...
Is the jaundice associated with hepatomegaly? There is little or no hepatomegaly associated with hemolytic anemias, pernicious anemia, Gilbert's disease, and Dubin-Johnson syndrome.
Is the hepatomegaly ... DIAGNOSTIC WORKUP
... READ EXCERPTS »
...
Is there a history of drug ingestion or injection? This will help diagnose drug reactions and serum sickness, which are common and easily discovered in the history. Patients with glucose-6-phosphate dehydrogenase deficiency may ... DIAGNOSTIC WORKUP
... READ EXCERPTS »
...
Is there a history of drug ingestion or injection? Of course, the history should reveal that the patient has been on a certain drug or has received certain antitoxins, serums, or vaccines.
Is there a rash? If there is a rash ... DIAGNOSTIC WORKUP
... READ EXCERPTS »
...
Fever is defined as an elevation of normal body temperature (37°C, or 98.6°F). True fever occurs when the body adopts a new thermoregulatory “set point” secondary to the release of pyrogenic cytokines in response to bacteria, viruses, or other... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Yellow skin pigmentation caused by elevated serum bilirubin level is termed jaundice. Bilirubin is the major breakdown product of hemoglobin that is released from dying or damaged erythrocytes. The normal serum bilirubin is less than 1 mg/dL, less than 5% of which is... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
The etiologies of rash with fever are vast, but a systematic approach will help the clinician quickly narrow the differential. Patients who appear “toxic” with fever and prostration must be rapidly and thoroughly evaluated to rule out life-threatening... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Cyclic or periodic fever is an unexplained fever that recurs after fever-free periods at almost predictably fixed intervals. True cyclic fever is rather uncommon in childhood; it should be differentiated from recurrent fever, which refers to... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Recurrent or relapsing fever is a cluster of febrile episodes that occur over a period of time, with documented fever-free intervals and without an apparent medical cause for each episode. It should be differentiated from cyclic fever, which refers to febrile episodes with... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Fever of unknown origin (FUO) is a term that is often misused to describe febrile illness without an obvious etiology or without other symptoms. The definition in different studies is arbitrary, but basically refers to at least 2 weeks of daily documented fever that is... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Jaundice refers to the presence of a yellow hue of the skin, sclerae, or mucous membranes. Direct, or more specifically, conjugated hyperbilirubinemia represents a pathologic condition of cholestasis. It is defined as a direct bilirubin fraction greater than 2 mg/dL, or greater... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Jaundice is the presence of a yellow hue of the skin, sclerae, or mucous membranes due to elevation of serum bilirubin; it usually becomes apparent at a total serum bilirubin level of 5 mg/dL. It is present in approximately 60% of term infants and 80% of premature infants during the first... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Fever is an elevation of body temperature over the normal daily range for a specific individual in response to different insults. It occurs when the thermoregulatory center in the hypothalamus is reset to higher temperature because of exogenous and... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
... The differential diagnosis of fever is best developed using physiology first and anatomy second.
FEVER, NONINFECTIOUS CAUSES
... READ EXCERPTS »
... Jaundice is not to be confused with xanthochromia, in which the skin turns orange from carotene deposits but the sclerae remain normal in appearance. Carotenemia is often seen in hypothyroidism and diabetes mellitus, but jaundice is not usually a
... READ EXCERPTS »
...Pyrexia
A fever is a common sign that can arise from many disorders. Because these disorders can affect virtually any body system, a fever in the absence of other signs usually has little diagnostic significance. A persistent high... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
...Icterus
A yellow discoloration of the skin, mucous membranes, or sclera of the eyes, jaundice indicates excessive levels of conjugated or unconjugated bilirubin in the blood. In fair-skinned patients, it’s most noticeable on the face, trunk, and sclera; in dark-skinned... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... Primarily Unconjugated Hyperbilirubinemia
Increased production
Hemolysis, intravascular or extravascular
Ineffective erythropoiesis
... READ EXCERPTS »
... Infection
Bacterial
Bacterial endocarditis
Sinusitis
Osteomyelitis
... READ EXCERPTS »
... Infections
Bacterial
Streptococcus pneumoniae
Salmonella spp.
Haemophilus influenzae
Staphylococcus aureus
... READ EXCERPTS »
... Colorado tick fever is a benign infection caused by the Colorado tick fever arbo-virus and transmitted to humans by a tick. It occurs in the Rocky Mountain region of the United States, mostly in April and May at lower altitudes and in June and... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Lassa fever is an epidemic hemorrhagic fever caused by the Lassa virus, an extremely virulent arenavirus. This highly fatal disorder kills 10% to 50% of its victims, but those who survive its early stages usually recover and acquire immunity to... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... An acute infectious disease caused by spirochetes of the genus Borrelia, relapsing fever (also called tick, fowl-nest, cabin, or vagabond fever or bilious typhoid) is transmitted to humans by lice or ticks and is characterized by relapses and remissions. Rodents and... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Acute rheumatic fever is a systemic inflammatory disease of childhood, in many cases recurrent, that follows a group A beta-hemolytic streptococcal infection. Rheumatic heart disease refers to the cardiac manifestations of rheumatic fever and includes pancarditis ... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Rocky Mountain spotted fever (RMSF) is a febrile, rash-producing illness caused by Rickettsia rickettsii. The disease is transmitted to humans by a tick bite.
RMSF is fatal in about 5% of patients. Mortality rises when treatment... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Fever is a common sign that can arise from numerous disorders. Because these disorders can affect virtually any body system, fever in the absence of other signs usually has little diagnostic significance. A persistent high fever, though, represents an emergency.
... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A yellow discoloration of the skin, mucous membranes, or sclera of the eyes, jaundice indicates excessive levels of conjugated or unconjugated bilirubin in the blood. In fair-skinned patients, it’s most noticeable on the face, trunk, and sclera; in dark... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Lyle J. Fagnan
Fever is a physiologic state in which the body temperature is elevated above the individual’s normal temperature. Patients and clinicians consider fever an important sign of illness.
Approach to the febrile patient. ... History ... Physical examination ... Testing. ... Diagnostic assessment. ... Pictures
... READ EXCERPTS »
... James M. Brian and Cara K. Fox
The hepatobiliary system removes bilirubin, a byproduct of hemoglobin metabolism, from the blood stream. Jaundice, a yellowing of the skin and sclera, results from tissue build-up of bilirubin when the hepatobiliary system... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
... READ EXCERPTS »
... Michael L. O’Dell
Fever with an accompanying rash represents a diagnostic challenge for even the most experienced of clinicians, as this combination of signs can represent trivial or life-threatening illnesses.... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
... READ EXCERPTS »
... Differential Overview
Conjugated
❑ Viral hepatitis
❑ Gallstone obstruction
❑ Drugs
❑ Carotinemia ... Diagnostic Approach ... Clinical Findings ... Pictures
... READ EXCERPTS »
... Differential Overview
Infection
❑ HIV
❑ Tuberculosis
❑ Endocarditis
❑ Osteomyelitis ... Diagnostic Approach ... Clinical Findings ... Pictures
... READ EXCERPTS »
... Often recurrent, acute rheumatic fever is a systemic inflammatory disease of childhood that follows a group A beta-hemolytic streptococcal infection. Rheumatic heart disease refers to the cardiac manifestations of rheumatic fever, including pancarditis ... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Fever is a common sign that can arise from any one of several disorders. Because these disorders can affect virtually any body system, fever in the absence of other signs usually has little diagnostic significance. A persistent high fever, though, represents an emergency. ... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Fever, or pyrexia, is a common sign that can arise from any one of several disorders. Because these disorders can affect virtually any body system, fever in the absence of other signs usually has little diagnostic significance. A persistent high fever, though, represents an emergency.... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A yellow discoloration of the skin, mucous membranes, or sclerae of the eyes, jaundice indicates excessive levels of conjugated or unconjugated bilirubin in the blood. Also known as icterus, jaundice is most apparent in natural... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Occurs whenpathologic process causes body temperature to exceed normal range. DuBois suggested that usual range ofnormal body temperature is 97–100.4°F (36.2–38.0°C)rectal or 96.8–99.3°F (36.0–37.4°C)oral. Rectal temperature tends to be 0.5–1.0°F... Principal Causes of Acute Fever ... Clinical Features and Diagnosis: Acute Fever ... Diagnostic Approach: Acute Fever ... Principal Causes of Fever of Unknown Origin ... Clinical Features and Diagnosis: Fever of Unknown Origin ... Diagnostic Approach: Fever of Unknown Origin ... References
... READ EXCERPTS »
... Jaundice,yellow discoloration of skin and sclera, is produced by depositionof bilirubin in these tissues. Increase in unconjugated or conjugatedbilirubin or both produce jaundice, which is visible when totalserum bilirubin is >2 mg/dL. Conjugated hyperbilirubinemia existswhen... Principal Causes of Unconjugated Hyperbilirubinemia ... Clinical Features and Diagnosis: Unconjugated Hyperbilirubinemia(Neonatal Onset) ... Clinical Features and Diagnosis: Unconjugated Hyperbilirubinemia(Postneonatal Onset) ... Diagnostic Approach: Unconjugated Hyperbilirubinemia ... Principal Causes of Conjugated Hyperbilirubinemia (NeonatalOnset) ... Clinical Features and Diagnosis: Conjugated Hyperbilirubinemia(Neonatal Onset) ... Principal Causes of Conjugated Hyperbilirubinemia (PostneonatalOnset) ... Clinical Features and Diagnosis: Conjugated Hyperbilirubinemia(Postneonatal Onset) ... Diagnostic Approach: Conjugated Hyperbilirubinemia ... References
... READ EXCERPTS »
... A fever is a common sign that can arise from many disorders. Because these disorders can affect virtually any body system, a fever in the absence of other signs usually has little diagnostic significance. A persistent high fever, though, represents an emergency.
... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... A yellow discoloration of the skin, mucous membranes, or sclera of the eyes, jaundice indicates excessive levels of conjugated or unconjugated bilirubin in the blood. In fair-skinned patients, it's most noticeable on the face, trunk, and sclera; in dark... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
...
The differential diagnosis of fever is best developed using
physiology first and anatomy second.
Physiology. Increased heat in the body is caused by increased
production or decreased elimination or dysfunction of the... Pictures
... READ EXCERPTS »
...
Jaundice is not to be confused with xanthochromia, in which the skin
turns orange from carotene deposits but the sclerae remain normal in
appearance. Carotenemia is often seen in hypothyroidism and diabetes
mellitus, but jaundice is not... Pictures
... READ EXCERPTS »
Many people with viral hepatitis don't know they are infected. Listen as experts discuss who should be tested and review the causes, prevention...
Hepatitis C is called a silent epidemic because many people are unaware they carry this virus of the liver. But experts say hepatitis C is a public...
What is an allergy and what is it that causes some people to suffer from them? Why do allergies flare up during certain times of the year? Learn...