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 example