QuestionSBA
QuestionChoice
An urgent referral may be warranted if LFTs show evidence of hepatitis or the patient has concerning symptoms such as fever/abdominal pain.
10015838
c
Urgent referral to gastroenterology
QuestionChoice
Not investigating jaundice is inappropriate.
10015837
b
Discharge with reassurance
QuestionChoice
The most likely diagnosis is Gilbert's syndrome, a benign condition where hyperbilirubinaemia occurs in the absence of liver disease. LFTs are required to check for an acute hepatitis and confirm that there are no other derangements other than an isolated rise in unconjugated bilirubin.
10015836
a
Request liver functon tests
QuestionChoice
Antimalarials are not indicated empirically in this case. The patient has no symptoms of malaria and Egypt is not an endemic area.
10015840
e
Treat with chloroquine
QuestionChoice
An urgent referral may be warranted if LFTs show evidence of hepatitis or the patient has concerning symptoms such as fever/abdominal pain.
10015839
d
Urgent referral to infectious diseases
QuestionComment
Or you could examine the patient who is sitting in front of you?
38702
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Serpiginous Uwave
QuestionComment
love the inclusion
51620
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Mediocre Medicine
QuestionComment
ta7ya misr, ta7ya sisi, ta7ya zift el quesmed dah. el as2ila dool zay el zift. 
52051
QuestionComment
yo doc phone up language line for me pls
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GIMP101
QuestionComment
translation: long live egypt, long live sisi, long live this (expletive) quesmed, what are these (expletive) questions.

For further info: Ta7ya Masr - Song by Ahmed Sheb; absolute bangerrr
Sisi: the current dictator of Egypt
62768
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canIhave12bottlesofbleachplease
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Chronic Procrastinosis
QuestionComment
what does ramadan have to do with this?
53879
QuestionComment
gilbert syndrome can present during illness, fasting or exercise
54606
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Lo
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N
QuestionComment
in another question about gilberts - answer was reassure ? and the pt had jaundice 
59698
QuestionComment
I think bc he came back from a high-risk country you want to exclude hepatitis just in case
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canIhave12bottlesofbleachplease
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Hypertension Kinase
Concept
Chapter
# Summary

Gilbert's syndrome is a benign autosomal recessive condition characterized by decreased activity of the enzyme that conjugates bilirubin with glucuronic acid due to a mutation in the UGT1A1 gene. Patients may remain asymptomatic or experience mild, intermittent jaundice during periods of stress, fasting, infection, or exercise. Diagnosis is typically confirmed with blood tests revealing mildly elevated bilirubin though otherwise norma liver function tests and a full blood count. No specific treatment is required for this condition. 

# Definition

Gilbert's syndrome is an inherited, autosomal recessive disorder where the liver does not properly process bilirubin. This is due to a mutation in the UGT1A1 gene, resulting in decreased activity of the enzyme that conjugates bilirubin with glucuronic acid.


# Signs and Symptoms

Patients with Gilbert's syndrome may often be asymptomatic. However, they may also experience intermittent mild jaundice triggered by stress, fasting, infection or exercise

# Differential diagnosis

The main differential diagnoses for Gilbert's syndrome are other causes of jaundice, such as:

- Hepatitis: presenting with symptoms such as fatigue, nausea, abdominal pain, dark urine, and pale stools
- Hemolytic anemia: characterized by symptoms including fatigue, weakness, shortness of breath, and a rapid heart rate
- Cholestasis: marked by pruritus, dark urine, pale stools, and steatorrhea

# Investigations

Blood tests show mildly elevated bilirubin but otherwise normal liver function tests and full blood count. A split bilirubin would show a raised unconjugated hyperbilirubinaemia.

# Management

Gilbert's syndrome is a benign condition that requires no specific treatment. Management strategies typically involve monitoring the patient's condition and providing reassurance about its benign nature.
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Gilbert's Syndrome
Topic
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Gastroenterology
Video
Concept
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Gilbert's Syndrome
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P1WWYUG
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Quesmed Tutorial: Liver Function Tests
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In individuals presenting with yellow skin (icterus) but lacking other symptoms or signs of liver disease, consider conducting liver function tests to rule out alternative causes before diagnosing Gilbert's syndrome.
Presentation
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Jaundice
UkmlaTopic
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Cancer
Presentation
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Jaundice
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6
Clinical haematology
Presentation
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Jaundice
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Gastrointestinal including liver
Presentation
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Jaundice
UkmlaTopic
18
Obstetrics and gynaecology
A 25-year-old man comes to the GP as his skin has become yellow. He denies any other symptoms. He has returned from visiting family in Egypt a few weeks ago and is currently observing Ramadan.

What is the most appropriate management plan?
a