Bilirrubin and Hereditary Hyperbilirrubinemias

Femoral Region

• "VAN" Mnemonic for Vein, Artery, and Nerve location

Bilirubin Pathway

Liver Anatomy

Celiac Trunk

• Esophageal varices = Left gastric vein
• Peptic Ulcer disease bleeding (Pyloric area) = Gastro-duodenal artery

GI Hormones

• CCK antagonist increases CCK levels and Acid secretion (Gastrin) - Kaplan Q-Bank question (m200297)!

Hepatitis Serologic Markers

Focus in the mind map:

• You must memorize the phrase "SEC".
• We have two kind of things: the Agents (Ag) and the Antobodies (Ab).
• Backing to the SEC phrase:
• In the firs act the letter S appears first, followed by de E and the last C - valid for agents.
• In the second act the order is inverse: first C, second E, and the last S - valid for antibodies.
• Agent (Ag) S = CARRIER (acute or chronic).
• Agent (Ag) E = TRANSMISSIBILITY, high on the onste like Ag, and low on the end like Ab.
• Agent (Ag) C = IGNORED for USMLE.
• Anti-body (Ab) S = IMMUNIZATION (vaccine or recovery).
• Anti-body (Ab) E = commented above (low transmissibility) and window period.
• Anti-body (Ab) C = IgM (acute), IgG (chronic) carrier, windows period, recovery.

Q1: A 56-years-old man comes with fatigue and severe jaundice. He has a history of intravenous drug abuse. Laboratory studies shows HBsAg and anti-hepatitis B core antibody (anti-HBc-G) are positive. What diagnosis has the patient using the hepatitis B serologic markers?

A1: Observe the mindmap:

• HBsAg = Carrier (acute or chronic).
• anti-HBc-G = IgG (chronic).
• History & Physical = CHRONIC drug abuse user + Active hepatitis.