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==[[Jaundice diagnosis|Diagnosis]]==
==[[Jaundice diagnosis|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." <ref name=eye>From "The Dictionary of Cliches" by James Rogers (Ballantine Books, New York, 1985).</ref>
The caregiver should ask questions regarding
* Alcohol/hepatotoxic medication use
'''Various Symptoms'''
* '''Alcohol Hepatitis'''
*:* Aspartate aminotransferase:alanine aminotransferase ratio > 2 (AST:ALT)
*:* [[Ddx:Fever|Fever]]
*:* [[Leukocytosis]]
* '''Viral Hepatitis'''
*:* [[Anorexia]]
*:* Dark urine
*:* [[Ddx:Fatigue|Fatigue]]
*:* [[Hepatomegaly]]
*:* Light-colored (acholic) loss stools
*:* [[Ddx:Nausea and Vomiting|Nausea]]
*:* [[Ddx:Pruritis|Pruritis]]
*:* [[Abdominal pain|Right upper quadrant (RUQ) pain]]
*:* [[Nausea and Vomiting]]
===Physical Examination===
* Complete physical exam including evidence of:
*:* [[Ddx:Hepatomegaly|Hepatomegaly]]
*:* [[Ddx:Splenomegaly|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 ==
== Treatment ==

Revision as of 16:45, 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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  • Discontinue (and avoid) use of hepatotoxic medications
  • Rehydrate
  • Treat underlying etiologies

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  • Steroids

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  • Cholecystectomy or ERCP


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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


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