Bilirubin and the biliary tree Flashcards

1
Q

What is bilirubin?

A

It is formed from RBC degradation in the spleen forming heme.

This is then converted to biliverdin

This is then converted to bilirubin by biliverdin reductase

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2
Q

How is unconjugated bilirubin carried to the liver?

A

Via albumin

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3
Q

What is bilirubin conjugated with?

A

Glucaronic acid

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4
Q

What is stercobilin?

A

Bilirubin that makes poo brown

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5
Q

What is urobilin?

A

Bilirubin that makes urine straw colour

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6
Q

Why does jaundice occur?

A

Build up of bilirubin the blood

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7
Q

What is a pre hepatic cause of jaundice and what would you see biochemically?

A

Anything that increases heamolysis, eg SCA

It would cause increased levels of unconjugated bilirubin

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8
Q

What is a hepatic cause of jaundice and what would you see biochemically?

A

Anything that blocks the liver. Cirrhosis, fatty liver

Increased un or conjugated depending where it is

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9
Q

What is a post hepatic cause of jaundice and what would you see biochemically?

A

A blocking of the biliary tree

Increased conjugated

You may get pale stools and dark urine if none get so these systems

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10
Q

Draw a biliary tree

A
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11
Q

What test can reveal acute pancreatitis?

A

Amylase

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12
Q

What tumour marker could suggest hepatic cancer?

A

AFP

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13
Q

What scan is best when wanting to see gall stones?

A

US

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14
Q

What scan is best when wanting to see pancreatitis?

A

CT

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15
Q

What scan can show liver function?

A

HIDA

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16
Q

When is an MRCP used?

A

To see inflammation

17
Q

What is an ERCP used for?

What can it cause?

A
  • is used to gain biopsies and enters up the biliary tree.
  • It can also be used to put dye in

Acute pancreatitis

18
Q

How big should the cystic duct be?

A

6mm 1mm for every 10 years after 60

19
Q

What is the difference between the ampulla of vater and sphincter of oddi?

A

A of V - union of CBD and major pancreatic duct

S of O - Sphincter controlling release to duodenum

20
Q

What makes urobilinogen?

A

Gut Bacteria

21
Q

What turns Haem to biliverdin?

A

Haem reductase