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Jaundice

Jaundice is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

Yellow pigmentation of tissues and body fluids due to hyperbilirubinemia, usually present at levels of >2.5 mg/dL

Etiology

  • Unconjugated (indirect) hyperbilirubinemia: Unconjugated bilirubin is the direct breakdown product of heme, is water insoluble, and is measured as indirect bilirubin:
    • Hemolytic:
      • Excessive production of unconjugated bilirubin
    • Hepatic:
      • Decreased hepatobiliary excretion of bilirubin by:
        • Defective uptake (drugs, Crigler–Najjar syndrome)
        • Defective conjugation (Gilbert syndrome drugs)
        • Defective excretion of bilirubin by the liver cell (drugs, Dubin–Johnson syndrome)
  • Conjugated (direct) hyperbilirubinemia:
    • Conjugated bilirubin is water soluble and measured as direct bilirubin.
    • In conjugated hyperbilirubinemia, bilirubin is returned to the bloodstream after conjugation in the liver instead of draining into the bile ducts.
    • Hepatocellular dysfunction:
      • Hepatitis
      • Cirrhosis
      • Tumor invasion
      • Toxic injury
    • Intrahepatic (nonobstructive) cholestasis
    • Extrahepatic (obstructive) cholestasis

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Citation

Rosen, Peter, et al., editors. "Jaundice." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307611/all/Jaundice.
Jaundice. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307611/all/Jaundice. Accessed April 26, 2019.
Jaundice. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307611/all/Jaundice
Jaundice [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307611/all/Jaundice.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Jaundice ID - 307611 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307611/all/Jaundice PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -