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
Post-hepatic (obstructive) jaundice Acquired / not inherited
Defect / target: Mechanical obstruction of bile flow downstream of a normally functioning liver
Mechanism: Conjugated bilirubin is made correctly but cannot reach the intestine; it backs up into plasma and is filtered into urine, while no pigment reaches the gut so no stercobilin or urobilinogen forms.
↑ Accumulates: Conjugated (direct) bilirubin in plasma and urine; bile salts in skin· ↓ Deficient: Stercobilin in stool, urobilinogen in urine
Presentation: Jaundice, dark urine, pale/clay-colored (acholic) stool, pruritus; causes: gallstones in common bile duct, pancreatic head cancer, cholangiocarcinoma, primary sclerosing/biliary cholangitis, biliary atresia in infants
Labs: Conjugated hyperbilirubinemia, marked bilirubinuria, absent urine urobilinogen, ALP/GGT markedly elevated out of proportion to AST/ALT
Treatment: Relieve obstruction (ERCP/stone removal, surgery)
Dark urine + pale stool = obstruction; ALP/GGT >> AST/ALT = cholestatic pattern
Learn the mechanism: Heme degradation & bilirubin (jaundice) →
FMK 08.4 Heme Metabolism · slide 22, 25, 27, 30; handout