Bilirubin Flashcards
How much blood is processed through the liver East minute
1500 mL per minute
What is the toxic pigment produced during RBC destruction ? What is it rapidly reduce to?
Biliverden and it is converted into free BiliRubin
Indirect Bilirubin
Toxic unconjugated free alcohol soluble only
Direct Bilirubin
Bilirubin diglucuronide Conjugated non-toxic water and alcohol soluble
What does deliver conjugate free BiliRubin with in order to make a non-toxic
Gluronic acid
What type of bilirubin Is soluble in water and plasma
Direct bilirubin
Conjugated bilirubin is excreted into the bile then into the small intestine where it is reduced by bacterial enzymatic action to form a group of colorless compounds known as
Urobilinogens
What is urobilinogen reduce to removed through the feces
Stercobiligen
Chromogen
Stercobilinigen porphobilinigen urobilinigen
Pigment
Bilirubin stercobilin urobilin
What gives stool it’s characteristic brown color
Stercobilinogen
What causes urine to darken upon standing
Urobilin
What is the term for when bilirubin in the blood exceeds the normal range greater than 2.0 mg/dL
Hyperbilirubinemia
What is the term for yellowing of the tissues skin and eyes due to excessive bilirubin levels in the blood called icterus
Jaundice
Increase destruction of red blood cells causes larger amounts of Bilirubin to be transported to the liver then can be excreted also causes increased levels of urobilinogen in urine and stool
Pre-hepatic jaundice
Most commonly caused by hemolytic transfusion resulting in massive distraction of RBCs release of hemoglobin and increased levels of bilirubin
Pre-hepatic jaundice
Hemolytic disease of the New Born
Pre-hepatic jaundice
Inability of the liver to conjugate in exercise BiliRubin because of liver disease or abnormalities
Hepatic jaundice
Hepatitis cirrohsis cancer and inherited metabolic defects in conjunction of bilirubin
Hepatic jaundice
And obstruction of the excretory ducks that prevents the excretion of bilirubin Caused by mechanical obstruction by stones stricture or tumors
Post hepatic or obstructive jaundice
What type of bilirubin are measured to detect and monitor jaundice
Total Bilirubin
What type of bilirubin are useful in making differential diagnosis
Direct and indirect bilirubin
What type of bilirubin is mostly present in neonatal jaundice
Unconjugated
Why are you serum the specimen of choice for bilirubin determinations
The addition of alcohol in the Evelyn Malloy method can precipitate proteins from plasma that interfere with the subsequent analysis
Why should hemolysis be avoided in bilirubin determination
It falsely depresses the bilirubin result in most Assays
Why should samples for bilirubin determination to be protected from light
Bilirubin Is light sensitive and can be destroyed by both light and heat
Reaction method one direct reaction where water soluble bilirubin and diazonium yield color corresponding only to the direct bilirubin fraction
2. Indirect reaction where alcohol is added to demonstrate the free water insoluble bilirubin
Van den Bergh Reaction
The Diaz reaction is used to determine the direct bilirubin in water methanol is added in a concentration that does not cause precipitation and proteins permitting the diazotization of indirect bilirubin Red violet color is red spectrophotometerically
Evelyn Malloy Bilirubin Procedure
Reaction at a strongly alkaline pH result in a blue color
Jensrassik- Grof procedure
Bilirubin + diazonium salts yields azobilirunin has a red violet color
Ehrlich reaction
Modification of the Evelyn Malloy procedure which results in moderately increased sensitivity we agents are different
Jendrassik-Grof procedure
Also call the Diazo reaction. Measures direct bilirubin only
Ehrlich reaction
