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12 Cards in this Set
- Front
- Back
What is the definition of jaundice?
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"Yellow Skin" related to Hyperbilirubinemia
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What is the pathogenesis of jaundice?
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A.Heme product degradation yields Hemoglobin
B.Hemoglobin transported to reticuloendothelial system, a.Heme is oxidized to bilverdin C.Bilverdin converted to Unconjugated Bilirubin D.Unconjugated Bilirubin circulates 1.Tightly bound to albumin and fat soluble 2.Unconjugated Bilirubin is insoluble in water 3.Concentrates in high albumin containing tissues skin and sclera jaundice Unconjugated bilirubin converts to conjugated bilirubin by glucuronosyltransferase enzyme - only conjuagted bilirubin can be excreted |
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What is the nl production of bilirubin?
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4 mg/kg/day
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How does unconjugated bilirubin circulate?
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1.Tightly bound to albumin and fat solublea.Displaced Bilirubin causesi.Albumin saturated with Bilirubin or
ii.Medications (e.g. Sulfisoxazole, Streptomycin, Vitamin K) b.Displaced Unconjugated Bilirubin crosses blood-brain barrier and placentai.Results in toxicity (e.g. Hepatic Encephalopathy, Kernicterus) 2.Unconjugated Bilirubin is insoluble in watera.Not found in tears or Saliva b.Unconjugated Bilirubin can not be excreted 3.Concentrates in high albumin containing tissuesa.Skin (especially face and trunk): Jaundice b.Sclera: Scleral Icterus |
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What is unconjuagted bilirubin measured as?
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Indirect
A.Normal: <1.0 mg/dl |
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What are causes of increased indirect levels?
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A.Hemolysis1.Hemolytic Anemia (mild Hyperbilirubinemia)
B.Large heme load (e.g. large hematoma reabsorption) C.Liver disease1.Hepatitis 2.Cirrhosis 3.Neoplasm D.Hepatic congestion E.Hereditary1.Gilbert's disease 2.Crigler-Najjar syndrome |
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what are nl levels for conjugated bilirubin?
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A.<0.2 mg/dl
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What are causes for increased conjugated bilirubin?
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A.Intrahepatic Causes1.Hepatocellular diseasea.Viral Hepatitis
b.Alcoholic Liver Disease 2.Biliary Tract Obstruction 3.Drug induced cholestasis 4.Prolonged Total Parenteral Nutrition 5.Sarcoidosis 6.Pregnancy 7.Primary Biliary Cirrhosis 8.Primary Sclerosing Cholangitis B.Extrahepatic Causes1.Cholelithiasis 2.Pancreatitis 3.Cryptosporidium infection (immunocompromised patient) 4.Cytomegalovirus infection 5.Cholangiocarcinoma 6.Cancer involving liver 7.Pancreatic Cancer 8.Lymphoma |
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What test looks for urobilogen?
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Ictotest
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What diseases are positive for urobilinogen?
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A.Hepatitis
B.Liver disease1.Cirrhosis 2.Liver Metastases 3.Liver infarction C.Hemolytic Jaundice |
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What is bilirubin?
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Substance formed when red blood cells are broken down. Bilirubin is part of the bile, which is made in the liver and is stored in the gallbladder. The abnormal buildup of bilirubin causes jaundice
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What is hyperbilirubinemia?
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pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice.
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