Jaundice in Clinical English:

Vocabulary & Key Phrases for Ward, Clinic, OET, and USMLE

Target readers: medical students, interns/residents, and clinicians who want to use English confidently when discussing jaundice—at the bedside, in clinic, in class, and in OET/USMLE settings.
What you’ll get: a practical Clinical English toolkit (then we’ll move to USMLE high-yield knowledge and OET practice in later sections).

You’re in clinic, you look up, and you notice it—“The sclera looks yellow.”
That moment tends to change the tone of the room.

This English article is designed as a 3-in-1 guide:

• Clinical English (how to say things clearly and professionally)
• USMLE high-yield review (First Aid–style knowledge, including key medications)
• OET Speaking/Writing (ready-to-use phrasing and structure)

But first, we build the foundation: the words and phrases you’ll actually use.

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Section 1. Clinical English Core Vocabulary for Jaundice

This section is your clinical-English “starter pack” for jaundice.
Rather than memorizing isolated words, we’ll learn them in the way clinicians speak:
term → meaning → how it’s used.

1) Must-know terms (you’ll hear and say these all the time)

Term	Plain meaning	Example (natural clinical English)
jaundice	yellowing due to elevated bilirubin	“The patient presents with jaundice.”
scleral icterus	yellowing of the whites of the eyes	“I noticed scleral icterus on exam.”
bilirubin	a yellow pigment measured in blood tests	“Total bilirubin is elevated.”
direct bilirubin (conjugated)	water-soluble bilirubin	“There’s a predominant rise in direct bilirubin.”
indirect bilirubin (unconjugated)	albumin-bound, not water-soluble	“This looks like unconjugated hyperbilirubinemia.”
cholestasis	impaired bile flow	“The labs suggest cholestasis.”
hepatocellular injury	liver-cell damage pattern	“This is more consistent with hepatocellular injury.”
obstructive jaundice	jaundice due to bile duct blockage	“We’re concerned about obstructive jaundice.”

2) High-frequency collocations (sound like a clinician, not a dictionary)

3) Patient-friendly words (for clinic and OET)

In OET and real clinic conversations, clarity matters more than perfect terminology.
Here are safe, patient-friendly options:

• “yellowing of the eyes/skin” (instead of “icterus”)
• “a blockage in the bile flow” (instead of “cholestasis”)
• “we need blood tests and an ultrasound” (simple plan)

4) Mini phrase bank: doctor-to-doctor summaries

• “This is a patient with progressive jaundice and a cholestatic pattern on labs.”
• “Obstructive causes, including malignancy, need to be ruled out.”
• “The patient is hemodynamically stable at this stage.”

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✅ Next up: we’ll shift from language to knowledge—USMLE High-Yield Jaundice Review (First Aid style), including the key medications related to jaundice patterns.

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Section 2. USMLE High-Yield Review of Jaundice (First Aid–Based)

In this section, we shift gears from language to knowledge.
The goal here is simple:

• Recognize jaundice-related questions on the USMLE
• Understand the underlying mechanisms without overcomplication
• Quickly identify the correct lab pattern and next step

This section closely follows the scope and style of First Aid, with brief clinical connections.

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2-1. What Is Jaundice? (Definition & Thresholds)

Jaundice refers to yellow discoloration of the skin and sclera caused by elevated serum bilirubin.

A critical exam mindset:

• Jaundice is a sign, not a diagnosis
• The real question is: where and why bilirubin is accumulating

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2-2. Bilirubin Metabolism (Very High Yield)

Understanding bilirubin metabolism is essential for answering USMLE questions efficiently.

1. Hemoglobin is broken down into unconjugated bilirubin
2. Unconjugated bilirubin travels in blood bound to albumin
3. In the liver, bilirubin is conjugated by UDP-glucuronyl transferase
4. Conjugated bilirubin is excreted into bile and enters the intestine

This single concept explains several classic exam findings, including dark urine and pale stools.

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2-3. Types of Jaundice: Think in Lab Patterns

For the USMLE, classification matters only insofar as it predicts lab patterns.

① Prehepatic Jaundice (Unconjugated)

• Typical cause: hemolysis
• ↑ indirect (unconjugated) bilirubin
• No bilirubin in urine
• ↑ urobilinogen

Key concept: unconjugated bilirubin cannot be excreted in urine.

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② Hepatic Jaundice (Mixed Pattern)

• Causes: viral hepatitis, drug-induced liver injury, cirrhosis
• ↑ AST / ALT
• Mixed elevation of direct and indirect bilirubin

This pattern reflects impaired hepatocyte function rather than obstruction.

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③ Posthepatic (Obstructive) Jaundice

• Causes: gallstones, pancreatic cancer, cholangiocarcinoma
• ↑ ALP and ↑ GGT
• Dark urine (conjugated bilirubin)
• Pale stools (lack of stercobilin)
• ↓ urobilinogen

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2-4. Liver Enzyme Patterns (AST, ALT, ALP, GGT)

USMLE questions often hinge on recognizing enzyme patterns rather than absolute values.

Hepatocellular Pattern

• Marked elevation of AST and ALT
• Seen in hepatitis, ischemic injury, toxic injury

Cholestatic Pattern

• Disproportionate elevation of ALP
• GGT confirms hepatic origin of ALP

Remember:

• AST/ALT reflect injury
• PT-INR reflects severity

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2-5. High-Yield Conditions You Must Recognize

• Gilbert syndrome: mild unconjugated hyperbilirubinemia, triggered by stress or fasting
• Dubin–Johnson syndrome: conjugated hyperbilirubinemia with normal liver enzymes
• Rotor syndrome: similar to Dubin–Johnson without liver pigmentation
• Acute cholangitis: fever, jaundice, RUQ pain (Charcot triad)

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2-6. Drugs Associated with Jaundice (First Aid Scope)

Drug-induced liver injury is commonly tested as a pattern-recognition question.

Drugs causing hepatocellular injury

• Acetaminophen
• Isoniazid
• Methyldopa
• Valproate

Drugs causing cholestatic injury

• Oral contraceptives
• Anabolic steroids
• Chlorpromazine
• Erythromycin

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➡️ Next: Section 3. OET-Focused Practice — how to explain jaundice clearly, take histories, and write referral letters in exam-ready English.

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USMLE High-Yield Points: What Has Actually Been Tested

These points reflect how jaundice is repeatedly tested in USMLE-style questions:
labs → pattern → diagnosis → next step.

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Section 3. OET-Focused Practice: Jaundice in Speaking & Writing

This section is designed for OET candidates who need to handle jaundice confidently in
patient communication, clinical discussions, and referral writing.

The focus is not on rare diagnoses, but on:

• Clear, patient-friendly explanations
• Safe and structured history taking
• Concise, professional referral letters

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3-1. OET Speaking: Explaining Jaundice to a Patient

In OET Speaking, your goal is to inform without alarming.
Avoid technical language unless you immediately explain it.

Key reassurance strategies:

• Acknowledge concern without minimizing symptoms
• Explain that jaundice is a sign, not a diagnosis
• Outline next steps clearly

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3-2. OET Speaking: History Taking for Jaundice

When taking a history, your questions should follow a logical flow.

Key questions (high yield)

• “When did you first notice the yellowing?”
• “Have you noticed any changes in your urine or stool colour?”
• “Do you have any itching of your skin?”
• “Have you had any fever, chills, or abdominal pain?”

Risk assessment questions

• “Have you started any new medications or supplements recently?”
• “Do you drink alcohol? If so, how much?”
• “Have you travelled overseas recently?”
• “Have you ever had liver or gallbladder problems before?”

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3-3. OET Speaking: Red Flags & Safety-Netting

You should clearly identify situations that require urgent care.

• High fever or chills
• Severe abdominal pain
• Confusion or drowsiness
• Rapidly worsening jaundice

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3-4. OET Writing: Referral Letter (Model Structure)

Jaundice is a common referral scenario in OET Writing.
Clarity and structure are more important than exhaustive detail.

Opening paragraph (reason for referral)

Relevant clinical findings

• Onset and progression of jaundice
• Associated symptoms (itching, pale stools)
• Relevant past medical history and medications

Investigations

• Elevated total and direct bilirubin
• Cholestatic liver enzyme pattern
• Ultrasound showing biliary dilatation

Closing & request

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3-5. Common English Pitfalls for Japanese Candidates

• ❌ “yellow eyes” → ✅ “yellowing of the eyes”
• ❌ “bilirubin is high” → ✅ “bilirubin levels are elevated”
• ❌ Overuse of technical terms without explanation

Remember: OET rewards clarity, empathy, and clinical logic more than complexity.

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Final Takeaway

If you can:

• Explain jaundice simply to a patient
• Recognize high-risk features
• Summarize the case clearly in writing

—you are already practicing at the level OET expects.

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Related Articles

• 
  Jaundice｜黄疸トップページ（Purpose-Based Navigation）
  
• 
  Initial Approach to Jaundice｜OSCE & Outpatient Focus
  
• 
  Bilirubin Metabolism Explained｜Clinical Reasoning Guide
  
• 
  Approach to Abdominal Pain｜Clinical Reasoning
  

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References

• First Aid for the USMLE Step 1. Gastrointestinal and Liver Disorders.
• Harrison’s Principles of Internal Medicine, 21st Edition.
  Approach to the Patient with Liver Disease; Disorders of Bilirubin Metabolism.
• Guyton and Hall Textbook of Medical Physiology.
  Liver Function and Bilirubin Metabolism.
• Murtagh’s General Practice, 8th Edition.
  Jaundice; Abnormal Liver Function Tests.
• UpToDate: Clinical approach to the patient with jaundice or asymptomatic hyperbilirubinemia.

This article integrates USMLE-oriented basic science knowledge with
general internal medicine and clinical reasoning perspectives.