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
Pre-hepatic (hemolytic) jaundice Acquired / not inherited
Defect / target: Excess RBC breakdown exceeding hepatic conjugation capacity; liver itself is normal
Mechanism: Overproduction of unconjugated bilirubin outpaces UGT1A1 conjugation; unconjugated bilirubin is albumin-bound and not filtered into urine, while a normal liver/gut converts more substrate into urobilinogen.
↑ Accumulates: Unconjugated (indirect) bilirubin in plasma; urobilinogen in urine and stool
Presentation: Jaundice with normal urine color ('acholuric jaundice'), normal or dark stool, anemia; causes: hemolytic anemias (G6PD deficiency, sickle cell disease, hereditary spherocytosis, pyruvate kinase deficiency, autoimmune hemolysis), ineffective erythropoiesis
Labs: Elevated unconjugated bilirubin, no bilirubinuria, increased urine urobilinogen, normal AST/ALT/ALP
Treatment: Treat underlying hemolysis
Pre-hepatic: up unconjugated, normal urine, up urobilinogen; chronic hemolysis can make pigment gallstones
Learn the mechanism: Heme degradation & bilirubin (jaundice) →
FMK 08.4 Heme Metabolism · slide 25, 26, 30; handout