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    Jaundice, (Hyperbilirubinemia) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Jaundice, (Hyperbilirubinemia) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Jaundice, (Hyperbilirubinemia) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Ebook88 pages35 minutes

    Jaundice, (Hyperbilirubinemia) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

    By Kenneth Kee

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    About this ebook

    Jaundice is the yellow color of the skin, mucus membranes, or eyes.
    The yellow coloring occurs from by the excessive accumulation in the tissues of bilirubin, a byproduct of old red blood cells.
    The normal serum bilirubin is about 3-20 μmol/L.
    Jaundice is not normally obvious until serum bilirubin is over 35 μmol/L.
    Jaundice can be a symptom of many health disorders.
    The detection and differential diagnosis of jaundice are essential in medical evaluation.
    The types of bilirubin are:
    1. Un-conjugated bilirubin which is toxic, fat soluble and cannot be excreted by the kidneys
    2. Conjugated bilirubin which the hepatocytes in the liver has conjugated the un-conjugated bilirubin and excretes in the bile.
    Conjugated bilirubin is water soluble and in high levels is also excreted in the urine as dark tea colored urine.
    Bilirubin is created from the breakdown of hemoglobin in the reticuloendothelial system.
    95% of the circulating bilirubin is un-conjugated and attached to albumin.
    The bilirubin-albumin complex is broken down by hepatocytes allowing free albumin to circulate.
    Jaundice can happen if:
    1. Too many red blood cells are dying or breaking down and going to the liver
    2. The liver is overloaded or injured
    3. The bilirubin from the liver is not able to properly move into the digestive tract
    Jaundice is often a sign of a disorder with the liver, gallbladder, or pancreas.
    The causes of jaundice are:
    1. Hemolytic anemia is due to the break up of red blood cells
    Here the major form of bile pigment is un-conjugated
    2. Hepato-cellular or liver causes:
    Acute liver causes are:
    a. Viral hepatitis A to F,
    b. Alcoholism,
    c. Toxic chemical hepatitis including drugs and
    d. Bacterial infections such as leptospirosis.
    More of conjugated bilirubin at early stages is followed by un-conjugated bilirubin.
    Chronic liver causes are:
    a. Chronic liver cirrhosis – produces mostly un-conjugated bilirubin
    3. Obstructive jaundice: mainly conjugated bilirubin accumulates
    a. Intra-hepatic cholestasis due to drug sensitivity
    b. Extra-hepatic gallstones, carcinoma of biliary systems or adjacent organs.
    Disorders that can cause jaundice are:
    1. Infections
    2. Use of certain drugs
    3. Cancer
    4. Blood disorders,
    5. Gallstones,
    6. Birth defects and
    7. A number of other medical disorders resulting in jaundice.
    The effects of jaundice are:
    1. Yellowing of the skin and white of eye and mucous membranes like inside of the lips
    2. Liver enlargement and palpable gallbladder in blockage
    3. Enlarged spleen especially in hemolytic anemia
    4. Dark colored urine due to presence of bilirubin in the urine
    5. Pale stools
    6. Prolonged tiredness from anemia, loss of blood,
    7. Encephalopathy from bilirubin affecting the brain
    8. Nausea and vomiting.
    9. Poor appetite
    Jaundice is not the same as carotenaemia (where the sclera remains white).
    Jaundice will be obvious if the total bilirubin is >35 μmol/L.
    In jaundice, the important rapid differentiation of the main causes (hepatitis, biliary stasis, hemolysis, resolution of hematoma or congenital causes) can often be obtained by doing:
    Urinary bilirubin and urobilinogen
    Hepatitis serology should be done in all patients with cholestasis, as distinguishing hepatitis from extra-hepatic obstructive causes may be very difficult.
    Liver function tests
    Serum antinuclear antibodies (ANAs), anti-smooth muscle antibody (ASMA)
    MRCP may become the test of choice in obstructive jaundice
    Liver biopsy
    Treatment will depend on the diagnosis and cause of the jaundice in each individual case
    a. Blood transfusion or platelet transfusion for hemolytic anemia
    b. Treatment of infections
    c. Surgery for obstructive lesions
    Others:
    a. Rest
    b. Fluids
    c. Vitamin B

    TABLE OF CONTENT
    Introduc

    LanguageEnglish
    PublisherKenneth Kee
    Release dateMay 24, 2017
    ISBN9781370084586
    Jaundice, (Hyperbilirubinemia) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Author

    Kenneth Kee

    Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

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      Book preview

      Jaundice, (Hyperbilirubinemia) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee

      Jaundice,

      (Hyperbilirubinemia)

      A

      Simple

      Guide

      To

      The Condition,

      Diagnosis,

      Treatment

      And

      Related Conditions

      By

      Dr Kenneth Kee

      M.B.,B.S. (Singapore)

      Ph.D (Healthcare Administration)

      Copyright Kenneth Kee 2017 Smashwords Edition

      Published by Kenneth Kee at Smashwords.com

      Dedication

      This book is dedicated

      To my wife Dorothy

      And my children

      Carolyn, Grace

      And Kelvin

      This book describes Jaundice, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

      (What The patient Need to Treat Jaundice)

      This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If the patient would like to share this book with another person, please purchase an additional copy for each reader.

      If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

      Thank the patient for respecting the hard work of this author.

      Introduction

      I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

      My purpose in writing these simple guides was for the health education of my patients.

      Health Education was also my dissertation for my Ph.D (Healthcare Administration).

      I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

      This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

      From which many free articles from the blog was taken and put together into 800 amazon kindle books and 200 into Smashwords.com eBooks.

      Some people have complained that the simple guides are too simple.

      For their information they are made simple in order to educate the patients.

      The later books go into more details of medical disorders.

      The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

      Since 2013, I have tried to improve my spelling and writing.

      As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

      Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

      I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

      I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

      I apologize if these repetitions are irritating to some readers.

      Chapter 1

      Jaundice

      What is Jaundice?

      Jaundice is the yellow color of the skin, mucus membranes, or eyes.

      The yellow coloring occurs from by the excessive accumulation in the tissues of bilirubin, a byproduct of old red blood cells.

      The normal serum bilirubin is about 3-20 μmol/L.

      Jaundice is not normally obvious until serum bilirubin is over 35 μmol/L.

      Jaundice can be a symptom of many health disorders.

      The detection and differential diagnosis of jaundice are essential in medical evaluation.

      It is important to find out what investigations are suitable and the importance of the results of investigations.

      What

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