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Elevated whole bilirubin Conjugated bilirubin Conjugated bilirubin Conjugated bilirubin fraction <20% fraction 20 50% fraction >50% Primarily unconjugated Mixed conjugated and Primarily conjugated hyperbilirubinemia: unconjugated hyperbilirubinemia hyperbilirubinemia extravascular hemolysis obstructive jaundice impaired bili uptake and/or hepatitis urinalysis: elevated urine conjugation urinalysis: each bilirubin and bilirubin, absent urobilinogen are elevated urobilinogen urinalysis: absent urine bilirubin, elevated urobilinogen within the urine Bile duct obstruction (cholelithiasis, tumor) Gilbert’s syndrome Cirrhosis Neonatal Jaundice Medications/toxins Post transfusion hemolysis Primary biliary cirrhosis Resorption of hematoma Primary sclerosing cholangitis Shunt hyperbilirubinemia Sepsis Crigler-Najar syndrome Total parenteral vitamin Ineffective hematopiesis Intrahepatic cholestasis of being pregnant Benign recurrent duct syndrome Rotor syndrome Dubin-Jonson syndrome Figure 20.
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