Jaundice: Difference between revisions
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[[Jaundice causes of jaundice#Common Causes|Common Causes]] | [[Jaundice causes of jaundice#Causes by Organ System|Causes by Organ System]] | [[Jaundice causes of jaundice#Causes in Alphabetical Order|Causes in Alphabetical Order]] | [[Jaundice causes of jaundice#Common Causes|Common Causes]] | [[Jaundice causes of jaundice#Causes by Organ System|Causes by Organ System]] | [[Jaundice causes of jaundice#Causes in Alphabetical Order|Causes in Alphabetical Order]] | ||
== Diagnosis == | ==[[Jaundice diagnosis|Diagnosis]]== | ||
===History and symptoms === | ===History and symptoms === | ||
Jaundice typically appears in a 'top to bottom' progression (starting with the face, progressing toward the feet), and resolves in a 'bottom to top' manner. It was once believed persons suffering from the medical condition jaundice saw everything as yellow, but this is not true. By extension, the jaundiced eye came to mean a prejudiced view, usually rather negative or critical. [[Alexander Pope]], in 'An Essay on Criticism' (1711), wrote: "All seems infected that the infected spy, As all looks yellow to the jaundiced eye." <ref name=eye>From "The Dictionary of Cliches" by James Rogers (Ballantine Books, New York, 1985).</ref> | Jaundice typically appears in a 'top to bottom' progression (starting with the face, progressing toward the feet), and resolves in a 'bottom to top' manner. It was once believed persons suffering from the medical condition jaundice saw everything as yellow, but this is not true. By extension, the jaundiced eye came to mean a prejudiced view, usually rather negative or critical. [[Alexander Pope]], in 'An Essay on Criticism' (1711), wrote: "All seems infected that the infected spy, As all looks yellow to the jaundiced eye." <ref name=eye>From "The Dictionary of Cliches" by James Rogers (Ballantine Books, New York, 1985).</ref> | ||
Revision as of 16:41, 16 July 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Assosciate Editor(s)-In-Chief: Prashanth Saddala M.B.B.S
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Synonyms and keywords: Icterus
Overview
Historical Perspective
Classification
Neonatal jaundice | Prehepatic jaundice | Hepatic jaundice | Posthepatic jaundice
Pathophysiology
Causes
Common Causes | Causes by Organ System | Causes in Alphabetical Order
Diagnosis
History and symptoms
Jaundice typically appears in a 'top to bottom' progression (starting with the face, progressing toward the feet), and resolves in a 'bottom to top' manner. It was once believed persons suffering from the medical condition jaundice saw everything as yellow, but this is not true. By extension, the jaundiced eye came to mean a prejudiced view, usually rather negative or critical. Alexander Pope, in 'An Essay on Criticism' (1711), wrote: "All seems infected that the infected spy, As all looks yellow to the jaundiced eye." [1]
The caregiver should ask questions regarding
- Alcohol/hepatotoxic medication use
Various Symptoms
- Alcohol Hepatitis
- Aspartate aminotransferase:alanine aminotransferase ratio > 2 (AST:ALT)
- Fever
- Leukocytosis
- Viral Hepatitis
- Anorexia
- Dark urine
- Fatigue
- Hepatomegaly
- Light-colored (acholic) loss stools
- Nausea
- Pruritis
- Right upper quadrant (RUQ) pain
- Nausea and Vomiting
Physical Examination
- Complete physical exam including evidence of:
- Hepatomegaly
- Splenomegaly
- Palpable gallbladder
- Signs of chronic liver disease
Appearance of the Patient Skin
- Jaundice is visible in conjunctiva, skin and mucosa when the serum bilirubin level rises above 2 mg/dL
Eyes
- Jaundice is usually best seen in the periphery of the ocular conjunctivae
Abdomen
- Hepatomegaly may be present
Neurologic
- A flap may be present
Lab tests
- Total and unconjugated bilirubin
- Bilirubin is the major breakdown product of hemoglobin that is released from dying or damaged erythrocytes
- The normal bilirubin range is 0.3-1.0 mg/dL
- Aspartate aminotransferase
- Alanine aminotransferase
- Albumin
- Alkaline phosphatase
- HIV serologies
- Hepatitis serologies
- Antinuclear antibody (ANA)
- Antimitochondrial antibodies
- Haptoglobin
- Reticulocyte count
- Lactic dehydrogenase (LDH)
MRI and CT
- Abdominal CT scan may be helpful
Echocardiography or Ultrasound
- Abdominal ultrasound
Other Diagnostic Studies
- Endoscopic retrograde cholangio-pancreatography (ERCP)
Treatment
- Discontinue (and avoid) use of hepatotoxic medications
- Rehydrate
- Treat underlying etiologies
Acute Pharmacotherapies
- Steroids
Surgery and Device Based Therapy
- Cholecystectomy or ERCP
See also
References
- ↑ From "The Dictionary of Cliches" by James Rogers (Ballantine Books, New York, 1985).
Template:Skin and subcutaneous tissue symptoms and signs Template:Nervous and musculoskeletal system symptoms and signs Template:Urinary system symptoms and signs Template:Cognition, perception, emotional state and behaviour symptoms and signs Template:Speech and voice symptoms and signs Template:General symptoms and signs
ar:يرقان bs:Žutica ca:Icterícia cs:Žloutenka da:Gulsot de:Ikterus eo:Iktero it:Ittero he:צהבת la:Icterus lt:Gelta ml:മഞ്ഞപ്പിത്തം ms:Demam kuning jaundis nl:Geelzucht no:Gulsott nn:Gulsot sk:Žltačka sl:Zlatenica fi:Keltaisuus sv:Gulsot te:పచ్చకామెర్లు