Excess bilirubin in the plasma causes?

Appeared in: DSSSB - 29 August 2019 (Shift-1)

Explanation

Jaundice is the correct term for the clinical sign caused by excess bilirubin in the plasma.
It is characterized by a yellow discoloration of the skin, sclera (whites of the eyes), and mucous membranes.
This occurs because bilirubin, a yellow pigment, is deposited in the tissues when its concentration in the blood (hyperbilirubinemia) becomes too high.
Clinically, jaundice is usually apparent when serum bilirubin levels rise above 2.5-3 mg/dL.

Option A: Cyanosis is a bluish discoloration of the skin due to high levels of deoxygenated hemoglobin in the blood, which is related to poor oxygenation, not bilirubin levels.
Option C: Cystic fibrosis is a genetic disorder affecting mucus and sweat glands. While it can lead to liver complications that might cause jaundice, it is not directly caused by excess bilirubin itself.
Option D: Leukemia is a cancer of the blood-forming tissues. While it can sometimes infiltrate the liver and cause dysfunction leading to jaundice, it is not the direct result of excess bilirubin.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology of Jaundice as background academic context rather than a clinical decision trigger.
Nurses must be skilled in assessing for jaundice, which includes inspecting the skin, and more reliably, the sclera, in natural daylight.
Monitoring trends in serum bilirubin levels is a key nursing responsibility for patients with liver disease, hemolytic conditions, or biliary obstruction.
Patient education is crucial. Nurses teach patients and families about the signs of worsening jaundice and the importance of follow-up, especially in newborns to prevent kernicterus (bilirubin-induced brain damage).

How to Approach the Question

First, identify the key term in the question stem: 'excess bilirubin'.
Recall the physiological function and breakdown products of red blood cells. Hemoglobin breakdown produces bilirubin, a yellow pigment.
Consider what happens when a substance is in 'excess' in the body. It often deposits in tissues, causing a visible sign.
Evaluate each option based on this knowledge. 'Jaundice' is the medical term for the yellowing of skin and eyes.
Eliminate the other options. Cyanosis is blue (related to oxygen), while cystic fibrosis and leukemia are distinct disease processes not defined by bilirubin levels.

Concept Tested & Keywords

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E6 Biochemistry U Satyanarayana— Part 1 (pp 26-420 of 840) pp. 208-210, 207-209

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 331-333

Practise the full DSSSB - 29 August 2019 (Shift-1)

Attempt every question from this paper in a timed mock, then review the full solution for each one.