Jaundice | Anatomy2Medicine
Jaundice Symptoms

Jaundice

    • Jaundice
  • Conjugated bilirubin (direct) is easily excreted because it is soluble in water.
  • Unconjugated bilirubin (indirect) is not soluble in water.
  • Jaundice is clinically apparent when the serum total bilirubin is above 3 mg/dL (MCQ)
    • Hemolysis causes elevated indirect bilirubin. (MCQ)
    • Impaired conjugation is caused by
      • reduced hepatic uptake resulting from liver disease (eg, hepatitis) (MCQ)
      • conjugation enzyme deficiencies.
    • Conjugated hyperbilirubinemia is caused by
      • reduced hepatic excretion
      • impaired bile flow (eg, bile duct obstruction)
  • Neonatal jaundice
      • occurs during the first week of life.
      • There is a mild and transient rise in unconjugated bilirubin with a benign clinical course.
      • It is caused by inadequate production of glucuronyl transferase by the immature liver. (MCQ)
      • It is treated by UV exposure. (MCQ)
  • Hemolytic disease of the newborn
      • caused by maternal-fetal Rh incompatibility (MCQ)
      • more clinically ominous
      • usually has higher bilirubin levels than benign neonatal jaundice. (MCQ)
    • Breast milk jaundice
      • occurs in some breastfed newborns
      • usually after the first week(MCQ)
      • lasts longer than physiologic jaundice. (MCQ)
    • Gilbert syndrome
      • a common cause of slightly increased unconjugated bilirubin
      • it ┬áis usually discovered by (MCQ)
  • family history
        • an incidental finding in routine laboratory testing.
      • There is no hepatic impairment or clinical symptoms(MCQ)
      • If the patient becomes stressed, or febrile it may lead to jaundice.
    • Crigler-Najjar syndrome
      • is a severe familial glucoronyl transferase enzyme deficiency
      • very high unconjugated bilirubin levels.
  • Type I
        • causes kernicterus
        • uniformly fatal.
  • Type II
      • less severe
      • responds to phenobarbital treatment(MCQ)
      • reduces the unconjugated bilirubin levels.
  • Dubin-Johnson syndrome
    • an autosomal recessive disease (MCQ)
    • defective protein carrier in the bile canalicular membrane
    • leads to impaired bile excretion
    • black pigmentation of the liver (MCQ)
    • elevated conjugated bilirubin levels.