RT Book, Section
A1 John, Savio
A1 Pratt, Daniel S.
A2 Jameson, J. Larry
A2 Fauci, Anthony S.
A2 Kasper, Dennis L.
A2 Hauser, Stephen L.
A2 Longo, Dan L.
A2 Loscalzo, Joseph
SR Print(0)
ID 1160010719
T1 Jaundice
T2 Harrison's Principles of Internal Medicine, 20e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259644016
LK accesspharmacy.mhmedical.com/content.aspx?aid=1160010719
RD 2024/04/18
AB Jaundice  is  a  yellowish  discoloration  of  body  tissues  resulting  from  the  deposition  of  bilirubin.  Tissue  deposition  of  bilirubin  occurs  only  in  the  presence  of  serum  hyperbilirubinemia  and  is  a  sign  of  either  liver  disease  or,  less  often,  a  hemolytic  disorder  or  disorder  of  bilirubin  metabolism.  The  degree  of  serum  bilirubin  elevation  can  be  estimated  by  physical  examination.  Slight  increases  in  serum  bilirubin  level  are  best  detected  by  examining  the  sclerae  for  icterus.  Sclerae  have  a  particular  affinity  for  bilirubin  due  to  their  high  elastin  content,  and  the  presence  of  scleral  icterus  indicates  a  serum  bilirubin  level  of  at  least  51  μmol/L  (3  mg/dL).  The  ability  to  detect  scleral  icterus  is  made  more  difficult  if  the  examining  room  has  fluorescent  lighting.  If  the  examiner  suspects  scleral  icterus,  a  second  site  to  examine  is  underneath  the  tongue.  As  serum  bilirubin  levels  rise,  the  skin  will  eventually  become  yellow  in  light-skinned  patients  and  even  green  if  the  process  is  long-standing;  the  green  color  is  produced  by  oxidation  of  bilirubin  to  biliverdin.