OnlineMedEd: Gastroenterology - "Jaundice" Flashcards
1
Q
Go through the order of yellowing in jaundice.
A
- First: sublingual mucosa
- Second: ears
- Third: sclera
- Fourth: skin
2
Q
Haptoglobin binds to _______________.
A
hemoglobin
3
Q
The rate-limiting step of conjugation is ______________.
A
2,3-UDP glucuronyltransferase
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)
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.