The cause of this jaundice - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 04-29-2010
FreakingOut's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 34
Threads: 27
Thanked 20 Times in 12 Posts
Reputation: 30
Liver The cause of this jaundice

A 19-year-old male presents to the student health service after his roommate noted a yellowish discoloration to his skin while up late studying for an exam. After a meal and several hours sleep, the discoloration resolved. Laboratory tests are obtained, ALT 25 U/dL, AST 20 U/dL, Bilirubin (direct) 0.8 mg/dL, Bilirubin (total) 2.5 mg/dL. Which of the following is responsible for this patientís disease?

A- Canalicular cholestasis
B- Decreased activity of glucuronyl transferase
C- Impaired transport of bilirubin into the bile canaliculus
D- Impaired uptake of circulating bilirubin
E- Immune hemolysis
Reply With Quote Quick reply to this message
The above post was thanked by:
aungawa (04-30-2010)



  #2  
Old 04-29-2010
USMLE Forums Scout
 
Steps History: Not yet
Posts: 73
Threads: 7
Thanked 40 Times in 21 Posts
Reputation: 60
Default A.

Just guess. More rational.
Reply With Quote Quick reply to this message
  #3  
Old 04-29-2010
ath.pantelis's Avatar
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 187
Threads: 4
Thanked 368 Times in 121 Posts
Reputation: 398
Default

This is typical presentation of Gilbert's syndrome (very impressive name, though harmless!), aka glycuronyl-transferase deficiency/insufficiency. The scenario describes a teenager/young adult with manifestation of jaundice after stress and low food intake. There are no pathophysiologic sequelae for this entity and the prognosis is excellent.

Binding of indirect bilirubin to glycuronic acid is the first step of rendering bilirubin water soluble (i.e. direct) and thus excretable (through the GI tract and the urine). Consequently, these patients manifest INdirect hyperbilirubinemia.
Reply With Quote Quick reply to this message
The above post was thanked by:
aungawa (04-30-2010), just_md (04-29-2010), Zain90 (04-12-2013)
  #4  
Old 04-29-2010
USMLE Forums Scout
 
Steps History: Not yet
Posts: 73
Threads: 7
Thanked 40 Times in 21 Posts
Reputation: 60
Default Thanks

Quote:
Originally Posted by ath.pantelis View Post
This is typical presentation of Gilbert's syndrome (very impressive name, though harmless!), aka glycuronyl-transferase deficiency/insufficiency. The scenario describes a teenager/young adult with manifestation of jaundice after stress and low food intake. There are no pathophysiologic sequelae for this entity and the prognosis is excellent.

Binding of indirect bilirubin to glycuronic acid is the first step of rendering bilirubin water soluble (i.e. direct) and thus excretable (through the GI tract and the urine). Consequently, these patients manifest INdirect hyperbilirubinemia.
You are right. It's Gilbert's syndrome.
Mild jaundice (harmless) may appear under conditions of exertion, stress, fasting, and infections.
Reply With Quote Quick reply to this message
  #5  
Old 04-10-2013
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 283
Threads: 35
Thanked 204 Times in 115 Posts
Reputation: 214
Default

Quote:
Originally Posted by FreakingOut View Post
A 19-year-old male presents to the student health service after his roommate noted a yellowish discoloration to his skin while up late studying for an exam. After a meal and several hours sleep, the discoloration resolved. Laboratory tests are obtained, ALT 25 U/dL, AST 20 U/dL, Bilirubin (direct) 0.8 mg/dL, Bilirubin (total) 2.5 mg/dL. Which of the following is responsible for this patientís disease?

A- Canalicular cholestasis
B- Decreased activity of glucuronyl transferase
C- Impaired transport of bilirubin into the bile canaliculus
D- Impaired uptake of circulating bilirubin
E- Immune hemolysis

This is Gilbert's syndrome. This has both problems in which Answer choices are B and D. I will shoot for D. Which one do you go for?
Reply With Quote Quick reply to this message
  #6  
Old 04-10-2013
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,109
Threads: 31
Thanked 520 Times in 394 Posts
Reputation: 539
Default

Quote:
Originally Posted by Doctor Ali View Post
This is Gilbert's syndrome. This has both problems in which Answer choices are B and D. I will shoot for D. Which one do you go for?
Dr. Ali u are right that this is Gilbert syndrome and both A and D are right but what will I choose?
I will choose A. My reasons are not conviencing though.
__________________
In USMLE, ďAny fool can know. The point is to understand.Ē
Reply With Quote Quick reply to this message



Reply

Tags
Gastrointestinal-Tract-, Hematology-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Hypotonia + Jaundice + Seizures + MR rasheed USMLE Step 1 Classic Clues 1 11-29-2011 04:32 AM
breast milk jaundice sharvaree19 USMLE Step 2 CK Forum 1 04-11-2010 08:59 AM
Gall Bladder Pain Jaundice Combinations wonder USMLE Step 1 Forum 2 12-21-2009 08:08 PM
Jaundice Cataract after birth Sarah-cali USMLE Step 1 Classic Clues 1 07-27-2009 09:52 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)