What is the significance of a direct bilirubin of 10.3 mg/dL when the total bilirubin is 15.5 mg/dL?
A 42 year old woman was admitted to the ER with complaints of nausea, vomiting, chills, fever, and severe right upper quadrant pain. She had experienced similar symptoms a few times in the past 6 months but the episodes had been much milder and had disappeared in 2-3 hours. The ER physician noticed that she was visibly jaundiced and ordered a hepatic function panel:
Additional results revealed:
1. In this case, the patient was visibly jaundiced. Which lab results correlate with a jaundiced patient?
2. Symptoms in this case correlate with acute appendicitis, cholelithiasis, cholangitis, hepatitis, pancreatitis, and cholecystitis. Which conditions are associated with the 4 F’s (female, forties, fat, fertile (estrogen promotes secretion of bile salts)?
3. What is the significance of a direct bilirubin of 10.3 mg/dL when the total bilirubin is 15.5 mg/dL?