Jaundice

Question 1

Extravascular Hemolysis/Ineffective Erythropoeisis Type of Hyperbilirubinemia and Urine Findings

Answer 1

UCB
Dark urine due to increased urobilinogen from increased CB in bile. NOT DUE TO INCREASED UCB, BECAUSE UCB IS NOT WATER SOLUBLE

Question 2

Physiologic Jaundice of the Newborn Type of Hyperbilirubinemia, Complication, and Treatment

Answer 2

UCB
Fat soluble, deposits in basal ganglia (kernicterus) and can lead to neurological deficit and death
Treat with phototherapy which does NOT conjugate BR, instead makes water soluble

Question 3

Gilbert Syndrome Type of Hyperbilirubinemia, Generally what it is and inheritance

Answer 3

UCB

AR mildly low UGT activity, get jaundice during stress but doesn’t matter

Question 4

Criggler-Najjar Syndrome Type of Hyperbilirubinemia, and what it is

Answer 4

UCB

Absence of UGT, generally leads to kernicterus and death

Question 5

Dubin-Johnson Syndrome Type of Hyperbilirubinemia, What it is/inheritance/gross finding

Answer 5

CB
AR deficiency of BR canalicular transport proteins. Not clinically significant usually
LIVER IS SUPER DARK

Question 6

Rotor Syndrome

Answer 6

Same thing as Dubin-Johnson but without dark liver

Question 7

Biliary Tract Obstruction Type of Hyperbilirubinemia, Urine Findings, another Lab Finding, General Symptoms

Answer 7

CB
Decreased urine urobilinogen because decreased CB in bile, but dark urine because increased soluble BR (CB)
Increased alk phos
Pale stools, pruritis, steatorrhea/malab, cholesterol xanthomas

Question 8

Viral Hepatitis Type of Hyperbilirubinemia/Urine

Answer 8

CB and UCB because inflammation affects hcytes and small bile ducts
Dark urine from bilirubinuria, but still urobilinogen normal or decreased