Approach_to_Jaundice_History, investigationa and management

jaundice

1. History in Approach to Jaundice – Key Clues • Medications & Substances – Prescription, herbal, supplements, recreational drugs • Alcohol Use – Significant intake: >210 g/week (males), >140 g/week (females) • Hepatitis Risk Factors – Travel to endemic areas – Blood transfusion (before 1992) – IV drug use • Past Medical/Surgical History – Abdominal surgeries (esp. gallbladder) – Inherited disorders (liver or hemolytic diseases) • Other Exposures – HIV status – Occupational/recreational toxins

2. History in Approach to Jaundice – Symptom Clues • Gilbert Syndrome → Jaundice worsens during stress • Acute Cholangitis → Fever, chills, RUQ pain, post-biliary surgery • Viral Hepatitis → Anorexia, malaise, myalgia • Extrahepatic Biliary Obstruction → RUQ pain • Cholestasis/Obstruction – Acholic (clay-colored) stool – Seen in acute cholestatic hepatitis or near-complete CBD obstruction