Approach to jaundice (unconjugated hyperbilirubinemia) Quiz: Ace Your Exams

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An 18-year-old woman presents to the emergency department due to yellowing of the skin for the past few days. The patient is very fatigued and has difficulty providing a history. Temperature is 37.5ºC (99.5ºF), pulse is 84/min, blood pressure is 123/78 mmHg, respiratory rate is 14/min, and SpO₂ is 98% on room air. On physical examination, the patient’s skin is jaundiced and the spleen is enlarged. Serum hemoglobin is 9.7 g/dL. Hemoglobin electrophoresis shows no abnormal hemoglobin. The peripheral smear shows hyperchromic dense erythrocytes without central pallor. Which of the following historical elements is likely to be present in this patient?

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Family history of hemolytic anemia

Family history of severe pain episodes

History of episodic jaundice

History of aortic valve replacement

History of recent travel to sub-Saharan Africa