Approach to jaundice (unconjugated hyperbilirubinemia) Quiz: Ace Your Exams
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A 52-year-old man presents to the emergency department due to malaise and headache. These symptoms started four days ago and have progressively worsened to the point that the patient has trouble getting out of bed. The patient went to an urgent care six days ago for acute bronchitis and was given moxifloxacin, which he only took for two days. The patient has no known medical history and takes no medications. Temperature is 38.4ºC (101.1ºF), pulse is 96/min, blood pressure is 112/75 mmHg, respirations are 16/min, and SpO2 is 100% on room air. On physical examination, the patient has icteric conjunctiva and appears lethargic. Serum studies show a hemoglobin of 8.1 g/dL (reference range: 13.5–17.5 g/dL) and indirect bilirubin of 5.7 mg/dL (reference range: 0.2–0.8 mg/dL). Peripheral blood smear shows red blood cells with normal morphology and ring-shaped structures within several cells. Which of the following historical elements is likely to be present?
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