Jaundice: The History of Disease and Related Things

Some things can be related to the mechanism of occurrence of jaundice. Then as a doctor we should ask questions related to several things, such as:

• Age. The older patient, carcinoma is more often the cause of jaundice, While the hepatitis, less frequent in old age.
• Injection or transfusion within the last 6 months (characterizing viral hepatitis), including drug addiction. You also have to looking for evidence of injection site.
• Contact with the patient's jaundice and a history of living abroad
• Jobs. farm employment and work in sewers at risk of leptospirosis.
• History of dark urine and pale stools in biliary obstruction.
• Drugs taken recently, especially phenothiazines and the contraceptive pill.
• Onset of illness until it becomes the main symptom of jaundice. hepatitis Agenerally lasts 1-3 weeks, carcinoma is 1-2 months, hepatitis B 6 weeks-6months, cirrhosis hepatic are usually very long.
• Alcohol consumption
• Abdominal pain which was recently, or dyspepsia may be a sign of chroniccholecystitis, cholangitis, gallstones, or pancreatic carcinoma.
• Recent surgery, anesthesia (halothane).
• Family history, if suspected of having Gilbert's syndrome.

Jaundice: The Causes and Cases

Jaundice is a yellow color to the skin and sclera. Usually only visible when bilirubun serum levels above 35 mol / L. Sclera is not colored in yellow skin due to hiperkeratonemia. The three basic causes: hemolytic, hepatocellular, obstructive. It's how to remember: H2O --> Hemolytic, Hepatocellular, Obstructive
Some of diseases that jaundice as the clinical sign are:

• Acute viral hepatitis, because the recovery is slow, or there is persistent intrahepatic cholestasis.
• Bile duct obstruction due to gallstones or carcinoma of the head of the pancreas.
• Jaundice due to drugs
• Multiple secondary deposits in liver carcinoma (clinical jaundice is rare but often increased bilirubin)
• intrahepatic cholestasis
• Mononukleus infectious
• Gilbert syndrome

Cardinal Sign of Acute Appendicitis

Cardinal sign of acute appendicitis:
- abdominal pain for less than 72 hours
- vomitting 1-3 times
- facial flush
- tenderness concentrated in the right iliac fossa
- rebound tenderness in the right iliac fossa
- anterior tenderness on rectal examination (9-11 positions)
- fever between 37,3 and 38,5 C
- no evidence of UTI on urine microscopy


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