer 4

Very common.

Bilirubin is mild to moderately high.

Peaks 72-96 hours of life.

If prolonged, may cause kernicterus (brain damage from bilirubin).

Treatment: phototherapy

Question 5

Carotenemia

Answer 5

Yellow discoloration of the skin caused by eating carrots.

NOT jaundice. This is evidenced by the white sclerae of the eyes.

Question 6

Heinz Body Stain

Answer 6

Inclusions within red blood cells composed of denatured hemoglobin.

This is observed in patients with G6PD deficiency.

Question 7

Biliary Atresia

Answer 7

Progressive obstruction of the large bile ducts in newborns by inflammation and subsequent scarring; the cause is unknown.

This is the most common reason for a pediatric liver transplant. Untreated BA leads to cirrhosis and liver failure and 100% will die by 3 years.