Jaundice ( I cterus ),Causes, Symptoms,Diagnosis and Pathophysiology. Author

Urine: conjugated bilirubin present, urobilinogen > 2 units but variable (except in children)
Plasma proteins show characteristic changes.
Plasma albumin level is low, but plasma globulins are raised due to an increased formation of antibodies.
Unconjugated bilirubin is hydrophobic, so cannot be excreted in urine. Thus, the finding of increased urobilinogen in the urine without the presence of bilirubin in the urine (due to its unconjugated state) suggests hemolytic jaundice as the underlying disease process. Urobilinogen will be greater than 2 units (i.e., hemolytic anemia causes increased heme metabolism; exception: infants where gut flora has not developed). Conversely, conjugated bilirubin is hydrophilic and thus can be detected as present in the urine — bilirubinuria — in contrast to unconjugated bilirubin which is absent in the urine.

Imaging.

Medical imaging such as ultrasound, CT scan, and HIDA scan are useful for detecting bile-duct blockage.^[35]

Differential diagnosis of Jaundice.

Yellow discoloration of the skin, especially on the palms and the soles, but not of the sclera or inside the mouth, is due to carotenemia—a harmless condition.

Treatment of Jaundice.

Treatment of jaundice varies depending on the underlying cause. If a bile duct blockage is present, surgery is typically required; otherwise, management is medical. Surgery in patients with obstructive jaundice are associated with significantly higher rates of complications (69% vs 38%, P=0.002) and mortality.^[41] Medical management may involve treating infectious causes and stopping medication that could be contributing to the jaundice.^[5] The itchiness may be helped by 
Hyperbilirubinemidraining the gallbladder or ursodeoxycholic acid.

Complications of Jaundice.

a, more precisely hyperbilirubinemia due to the unconjugated fraction, may cause bilirubin to accumulate in the grey matter of the central nervous system, potentially causing irreversible neurological damage, leading to a condition known as kernicterus. Depending on the level of exposure, the effects range from unnoticeable to severe brain damage and even death. Newborns are especially vulnerable to hyperbilirubinemia-induced neurological damage, so must be carefully monitored for alterations in their serum bilirubin levels.
Individuals with parenchymal liver disease who have impaired hemostasis may develop bleeding problems.^[42]
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Prof. Hayk S. Arakelyan