Internal Medicine

P1: RLJ/OZN P2: KUF

0521779407-D-01 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:41

Dubin-Johnson Syndrome Dyspepsia 509

■absent multiple drug-resistant protein (MRP2) function, an ATP

dependent hepatocyte canilicular transporter of multiple anions and

conjugated bilirubin

■gene probe: mutations in MRP2

Other Diagnostic

■oral cholecystogram: poor gallbladder visualization

Treatment

■none

differential diagnosis

n/a

management

n/a

specific therapy

n/a

follow-up

n/a

complications and prognosis

■hepatic adenomas reported rarely; excellent prognosis

Dyspepsia..........................................

M. BRIAN E. FENNERTY, MD

history & physical

Signs & Symptoms

■epigastric pain

■belching/bloating

■nausea/vomiting

■weight change

■early satiety

■pain may be relieved with acid reduction

■food may make better or worse

■epigastric tenderness

■abdominal distension

■succusion splash in those with gastric outlet obstruction

■weight loss in those with malignancy

■melena in those with bleeding