OnlineMedEd: Gastroenterology - "Jaundice" Flashcards

1
Q

Go through the order of yellowing in jaundice.

A
  • First: sublingual mucosa
  • Second: ears
  • Third: sclera
  • Fourth: skin
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2
Q

Haptoglobin binds to _______________.

A

hemoglobin

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3
Q

The rate-limiting step of conjugation is ______________.

A

2,3-UDP glucuronyltransferase

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4
Q

Review the three categories of jaundice and some causes of each.

A

•Prehepatic (unconjugated bilirubinemia):

  • Hemolysis (G6PD deficiency, hereditary spherocytosis)
  • Resorption of a hematoma

•Intrahepatic (unconjugated or conjugated bilirubinemia):

  • Gilbert’s (unconjugated)
  • Crigler-Najjar (unconjugated)
  • Rotor’s (conjugated)
  • Dubin-Johnson (conjugated) –black liver!!
  • Hepatitis (mixed)

•Posthepatic (conjugated bilirubinemia):

  • Gallstones (which will be painful)
  • Cancer (which will be painless)
  • Strictures (which will be painless)
  • Biliary atresia (in an infant)
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5
Q

How can you use the history to figure out if the jaundice is conjugated or unconjugated?

A

•”Is your urine dark?”

- Dark urine means conjugated bilirubinemia.

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