Diagnostic Workup History/Physical		The history and physical exam, as mentioned, are extremely important in the diagnosis of cholestasis. Some diagnostic clues in the history include: Family history of prolonged jaundice - Alagille, cystic fibrosis, alpha-1-antitrypsin, PFIC Cholestasis of pregnancy in the mother - PFIC Maternal infection - TORCH Abnormal fetal ultrasound - choledochal cyst or bowel duplication SGA - TORCH Hemolytic disease of the newborn - inspissated bile syndrome Vomiting - metabolic disorders, bowel obstruction, sepsis Nutritional source - galactose/lactose containing - galactosemia - fructose/sucrose containing - fructose intolerance CNS - irritability - metabolic disorder, sepsis - lethargy - hypothyroid, hypopit, sepsis Diagnostic clues in the physical exam include: Dysmorphic facies - Alagille Congenital heart disease - Alagille, embryonic biliary atresia Petechiae, rashes - TORCH Fundoscopy - cataracts - TORCH, galactosemia - embryotoxon - Alagille - chorioretinitis - TORCH Return to top of page