Learn / FMK
Every FMK condition
299 diseases, deficiencies, toxicities and drug mechanisms harvested from every FMK deck — the ones sprinkled through a single bullet as much as the ones with their own slide. Pick what you're given and what you have to name, or let it cycle; distractors come from the same category so you have to discriminate (hypoketotic vs. ketotic hypoglycemia, which GSD, which urea-cycle enzyme…). Every answer shows the whole card with the lecture and slide.
Heme · FMK 08.4
Kernicterus (bilirubin encephalopathy) Acquired / not inherited
Defect / target: Free unconjugated bilirubin exceeding albumin-binding capacity crossing the immature blood-brain barrier
Mechanism: Lipophilic unconjugated bilirubin crosses the neonatal blood-brain barrier and deposits in the basal ganglia, causing irreversible neuronal injury.
↑ Accumulates: Unconjugated bilirubin in basal ganglia· ↓ Deficient: Albumin binding capacity (relative)
Presentation: Neonatal lethargy, hypotonia then hypertonia, seizures, irreversible neurologic injury; risk in severe physiologic jaundice, Crigler-Najjar I, hemolytic disease of the newborn, or drug displacement from albumin
Labs: Markedly elevated unconjugated bilirubin
Treatment: Prevent with phototherapy or exchange transfusion
Unconjugated = lipophilic = crosses BBB
Learn the mechanism: Heme degradation & bilirubin (jaundice) →
FMK 08.4 Heme Metabolism · slide 20, 28, 29; handout