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Acute Hepatitis and Jaundice Concern
Resuscitation and Universal Approaches
Approach to Unresponsive Patient
Approach to Airway Obstruction And Stridor
Approach to Acute Respiratory Distress With Impending Failure
Approach to Peri-arrest Hypotension
Approach to Post Resuscitation Care After Rosc
Approach to Cardiac Arrest Rhythms, Pea, Asystole
Approach to Cardiac Arrest Rhythms, Vf, Pulseless Vt
Approach to Severe Agitation With Safety Risk
Approach to Procedural Sedation
Chest and Cardiovascular
Approach to Pacemaker And Icd Related Presentations
Approach to Acute Limb Ischemia And Leg Pain
Approach to Suspected Deep Vein Thrombosis Symptoms
Approach to Hypertension
Approach to Chest Pain
Approach to Palpitations And Tachyarrhythmia Symptoms
Approach to Bradycardia Symptoms
Approach to Syncope And Presyncope
Approach to Syncope With Neurologic Concern
Approach to Unilateral Leg Swelling
Approach to Bilateral Leg Swelling
Approach to Calf Pain And Swelling
Respiratory
Approach to Wheezing, Undifferentiated
Approach to Wheezing In Infants
Approach to Stridor And Upper Airway Symptoms
Approach to Dyspnea
Approach to Aspiration Event
Approach to Cough
Approach to Hemoptysis
Approach to Upper Respiratory Infection Symptoms
Approach to Suspected Pulmonary Embolism Presentation
Approach to Smoke Inhalation Concern
Approach to Smoke Exposure And Inhalational Injury
Abdominal and Gastrointestinal
Approach to Abdominal Distension
Approach to Abdominal Pain, Undifferentiated
Approach to Acute Abdominal Pain (general)
Approach to Suspected Incarcerated Or Strangulated Hernia
Approach to Pancreatitis Concern
Approach to Biliary Colic And Cholecystitis Concern
Approach to Appendicitis Concern
Approach to Diverticulitis Concern
Approach to Rectal Pain And Anorectal Complaints
Approach to Dysphagia And Food Bolus Impaction
Approach to Foreign Body Ingestion
Approach to Refractory Vomiting And Recurrent Vomiting Syndromes
Approach to Cannabis Associated Hyperemesis
Approach to Upper Gastrointestinal Bleeding Symptoms (melena)
Approach to Lower Gastrointestinal Bleeding And Hematochezia
Approach to Constipation And Obstipation
Approach to Diarrhea
Approach to Acute Hepatitis And Jaundice Concern
Approach to Right Upper Quadrant Pain
Approach to Epigastric Pain
Approach to Left Upper Quadrant Pain
Approach to Right Lower Quadrant Pain
Approach to Left Lower Quadrant Pain
Approach to Suprapubic Pain
Renal and Urinary
Approach to Oliguria And Anuria
Approach to Catheter Related Urinary Complaints
Approach to Dialysis Patient Presentations
Approach to Flank Pain And Renal Colic Concern
Approach to Urinary Retention
Approach to Hematuria
Approach to Scrotal Pain
Neurologic
Approach to Transient Neurologic Deficits
Approach to Acute Aphasia And Speech Disturbance
Approach to Acute Confusion And Delirium
Approach to Postictal State And Seizure Recurrence Concern
Approach to Seizure
Approach to Acute Vision Loss
Approach to New Tremor And Involuntary Movements
Approach to Headache
Approach to Vertigo
Approach to Acute Weakness Or Numbness
Approach to Gait Instability And Ataxia
Back and Neck
Approach to Atraumatic Back Pain
Approach to Sciatica And Radicular Back Pain
Approach to Back Pain With Neurologic Deficit, Cauda Equina Concern
Approach to Back Pain With Fever Or Immunosuppression, Spinal Infection Concern
Approach to Atraumatic Neck Pain
Approach to Neck Pain After Trauma
Approach to Neck Pain With Meningismus Concern
Approach to Acute Torticollis
Women's Health, Pregnancy, and GU
Approach to Vaginal Discharge
Approach to Hyperemesis Gravidarum Concern
Approach to Hypertensive Disorders Of Pregnancy Symptoms
Approach to Postpartum Hemorrhage Concern
Approach to Postpartum Infection Concern
Approach to Sexual Assault Medical Evaluation Overview
Approach to Pelvic Pain
Approach to Vaginal Bleeding, Nonpregnant
Approach to Vaginal Bleeding In Pregnancy
Approach to Pelvic Pain In Pregnancy
Approach to Post Procedure Or Post Abortion Complications Concern
Infectious Disease and Fever Syndromes
Approach to Fever In The Immunocompromised Patient
Approach to Fever With Rash
Approach to Animal Bites And Rabies Risk Assessment
Approach to Tick Exposure And Tick Borne Illness Concern
Approach to Sepsis Concern Without Clear Source
Approach to Soft Tissue Infection Concern
Approach to Abscess And Skin Infection Concern
Approach to Sore Throat
Approach to Sore Throat And Pharyngitis Symptoms
Approach to Meningitis
Approach to Envenomation And Bites
Allergy and Dermatology
Approach to Pruritus Without Rash
Approach to Contact Dermatitis And Eczema Flare
Approach to Herpes Zoster Concern
Approach to Drug Eruption Concern And Severe Cutaneous Reaction Red Flags
Approach to Urticaria
Approach to Angioedema Concern
Approach to Unexplained Bruising Or Bleeding Symptoms
Musculoskeletal and Extremities
Approach to Shoulder Pain
Approach to Elbow Pain
Approach to Wrist Pain
Approach to Hand Pain
Approach to Hip Pain
Approach to Knee Pain
Approach to Ankle Pain
Approach to Foot Pain
Approach to Cast Or Splint Complication Symptoms
Approach to Wound Check And Suture Related Visits
Approach to Joint Swelling And Monoarthritis
Approach to Suspected Septic Joint Presentation
Approach to Suspected Tendon Rupture Presentation
Approach to Limp Or Refusal To Bear Weight
Trauma and Wounds
Approach to Motor Vehicle Collision Evaluation
Approach to Chest Wall Trauma And Rib Injury
Approach to Blunt Abdominal Trauma Evaluation
Approach to Penetrating Trauma Evaluation
Approach to Pediatric Minor Head Trauma
Approach to Pediatric Head Trauma
Approach to Facial Lacerations And Dental Trauma
Approach to Hand Lacerations With Tendon Injury Concern
Approach to Puncture Wounds And Retained Foreign Body Concern
Approach to Electrical Injury
Approach to Burn Injury
Approach to Fall Evaluation
Approach to Assault And Interpersonal Violence Evaluation
Approach to Eye Trauma And Hyphema Concern
ENT, Eye, Dental
Approach to Dysphagia And Odynophagia
Approach to Throat Pain
Approach to Ear Pain
Approach to Foreign Body In Ear Or Nose
Approach to Vision Loss Complaint
Approach to Flashes And Floaters
Approach to Atraumatic Eye Pain
Approach to Red Eye
Approach to Dental Abscess Concern
Approach to Post Extraction Pain And Complications
Endocrine, Metabolic, and Abnormal Labs
Approach to Hyperglycemia
Approach to Hypoglycemia
Approach to Hyponatremia Symptoms
Approach to Hyperkalemia Symptoms
Approach to Hypokalemia Symptoms
Approach to Rhabdomyolysis Concern
Approach to Anticoagulation Related Abnormal Coagulation Studies
Approach to Acute Kidney Injury And Elevated Creatinine Referral
Approach to Symptomatic Anemia Concern
Toxicology and Behavioral
Approach to Undifferentiated Overdose
Approach to Opioid Toxicity
Approach to Opioid Withdrawal
Approach to Alcohol Intoxication
Approach to Alcohol Withdrawal
Approach to Stimulant Toxicity
Approach to Pediatric Ingestion
Approach to Carbon Monoxide Exposure
Approach to Inhalational Or Chemical Exposure
Approach to Suicidal Ideation And Self Harm Risk Assessment
Approach to Acute Psychosis And Mania Symptoms
Approach to Anxiety And Panic Symptoms
Approach to Capacity Assessment And Safe Disposition
Approach to Behavioral Escalation And Restraint Considerations
Pediatrics
Approach to Fever In The Neonate And Young Infant
Approach to Pediatric Fever By Age 0 To 28 Days
Approach to Pediatric Fever By Age 29 To 60 Days
Approach to Pediatric Fever By Age 2 To 24 Months
Approach to Pediatric Respiratory Distress
Approach to Croup And Stridor In Children
Approach to Pediatric Dehydration
Approach to Pediatric Abdominal Pain
Approach to Febrile Seizure
Approach to Rash In The Child
Approach to Poor Feeding And Lethargy In The Infant
Approach to Vomiting In The Child
Approach to Diarrhea In The Child
Approach to Pediatric Trauma Evaluation
Approach to Brief Resolved Unexplained Event In The Infant And Apparent Life Threatening Event Concern
Approach to Lethargy And Altered Mental Status In The Child
Environmental and Exposure
Approach to Heat Illness
Approach to Hypothermia And Cold Exposure
Approach to Frostbite Concern
Approach to Drowning And Submersion Injury
Acute Hepatitis and Jaundice Concern
POCUS
Procedures
Calculators
Resuscitation
ECG Guide
Back
Clinical Assessment Checklist
Browse categories and answer follow-up questions to refine your symptom profile.
History
Presenting features
Symptom timeline and pattern
▶
Onset date and time
Progression pattern
Prior similar episodes
Baseline sclera and skin color
Jaundice associated features
▶
Dark urine
Pale stools
Pruritus
Fatigue and malaise
Anorexia
Nausea
Vomiting
Abdominal pain if present
▶
OPQRST framework
▶
Onset
▶
Sudden
Gradual
Provocation or palliation
▶
Worse after fatty meals
Worse with movement
Relief with sitting forward
Relief with analgesics
Quality
▶
Dull
Colicky
Sharp
Burning
Region or radiation
▶
Right upper quadrant
Epigastric
Radiation to back
Radiation to right shoulder
Severity
▶
Peak severity
Current severity
Timing
▶
Constant
Intermittent
Postprandial
Nocturnal
Infectious context
▶
Fever and rigors
Sick contacts
Recent gastroenteritis
Hepatic encephalopathy and bleeding symptoms
Neurocognitive change screen
▶
Confusion
Somnolence
Personality change
Asterixis history
Bleeding symptoms
▶
Easy bruising
Gum bleeding
Epistaxis
Hematemesis
Melena
Hematochezia
Alarm Features
Immediate escalation triggers
Unstable or septic physiology
▶
Hypotension
Tachycardia with poor perfusion
Lactate elevation
Altered mental status
Acute liver failure concern
▶
INR 1.5 or higher with encephalopathy
Rapidly rising INR
Hypoglycemia
Persistent vomiting with dehydration
Acute cholangitis concern
▶
Fever
Jaundice
Right upper quadrant pain
Hypotension or confusion
High risk historical triggers
High risk toxin exposure
▶
Acetaminophen overdose
Mushroom ingestion
Industrial solvent exposure
High risk ischemic triggers
▶
Shock episode
Cardiac arrest
Severe hypoxemia
Medications
Hepatotoxic exposure screen
Prescription medications with hepatotoxic potential
▶
Acetaminophen containing products
Amoxicillin clavulanate
Isoniazid
Valproate
Statins
Methotrexate
Antiretrovirals
OTC and supplements
▶
Herbal products
Bodybuilding supplements
Weight loss supplements
Recent medication changes
▶
New start within 3 months
Dose increase within 3 months
Medication risks for management
Analgesic and antiemetic cautions
▶
Avoid additional acetaminophen when overdose possible
Avoid NSAIDs with significant coagulopathy
Avoid sedatives with encephalopathy concern
Diet
Intake and exposure
Oral intake
▶
Reduced intake
Inability to tolerate fluids
Recent fasting
Alcohol exposure
▶
Last use date
Daily quantity pattern
Recent binge
Foodborne risk
▶
Undercooked shellfish
Unpasteurized products
Review of Systems
Constitutional and infectious
System screen
▶
Fever
Chills
Night sweats
Weight loss
Myalgias
Hepatobiliary and GI
System screen
▶
Pruritus
Dark urine
Pale stools
Abdominal pain
Nausea
Vomiting
Diarrhea
Hematemesis
Melena
Hematochezia
Cardiorespiratory and neuro
System screen
▶
Chest pain
Dyspnea
Syncope
Headache
Confusion
Focal deficits
Collateral History and Family History
Collateral sources
Source and reliability
▶
Family
Caregiver
Pharmacy records
EMS report
Family history relevant to jaundice
Inherited and metabolic disorders
▶
Hemochromatosis (E83.110)
Wilson disease (E83.01)
Alpha 1 antitrypsin deficiency (E88.01)
Hemolytic anemia
Liver disease history
▶
Cirrhosis (K74.60)
Hepatocellular carcinoma (C22.0)
Risk Factors
Viral hepatitis risk
Blood and sexual exposure
▶
Injection drug use
Shared intranasal drug equipment
New sexual partners
Condomless sex
Known hepatitis exposure
Healthcare and procedure exposure
▶
Recent transfusion
Recent hemodialysis
Needle stick
Tattoos or piercings
Obstructive and gallstone risk
Biliary risk profile
▶
Prior gallstones
Prior biliary colic
Prior pancreatitis
Prior cholecystectomy with retained stone risk
Special populations
Pregnancy and postpartum
▶
Pregnancy status
Preeclampsia or HELLP history
Immunocompromised
▶
Transplant recipient
Chronic steroids
HIV
Differential Diagnosis
Life threatening
Critical diagnoses
▶
Acute liver failure (K72.0)
▶
Encephalopathy
INR 1.5 or higher
Hypoglycemia
Acute cholangitis (K83.0)
▶
Fever
Hypotension
Confusion
Acetaminophen toxicity (T39.1)
▶
Very high aminotransferases
Metabolic acidosis
Elevated INR
Ischemic hepatitis
▶
Shock episode
Marked AST and ALT elevation
Fulminant viral hepatitis
▶
Rapid jaundice progression
Coagulopathy
Acute biliary obstruction with sepsis
▶
Rising bilirubin
Leukocytosis
Hypotension
Common
High frequency causes
▶
Acute viral hepatitis A (B15.9)
▶
Travel
Foodborne exposure
Acute viral hepatitis B (B16)
▶
Sexual exposure
Blood exposure
Drug induced liver injury (K71)
▶
New medication within 3 months
Herbal supplement use
Alcohol associated hepatitis (K70.10)
▶
Heavy alcohol use
AST to ALT ratio elevation pattern
Choledocholithiasis (K80.50)
▶
Colicky pain
Cholestatic labs
Gilbert syndrome (E80.4)
▶
Intermittent mild unconjugated bilirubin
Normal liver enzymes
Less common
Lower frequency causes
▶
Autoimmune hepatitis (K75.4)
▶
Autoimmune history
Hypergammaglobulinemia
Primary biliary cholangitis (K74.3)
▶
Prominent pruritus
Cholestatic labs
Primary sclerosing cholangitis (K83.01)
▶
Inflammatory bowel disease
Cholestatic labs
Pancreatic head malignancy (C25.0)
▶
Painless jaundice
Weight loss
Hemolysis
▶
Anemia
Elevated LDH
Low haptoglobin
Wilson disease (E83.01)
▶
Young age
Hemolysis
Neuropsychiatric symptoms
Past Medical History
Liver and biliary history
Prior hepatobiliary disease
▶
Known hepatitis infection
Cirrhosis (K74.60)
Prior jaundice episode
Prior cholangitis
Known gallstones
Prior procedures
▶
ERCP history
Cholecystectomy history
Biliary stent history
Comorbidities affecting risk
Relevant chronic conditions
▶
Diabetes mellitus (E11.9)
Obesity (E66.9)
Heart failure (I50.9)
Chronic kidney disease (N18.9)
Physical Exam
General and vitals
Appearance and perfusion
▶
Toxic appearance
Jaundice
Scleral icterus
Dehydration signs
Vital sign patterns
▶
Fever
Hypotension
Tachycardia
Tachypnea
Hypoxia
Abdominal exam
Hepatobiliary focused exam
▶
Right upper quadrant tenderness
Murphy sign
Hepatomegaly
Splenomegaly
Ascites
Peritoneal signs
Abdominal mass
Skin and stigmata
Chronic liver disease features
▶
Spider angiomata
Palmar erythema
Caput medusae
Easy bruising
Neuro exam
Encephalopathy screen
▶
Orientation deficits
Asterixis
Somnolence
Focal deficits
Lab Studies
Core hepatic and metabolic panel
Hepatic injury and function tests
▶
AST
ALT
Alkaline phosphatase
Gamma glutamyl transferase
Total bilirubin
Direct bilirubin
Albumin
INR
Metabolic risk and complications
▶
Glucose
Sodium
Potassium
Creatinine
Urea
Hematology and hemolysis
Hematology evaluation
▶
CBC
Platelets
Peripheral smear
Hemolysis panel when unconjugated pattern suspected
▶
LDH
Haptoglobin
Reticulocyte count
Direct antiglobulin test
Etiology testing
Viral hepatitis labs
▶
Hepatitis A IgM
Hepatitis B surface antigen
Hepatitis B core IgM
Hepatitis C antibody
Hepatitis C RNA when antibody positive or early exposure
Toxin and drug related labs
▶
Acetaminophen level
Salicylate level if mixed ingestion concern
Ethanol level if intoxication or withdrawal concern
Autoimmune and metabolic labs when unclear
▶
ANA
Anti smooth muscle antibody
IgG
Ceruloplasmin when young or hemolysis pattern
Ferritin and transferrin saturation when iron overload concern
Interpretation pearls
Pattern recognition
▶
Hepatocellular pattern
▶
Marked AST and ALT elevation
R value high
Cholestatic pattern
▶
Alkaline phosphatase elevation
Direct bilirubin elevation
R value low
Mixed pattern
▶
Both enzyme groups elevated
R value intermediate
Synthetic dysfunction
▶
INR elevation
Albumin reduction
Hypoglycemia
Imaging
Scoring Systems
Acute liver failure and liver disease scores
▶
King’s College criteria
▶
Acetaminophen pathway
▶
Arterial pH threshold
INR threshold
Creatinine threshold
Encephalopathy grade threshold
Non acetaminophen pathway
▶
INR threshold
Bilirubin threshold
Encephalopathy grade threshold
Etiology high risk category
MELD Na score
▶
Uses bilirubin
Uses INR
Uses creatinine
Uses sodium
Maddrey discriminant function for alcohol associated hepatitis
▶
Prothrombin time difference
Bilirubin
MRI
MRCP and liver MRI
▶
MRCP indications
▶
Persistent cholestatic labs with nondiagnostic ultrasound
Suspected choledocholithiasis
Suspected biliary stricture
Contraindications and limitations
▶
MRI incompatible devices
Claustrophobia
Limited availability urgent settings
Interpretation pearls
▶
Bile duct dilation level
Transition point
Intrahepatic duct beading pattern
CT
CT abdomen indications
▶
Concern for malignancy or mass effect
Complicated pancreatitis concern
Alternative diagnosis when ultrasound limited
Contrast safety
▶
Contrast allergy history
Renal impairment
Pregnancy consideration
Interpretation pearls
▶
Pancreatic head lesion
Biliary dilation
Hepatic perfusion abnormality pattern
Ultrasound
Right upper quadrant ultrasound
▶
First line for jaundice with cholestatic pattern
Gallstones assessment
Common bile duct diameter assessment
Intrahepatic duct dilation assessment
POCUS adjunct
▶
Gallbladder wall thickening
Pericholecystic fluid
Sonographic Murphy sign
Pitfalls
▶
Obesity and bowel gas limiting views
Early obstruction without dilation
Post cholecystectomy anatomy
Special Tests
Procedural and bedside diagnostics
Paracentesis when ascites present
▶
Cell count and differential
Culture
Albumin for SAAG
Blood cultures when febrile or cholangitis concern
▶
Two sets before antibiotics
Timing not to delay resuscitation
Toxicology risk tools
▶
Rumack Matthew nomogram when single acute acetaminophen ingestion
Not valid for repeated supratherapeutic ingestion
Specialty directed tests
ERCP pathway triggers
▶
Acute cholangitis concern
Persistent obstruction evidence
Clinical deterioration with biliary dilation
Liver biopsy considerations
▶
Unclear diagnosis after standard workup
Coagulopathy increases bleeding risk
Specialty consultation required
ECG
Indications and high risk patterns
ECG triggers in jaundice and hepatitis presentations
▶
Chest pain
Syncope
Significant electrolyte abnormality
Suspected hyperkalemia
QT prolongation risk
▶
Antiemetic exposure
Antipsychotic exposure
Electrolyte disturbances
Assessment
Problem representation and pattern
Jaundice pattern classification
▶
Predominantly hepatocellular injury
▶
AST and ALT predominant elevation
Viral or toxic pattern consideration
Predominantly cholestatic
▶
Alkaline phosphatase predominant elevation
Biliary obstruction and cholangitis consideration
Predominantly unconjugated hyperbilirubinemia
▶
Hemolysis consideration
Gilbert syndrome consideration
Severity and complication stratification
▶
Synthetic dysfunction present
▶
INR elevation
Hypoglycemia
Encephalopathy present
▶
Altered mental status
Asterixis
Working diagnoses
Leading diagnosis candidates with codes
▶
Acute viral hepatitis (B15.9, B16, B17.1)
▶
Exposure risk present
Hepatocellular lab pattern
Drug induced liver injury (K71)
▶
New medication or supplement exposure
Mixed or hepatocellular pattern
Choledocholithiasis (K80.50)
▶
Cholestatic labs
Duct dilation on ultrasound
Acute cholangitis (K83.0)
▶
Fever
Leukocytosis
Hypotension or confusion
Plan
First 5 minutes and stabilization
Immediate priorities
▶
Resuscitation bay if hypotension or altered mental status
Cardiac monitor and pulse oximetry
Two large bore IV access if septic or bleeding concern
Point of care glucose
If glucose low, dextrose IV
Sepsis pathway when indicated
▶
IV fluids
▶
20 mL per kg crystalloid for hypotension or lactate elevation
Reassess after each bolus
Antibiotics if cholangitis suspected
▶
Piperacillin tazobactam IV 4.5 g every 6 hours
Ceftriaxone IV 2 g daily plus metronidazole IV 500 mg every 8 hours
Vasopressors if refractory shock
▶
Norepinephrine IV start 0.05 microgram per kg per minute
Titrate every 2 to 5 minutes to MAP 65 mmHg
Diagnostic sequencing
Core testing sequence
▶
Hepatic panel plus INR and glucose
CBC and electrolytes including creatinine
Pregnancy test when applicable
Acetaminophen level with any uncertainty
Imaging sequence
▶
Right upper quadrant ultrasound early
MRCP when cholestatic pattern and ultrasound nondiagnostic
CT abdomen when mass or alternate diagnosis concern
Therapeutics
Acetaminophen toxicity pathway
▶
Start N acetylcysteine if overdose suspected or aminotransferases very high with unclear history
N acetylcysteine IV protocol local protocol dependent
▶
Weight based loading dose
Maintenance infusion phases
Symptom control
▶
Antiemetic
▶
Ondansetron ODT 4 mg once
Ondansetron IV 4 mg once
Pruritus in cholestasis
▶
Cholestyramine 4 g once to twice daily
Separate from other meds by at least 4 hours
Pain control
▶
Avoid NSAIDs with significant coagulopathy
Avoid sedatives with encephalopathy concern
Monitoring and reassessment loop
Serial reassessment targets
▶
Mental status every 30 to 60 minutes when encephalopathy concern
Vitals every 15 minutes when unstable
Urine output monitoring when septic or AKI risk
Repeat labs timing
▶
INR and glucose every 4 to 6 hours when acute liver failure concern
AST and ALT trend every 6 to 12 hours when severe
Consultation and escalation
Early consultation triggers
▶
GI for suspected biliary obstruction
Surgery for complicated cholecystitis concern
Toxicology for suspected ingestion
ICU for acute liver failure or septic shock
Transfer considerations
▶
Liver transplant center for acute liver failure
ERCP capable center for acute cholangitis
Disposition
ICU and inpatient criteria
ICU criteria
▶
Encephalopathy with INR 1.5 or higher
Hypoglycemia requiring IV dextrose
Vasopressor requirement
Worsening acidosis
Inpatient admission criteria
▶
Acute cholangitis or suspected biliary obstruction needing urgent intervention
Rising INR or bilirubin trend
Significant dehydration with AKI
Inability to tolerate oral intake
Severe pain requiring parenteral analgesia
Observation and discharge criteria
Copy
Observation pathway candidates
▶
Stable vitals
No encephalopathy
INR normal or stable
Imaging without obstruction
Discharge criteria
▶
Hemodynamically stable
No encephalopathy
INR normal
Reliable follow up within 24 to 72 hours
Clear etiology plan and pending results plan
Discharge Instructions
Copy discharge instructions
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You were seen today for yellowing of the eyes or skin and possible liver inflammation or bile duct blockage
▶
Your blood tests showed changes in liver enzymes or bilirubin
Some test results may still be pending
Medicines
▶
Do not take acetaminophen unless you were told it is safe for you
Avoid alcohol until you are cleared by your clinician
Take nausea medicine only as prescribed
Activity and diet
▶
Drink fluids to keep urine light yellow
Eat small meals as tolerated
Follow up
▶
Follow up with your primary care clinician within 24 to 72 hours
Follow up sooner if you were told you need repeat blood tests
Return to the emergency department now if any of the following happen
▶
Confusion
Fainting
Trouble breathing
Severe or worsening belly pain
Fever
Repeated vomiting
Black stools
Vomiting blood
New or worsening weakness
References
Guidelines and key sources
Core references
▶
American Association for the Study of Liver Diseases acute liver failure guidance 2022
European Association for the Study of the Liver clinical practice guideline drug induced liver injury 2019
Centers for Disease Control and Prevention viral hepatitis clinical information 2024
Tokyo Guidelines acute cholangitis and cholecystitis 2018
American College of Radiology appropriateness criteria jaundice 2023
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.
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Acute Hepatitis and Jaundice Concern