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Surgical Jaundice (Viva (Definition (Yellow discoloration of the skin and…

- - - - Dark urine, pale stools
        
        Itching
        
        Stones: RUQ pain or biliary colic
        
        Malignancy
        
        Wt. ↓ and ↓ appetite
        
        Change in bowel habit: esp. steatorrhoea
        
        Back pain
    - - EtOH intake
        
        Foreign travel: Hep A
        
        Blood transfusions, IVDU, Sex: Hep B and C
        
        Sore throat: EBV
        
        Drug Hx: OCP, Abx, neuroleptics, OTCs
    - - Anaemia: tired, SOB, palpitations, ankle swelling
        
        FH
  - - - ↑↑BR, no urobilinogen
    - - LFTs: ↑cBR ↑↑↑ALP, ↑AST/ALT, ↑GGT
      - Clotting: ↑ INR
      - Auto-Abs: AMA, pANCA, ANA
    - - US
        
        Underlying hepatic disease
        
        Dilated ducts: >6mm
        
        Gallstones
        
        Pancreatic mass or lymphadenopathy
      - MRCP
      - ERCP
      - CT: staging tumour
- - - - Cachexia
        Signs of chronic liver disease
        Look in sclera and at frenulum (of tongue): jaundice
        Palpate for Virchow’s node
    - - Ascites
        Dilated abdominal veins
        Umbilical / para-umbilical hernia