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BILIRUBIN Flashcards

1
Q

What is bilirubin?

A

A breakdown product of the porphyrin ring of heme

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2
Q

How many fractions is bilirubin found in the blood?

A

2

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3
Q

What are the two fractions of bilirubin found in the blood?

A

Conjugated (B2) and Unconjugated (B1)

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4
Q

What is the alternative name for conjugated bilirubin?

A

Direct

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5
Q

What is the alternative name for unconjugated bilirubin?

A

Indirect

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6
Q

Who first described the reaction of bilirubin?

A

Ehrlich

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7
Q

What reagent was used in Ehrlich’s description of the bilirubin reaction?

A

Diazotized sulfanilic acid

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8
Q

What name was given to the type of reaction described by Ehrlich?

A

Diazo reaction

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9
Q

What color pigment was formed in the diazo reaction?

A

Red-blue

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10
Q

What did Van den Bergh find in 1913 regarding the diazo reaction?

A

It could be applied to serum samples with an accelerator or solubilizer

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11
Q

What is the chief purpose of neonatal bilirubin quantitation?

A

To monitor diseases causing jaundice in the newborn

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12
Q

What is another name for erythroblastosis fetalis?

A

Hemolytic disease of the newborn

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13
Q

What is a common cause of hemolytic disease of the newborn (HDN)?

A

Maternal alloimmunization to RhD

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14
Q

What is the average peak serum bilirubin concentration in a full-term newborn infant?

A

5 to 6 mg/dL

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15
Q

At what serum bilirubin concentration range is physiologic jaundice seen?

A

7 to 17 mg/dL

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16
Q

What term refers to the yellow staining of the basal ganglia due to severe jaundice?

A

Kernicterus

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17
Q

Which condition is NOT listed as a cause of neonatal jaundice?

A

Diabetes

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18
Q

Which type of bilirubin is water soluble?

Which type of bilirubin is found in urine?

A

Conjugated (Direct)

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19
Q

Which type of bilirubin has a high molecular weight?

Which type of bilirubin gives an indirect Van den Bergh reaction?

A

Unconjugated (Indirect)

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20
Q

Where is unconjugated (indirect) bilirubin normally found?

A

In plasma

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21
Q

What is unconjugated (indirect) bilirubin attached to non-covalently?

A

Albumin

22
Q

Conjugated bilirubin is normally present in which location?

A

Bile

23
Q

What is the Van den Bergh Reaction?

A

A reaction between bilirubin and Ehrlich diazo reagent

24
Q

What is the color of the compound formed in the Van den Bergh Reaction?

A

Reddish purple

25
Q

What type of bilirubin reacts directly with Ehrlich diazo reagent?

A

Conjugated bilirubin

26
Q

What is conjugated bilirubin also known as?

A

Direct bilirubin

27
Q

When does unconjugated bilirubin react with Ehrlich diazo reagent?

A

After the addition of methyl alcohol

28
Q

What is unconjugated bilirubin also known as?

A

Indirect bilirubin

29
Q

Wahlefeld et al.

A

Detergent as accelerator

30
Q

What is the purpose of using a detergent in the Wahlefeld method?

A

To accelerate the reaction and avoid protein precipitation

31
Q

Under what conditions does DPD react with bilirubin?

A

Acidic

32
Q

What is the main component that DPD reacts with in the Wahlefeld method?

A

Bilirubin

33
Q

Van den Bergh

A

Serum

34
Q

What is the pH range of the acidic medium used in coupling total bilirubin with a diazonium salt?

A

1-2

35
Q

Which compound is coupled with total bilirubin in the Wahlefeld Method?

A

Diazonium salt (DPD)

36
Q

What is the main product formed when total bilirubin reacts with DPD?

A

Azobilirubin

37
Q

Malloy & Evelyn

A

50% methanol

38
Q

Within how many hours should samples kept at room temperature be analyzed?

A

Two hours

39
Q

How long can bilirubin in serum remain stable when stored frozen at -20°C?

A

Three months

40
Q

What is the effect of direct sunlight on bilirubin levels in the serum within one hour?

A

Decrease up to 50%

41
Q

Up to what concentration of serum triglycerides is considered non-interfering?

A

1000 mg/dl

42
Q

Which of the following is a mechanism of unconjugated hyperbilirubinemia?

A

Increased bilirubin production

43
Q

What can cause decreased liver uptake in relation to unconjugated hyperbilirubinemia?

A

Decreased liver uptake

44
Q

Which mechanism involves the liver’s inability to properly process bilirubin resulting in unconjugated hyperbilirubinemia?

A

Decreased liver conjugation

45
Q

Decreased liver uptake results in:

A

Retention of unconjugated bilirubin

46
Q

What is the normal range for adults and infants older than 1 month?

A

0.2-1.0 mg/dl

47
Q

What is the expected blood content range for a full term newborn up to 24 hours?

A

2.0-6.0 mg/dl

48
Q

What are the expected blood values for infants up to 48 hours?

A

6.0-10.0 mg/dl

49
Q

What is the expected range of blood content in infants from 3 to 5 days?

A

4.0-8.0 mg/dl

50
Q

MAMA MO

A

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