№ 21Gastroenterology14 min read
Types and differentiation of different forms of jaundice
1. Big picture
Jaundice is yellow discoloration of the sclera, skin, and mucous membranes caused by hyperbilirubinemia. It usually becomes clinically visible when serum bilirubin reaches about 2–3 mg/dL, approximately 34–51 µmol/L. ([Merck Manuals][1])
For the exam, jaundice must be approached in three steps:
1. Is bilirubin mainly unconjugated or conjugated?
↓
2. Is the problem before the liver, inside the liver, or after the liver?
↓
3. Is there an emergency: cholangitis or acute liver failure?
The most important classification:
| Type | Main mechanism | Typical examples |
|---|---|---|
| Prehepatic jaundice | Increased bilirubin production before the liver | Hemolysis |
| Hepatic/intrahepatic jaundice | Hepatocyte uptake, conjugation, or excretion problem | Viral hepatitis, alcoholic hepatitis, cirrhosis, drug-induced liver injury |
| Posthepatic/obstructive jaundice | Impaired bile flow after conjugation | Gallstones, pancreatic head cancer, cholangiocarcinoma |
Unlock the rest of this topic
Subscribe to Internal Medicine for $10/month and unlock all 229 topics — full exam-structured notes, the State Exam questions integrated into every topic, and the downloadable Anki deck. Cancel anytime.
- ✓All 229 Internal Medicine topics, exam-structured
- ✓State Exam questions in every topic
- ✓Downloadable Anki deck (.apkg)
- ✓Cancel anytime
Already subscribed? Sign in
