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CC LEC > Bilirubin > Flashcards

Bilirubin Flashcards

1
Q

end product of hemoglobin metabolism

A

bilirubin

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2
Q

principal pigment in bile

A

bilirubin

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3
Q

2 sources of bilirubin

A

heme (85%)
myoglobin, cytochrome, peroxidase/catalase (in some books)

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4
Q

circulation (pre-hepatic) steps

A
  1. RBC (old)
    (releases)
  2. hemoglobin
    (degraded)
    - iron
    - heme
    - globin
    (heme oxygenase)
  3. biliverdin
    (biliverdin reductase)
  4. bilirubin (B1)
    (attaches to albumin)
  5. LIVER
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5
Q

the iron are bound to ______ which is the transport protein which will be delivered to other organs

A

transferrin

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6
Q

_____ is where the bilirubin derived. it is degraded to deliver by the action of ______

A

heme
heme oxygenase

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7
Q

_____ are degraded and the amino acids are released or recycled by the body

A

globin

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8
Q

liver (hepatic) steps

A
  1. bilirubin (B1)
    (released by albumin and picked up by ligandins)
    (UDPGT)
  2. bilirubin monoglucoronide
    (UDPGT)
  3. bilirubin diglucoronide/bilirubin 2
  4. INTESTINE
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9
Q

B1 is released by albumin and picked up by a transport protein called _____

A

ligandins

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10
Q

the B1 will be conjugated to _____

A

bilirubin monoglucoronide

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11
Q

UDPGT meaning

A

uridine diphosphate glucoronyl transferase

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12
Q

in some books, UDPGT is _____

A

uridine diphosphate glucoronosyl transferase

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13
Q

UDPGT is the conjugation of B1 to form _____

A

Bilirubin 2

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14
Q

we esterify ______ into the _____ present in the bilirubin molecule

A

glucoronic acid
2 propionic acid

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15
Q

intestine (post-hepatic) steps

A
  1. bilirubin 2
    (will be reduced)
  2. mesobilirubin
  3. mesobilirubinogen
  4. urobilinogen
    - stercobilin
    * stercobilin
    * stool (brown color)
    - reabsorbed
    * urobilin
    (excreted)
    *urine
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16
Q

these are intestinal bacteria

A

mesobilirubin
mesobilirubinogen
urobilinogen

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17
Q

a colorless product

A

urobilinogen

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18
Q

stercobilinogen is ____

A

80%

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19
Q

reabsorbed is ____

A

20%

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20
Q

forms of bilirubin

A

bilirubin 1
bilirubin 2

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21
Q

found in the circulation, in the blood

A

bilirubin 1

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22
Q

unconjugated bilirubin
water insoluble
non-polar bilirubin
indirect bilirubin
hemobilirubin
slow reacting
prehepatic bilirubin

A

bilirubin 1

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23
Q

why bilirubin 1 is water insoluble?

A

bc it is non-polar due to the presence of 2 propionic acid

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24
Q

bilirubin 1 is slow reacting, what should be added?

A

accelator/accelerant

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25
Q

forms of bilirubin that is synthesized in the liver

A

bilirubin 2

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26
Q

conjugated bilirubin
water soluble
polar bilirubin
direct bilirubin
cholebilirubin
one-minute/prompt bilirubin
post-hepatic/hepatic/obstructive/regurgitative bilirubin

A

bilirubin 2

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27
Q

specimen used for bilirubin measurement

A

serum or plasma

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28
Q

RV for unconjugated bilirubin

A

0.2 - 0.8 mg/dL

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29
Q

RV for conjugated bilirubin

A

0.0 - 0.2 mg/dL

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30
Q

RV for total bilirubin

A

0.2 - 1.0 mg/dL

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31
Q

normally present in bilirubin

A

unconjugated bilirubin

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32
Q

normal kahit walang conjugated bilirubin sa serum

A

conjugated bilirubin

33
Q

it is formed due to prolonged elevation of conjugated bilirubin

A

delta bilirubin

34
Q

comjugated bilirubin tightly bound to albumin and has longer life compared to any other forms of bilirubin

A

delta bilirubin

35
Q

type of bilirubin that reacts with diazo reagent

A

delta bilirubin

36
Q

RV for delta bilirubin

A

<0.2mg/dL

37
Q

formula for delta bilirubin

A

delta bilirubin = TB - DB + IB

38
Q

surgical removal of gallbladder

A

cholecystectomy

39
Q

serum must be stored from light immediately bc it can decreased upto ____

A

30-50%/hr

40
Q

serum sample for bilirubin measurement (room temp)

A

2 days

41
Q

serum sample for bilirubin measurement (ref)

A

4C for 1 week

42
Q

serum sample for bilirubin measurement (freezer)

A

-20C for indefinite

43
Q

(T/F)
fasting sample is preferred but not required in bilirubin measurement

A

true

44
Q

interferences in bilirubin measurement

A

lipemia
hemolysis

45
Q

falsely increases bilirubin concentration

A

lipemia

46
Q

decrease reaction of bilirubin with diazo reagent (decreased bilirubin)

A

hemolysis

47
Q

reaction in bilirubin measurement

A

Van den Berg reaction

48
Q

diazotization of bilirubin to form azobilirubin

A

Van den Berg reaction

49
Q

only measure conjugated bilirubin and total bilirubin

A

Van den Berg reaction

50
Q

(T/F)
for unconjugated bilirubin, we add accelerants or accelerators bc masyado syang mabagal

A

true

51
Q

it has direct action with Van den Berg reaction

A

conjugated bilirubin
total bilirubin

52
Q

2 methods in bilirubin measurement

A

evelyn & malloy method
jendrassik & grof method

53
Q

coupling accelerator of evelyn & malloy method

A

methanol

54
Q

methanol is used to measure ______

A

bilirubin 1

55
Q

diazo reagents in evelyn & malloy method

A

diazo A: 0.1% sulfanilic acid, HCl
diazo B: 0.5% sodium nitrite
diazo Blank: 1.5% HCl

56
Q

Diazo A is _____

A

0.1% sulfanilic acid, HCl

57
Q

Diazo B is _____

A

0.5% sodium nitrite

58
Q

Diazo Blank is _____

A

1.5% HCl

59
Q

final reaction of evelyn & malloy method

A

pink to purple azobilirubin (measured @ 560 nm)

60
Q

commonly used method bc it is more sensitive than evelyn & malloy

A

jendrassik-grof method

61
Q

popular technique for discreet analyzers

A

jendrassik-grof method

62
Q

main reagent in jendrassik-grof method

A

diazo reagent

63
Q

accelerator in jendrassik-grof method

A

caffeine sodium benzoate

64
Q

buffer in jendrassik-grof method

A

sodium acetate

65
Q

terminates the accelerator and destroys excess diazo reagent

A

ascorbic acid

66
Q

provides alkaline pH after addition of ascorbic acid

A

alkaline tartrate solution

67
Q

final reaction of jendrassik-grof method

A

blue azobilirubin (measured @ 600 nm)

68
Q

increased bilirubin can cause ____

A

jaundice

69
Q

jaundice is the most common cause of ______ or ______

A

cholelithiasis or gallstones

70
Q

characterized by yellow discoloration of the skin, sclera, and mucus membranes

A

hyperbilirubinemia

71
Q

RV for overt jaundice

A

1.0 - 1.5 mg/dL

72
Q

type of jaundice that is not visible to the naked eye

A

overt jaundice

73
Q

RV for visible jaundice

A

3.0 - 5.0mg/dL

74
Q

more commonly termed for serum or plasma with yellow discoloration due to hyperbilirubinemia

A

icterus

75
Q

RV for icterus

A

> 25mg/dL

76
Q

classifications of jaundice and all of these have increased total bilirubin

A

pre-hepatic jaundice
post-hepatic jaundice
hepatic jaundice

77
Q

too much RBC destruction
elevated indirect bilirubin

A

pre-hepatic jaundice

78
Q

failure of bile to flow in the intestine (impaired bilirubin excretion)
elevated direct bilirubin

A

post-hepatic jaundice

79
Q

hepatocyte injury caused by viruses, alcohol, and parasites
elevated direct and indirect bilirubin

A

hepatic jaundice

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