PBL Cases

Which bilirubin give you yellowish skin?

Unconjugated bilirubin causes jaundice, leading to yellowish skin.

Direct and Indirect bilirubin

Direct: conjugated (in urine)

Indirect: unconjugated (jaundice)

Bile salts digest fat but accumulation causes ________

itching (cholestatic pruritus)

Pemphigus vs Pemphigoid

Pemphigus: Intraepithelial (within epidermis) (nikolsky sign) (mortality)

Pemphigoid: Subepithelial (beneath epithelium)

Which viral hepatitis is never chronic?

Hepatitis A

Time for acute and chronic hepatitis

Acute is less than 6 month

Chornic more than 6 month

3 stages of Hep B

Prodromal: 3 to 10 days, 

Icteric: Dark urine, light color stool, jaundice, pale color stool

Convalescent: 

Acholic Stool

Light color pale stool in hepatitis

HBsAg vs HBsAb vs HBcAb

Active Hep B

Vaccinated and immune to Hep B (appear last)

Antibody to Hep B

Urobilinogen is excreted by 

feces (gut)

SSYC culture

Salmonella, Shigella, Yersinia, Campylobacter

If you have Anti-HAV IgG but not IgM, what does that mean?

Previous infection of HAV

Anti-HBs negative

Anti-HBc IgM positive

HBV DNA positive

HBsAg positive

No immunity yet

Early infection

Virus actively replicating

Active infection

Window period

Antigen is not present

Antibody not yet made

Hepatitis B vaccine is made form _______

HBsAg

Antibiotics safe in hepatitis

Antibiotics high risk in hepatitis

Beta-lactams, cephalosporins, Aminoglycosides, Macrolides (azithromycin)

Tetracycline, Erythromycin, Fluoroquinolones