Icterus examination

AMA Citation Singh M, Whitfield D. Singh M, & Whitfield D Singh, Manpreet, and Denise Whitfield.Conjunctival Icterus. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. Knoop K.J., & Stack L.B., & Storrow A.B., & Thurman R(Eds.), Eds. Kevin J. Knoop, et al.eds. The Atlas of Emergency Medicine, 5e. McGraw Hill; 2021. Accessed June 16, 2023. https://accessmedicine.mhmedical.com/content.aspx?bookid=2969§ionid=250454132 APA Citation Singh M, Whitfield D. Singh M, & Whitfield D Singh, Manpreet, and Denise Whitfield. (2021). Conjunctival icterus. Knoop KJ, Stack LB, Storrow AB, Thurman R. Knoop K.J., & Stack L.B., & Storrow A.B., & Thurman R(Eds.), Eds. Kevin J. Knoop, et al. The Atlas of Emergency Medicine, 5e. McGraw Hill. https://accessmedicine.mhmedical.com/content.aspx?bookid=2969§ionid=250454132 MLA Citation Singh M, Whitfield D. Singh M, & Whitfield D Singh, Manpreet, and Denise Whitfield. "Conjunctival Icterus." The Atlas of Emergency Medicine, 5e Knoop KJ, Stack LB, Storrow AB, Thurman R. Knoop K.J., & Stack L.B., & Storrow A.B., & Thurman R(Eds.), Eds. Kevin J. Knoop, et al. McGraw Hill, 2021, https://accessmedicine.mhmedical.com/content.aspx?bookid=2969§ionid=250454132. Conjunctival icterus is an indicator of elevated bilirubin levels (hyperbilirubinemia) due to an underlying disease that affects the metabolism or excretion of bilirubin. The eye conjunctiva is a thin layer that overlies the sclera. It is one of the very first tissues to change in color due to ...

icterus is used interchangeably with jaundice to refer to yellow discoloration of skin, mucous membranes, and sclerae caused by an accumulation of bilirubin pigment in plasma (hyperbilirubinemia) and tissues. Icterus generally becomes visible when serum bilirubin concentration exceeds 2 to 3mg/dL (35 to 50 µmol/L), or greater than five- to 10-fold above reference range. Unlike other nonspecific clinical signs of hepatobiliary disease (e.g., inappetence, lethargy, weight loss, vomiting, diarrhea, and dehydration), icterus correlates with hyperbilirubinemia and is therefore a highly specific clinical sign consistent with decreased excretion of bilirubin in association with hepatobiliary disease or increased formation in association with severe hemolysis. Despite excellent specificity, icterus and hyperbilirubinemia are relatively insensitive indicators, found only in moderate to severe hepatic insufficiency and overall in less than 50% of dogs and cats with hepatic disease. 1 prehepatic, which results from accelerated red blood cell destruction (hemolysis) and increased bilirubin production; (b) hepatic, which is caused by intrinsic hepatocellular disease and reduced hepatocyte uptake, conjugation, and secretion of bilirubin; and (c) posthepatic, which is caused by extrahepatic cholestasis and disruption of bile flow through the extrahepatic biliary system (Fig. 18-1). 1, 2 This mechanistic classification helps to explain how different categories of disease can cause hyperbi...

A 2-week-old male is brought to the emergency department by his parents for Laboratory value Result Hemoglobin 16.5 mg/dL 49.5% Mean corpuscular hemoglobin 27.8 pg/cell Leukocyte count 7,100/mm 3 23.0 mg/dL 0.3 mg/dL Which of the following interventions will provide definitive treatment for this patient’s condition? Sitemap USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.

Jaundice in an adult patient can be caused by a wide variety of benign or life-threatening disorders. Organizing the differential diagnosis by prehepatic, intrahepatic, and posthepatic causes may help make the work-up more manageable. Prehepatic causes of jaundice include hemolysis and hematoma resorption, which lead to elevated levels of unconjugated (indirect) bilirubin. Intrahepatic disorders can lead to unconjugated or conjugated hyperbilirubinemia. The conjugated (direct) bilirubin level is often elevated by alcohol, infectious hepatitis, drug reactions, and autoimmune disorders. Posthepatic disorders also can cause conjugated hyperbilirubinemia. Gallstone formation is the most common and benign posthepatic process that causes jaundice; however, the differential diagnosis also includes serious conditions such as biliary tract infection, pancreatitis, and malignancies. The laboratory work-up should begin with a urine test for bilirubin, which indicates that conjugated hyperbilirubinemia is present. If the complete blood count and initial tests for liver function and infectious hepatitis are unrevealing, the work-up typically proceeds to abdominal imaging by ultrasonography or computed tomographic scanning. In a few instances, more invasive procedures such as cholangiography or liver biopsy may be needed to arrive at a diagnosis. The word “jaundice” comes from the French word jaune, which means yellow. Jaundice is a yellowish staining of the skin, sclera, and mucous mem...

icterus is used interchangeably with jaundice to refer to yellow discoloration of skin, mucous membranes, and sclerae caused by an accumulation of bilirubin pigment in plasma (hyperbilirubinemia) and tissues. Icterus generally becomes visible when serum bilirubin concentration exceeds 2 to 3mg/dL (35 to 50 µmol/L), or greater than five- to 10-fold above reference range. Unlike other nonspecific clinical signs of hepatobiliary disease (e.g., inappetence, lethargy, weight loss, vomiting, diarrhea, and dehydration), icterus correlates with hyperbilirubinemia and is therefore a highly specific clinical sign consistent with decreased excretion of bilirubin in association with hepatobiliary disease or increased formation in association with severe hemolysis. Despite excellent specificity, icterus and hyperbilirubinemia are relatively insensitive indicators, found only in moderate to severe hepatic insufficiency and overall in less than 50% of dogs and cats with hepatic disease. 1 prehepatic, which results from accelerated red blood cell destruction (hemolysis) and increased bilirubin production; (b) hepatic, which is caused by intrinsic hepatocellular disease and reduced hepatocyte uptake, conjugation, and secretion of bilirubin; and (c) posthepatic, which is caused by extrahepatic cholestasis and disruption of bile flow through the extrahepatic biliary system (Fig. 18-1). 1, 2 This mechanistic classification helps to explain how different categories of disease can cause hyperbi...

Jaundice in an adult patient can be caused by a wide variety of benign or life-threatening disorders. Organizing the differential diagnosis by prehepatic, intrahepatic, and posthepatic causes may help make the work-up more manageable. Prehepatic causes of jaundice include hemolysis and hematoma resorption, which lead to elevated levels of unconjugated (indirect) bilirubin. Intrahepatic disorders can lead to unconjugated or conjugated hyperbilirubinemia. The conjugated (direct) bilirubin level is often elevated by alcohol, infectious hepatitis, drug reactions, and autoimmune disorders. Posthepatic disorders also can cause conjugated hyperbilirubinemia. Gallstone formation is the most common and benign posthepatic process that causes jaundice; however, the differential diagnosis also includes serious conditions such as biliary tract infection, pancreatitis, and malignancies. The laboratory work-up should begin with a urine test for bilirubin, which indicates that conjugated hyperbilirubinemia is present. If the complete blood count and initial tests for liver function and infectious hepatitis are unrevealing, the work-up typically proceeds to abdominal imaging by ultrasonography or computed tomographic scanning. In a few instances, more invasive procedures such as cholangiography or liver biopsy may be needed to arrive at a diagnosis. The word “jaundice” comes from the French word jaune, which means yellow. Jaundice is a yellowish staining of the skin, sclera, and mucous mem...

AMA Citation Singh M, Whitfield D. Singh M, & Whitfield D Singh, Manpreet, and Denise Whitfield.Conjunctival Icterus. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. Knoop K.J., & Stack L.B., & Storrow A.B., & Thurman R(Eds.), Eds. Kevin J. Knoop, et al.eds. The Atlas of Emergency Medicine, 5e. McGraw Hill; 2021. Accessed June 16, 2023. https://accessmedicine.mhmedical.com/content.aspx?bookid=2969§ionid=250454132 APA Citation Singh M, Whitfield D. Singh M, & Whitfield D Singh, Manpreet, and Denise Whitfield. (2021). Conjunctival icterus. Knoop KJ, Stack LB, Storrow AB, Thurman R. Knoop K.J., & Stack L.B., & Storrow A.B., & Thurman R(Eds.), Eds. Kevin J. Knoop, et al. The Atlas of Emergency Medicine, 5e. McGraw Hill. https://accessmedicine.mhmedical.com/content.aspx?bookid=2969§ionid=250454132 MLA Citation Singh M, Whitfield D. Singh M, & Whitfield D Singh, Manpreet, and Denise Whitfield. "Conjunctival Icterus." The Atlas of Emergency Medicine, 5e Knoop KJ, Stack LB, Storrow AB, Thurman R. Knoop K.J., & Stack L.B., & Storrow A.B., & Thurman R(Eds.), Eds. Kevin J. Knoop, et al. McGraw Hill, 2021, https://accessmedicine.mhmedical.com/content.aspx?bookid=2969§ionid=250454132. Conjunctival icterus is an indicator of elevated bilirubin levels (hyperbilirubinemia) due to an underlying disease that affects the metabolism or excretion of bilirubin. The eye conjunctiva is a thin layer that overlies the sclera. It is one of the very first tissues to change in color due to ...

A 2-week-old male is brought to the emergency department by his parents for Laboratory value Result Hemoglobin 16.5 mg/dL 49.5% Mean corpuscular hemoglobin 27.8 pg/cell Leukocyte count 7,100/mm 3 23.0 mg/dL 0.3 mg/dL Which of the following interventions will provide definitive treatment for this patient’s condition? Sitemap USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.

Jaundice in an adult patient can be caused by a wide variety of benign or life-threatening disorders. Organizing the differential diagnosis by prehepatic, intrahepatic, and posthepatic causes may help make the work-up more manageable. Prehepatic causes of jaundice include hemolysis and hematoma resorption, which lead to elevated levels of unconjugated (indirect) bilirubin. Intrahepatic disorders can lead to unconjugated or conjugated hyperbilirubinemia. The conjugated (direct) bilirubin level is often elevated by alcohol, infectious hepatitis, drug reactions, and autoimmune disorders. Posthepatic disorders also can cause conjugated hyperbilirubinemia. Gallstone formation is the most common and benign posthepatic process that causes jaundice; however, the differential diagnosis also includes serious conditions such as biliary tract infection, pancreatitis, and malignancies. The laboratory work-up should begin with a urine test for bilirubin, which indicates that conjugated hyperbilirubinemia is present. If the complete blood count and initial tests for liver function and infectious hepatitis are unrevealing, the work-up typically proceeds to abdominal imaging by ultrasonography or computed tomographic scanning. In a few instances, more invasive procedures such as cholangiography or liver biopsy may be needed to arrive at a diagnosis. The word “jaundice” comes from the French word jaune, which means yellow. Jaundice is a yellowish staining of the skin, sclera, and mucous mem...

A 2-week-old male is brought to the emergency department by his parents for Laboratory value Result Hemoglobin 16.5 mg/dL 49.5% Mean corpuscular hemoglobin 27.8 pg/cell Leukocyte count 7,100/mm 3 23.0 mg/dL 0.3 mg/dL Which of the following interventions will provide definitive treatment for this patient’s condition? Sitemap USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.