[C] 1.33 Pathologic pigmentation caused by hematoidin, and bilirubin

Question 1

Hematoidin

Answer 1

• Brownish pigment
• Old haemorrhages
• Iron-free derivate of haem
• Need-shaped or rhomboid crystals

Question 2

Bilirubin

Answer 2

(Biliverdin: Oxidised): Bile pigment

• MPS cells (indirect bilirubin)
• Liver cells (direct bilirubin conjugated to glucuronic acid)

Question 3

Jaundice/Icterus

• Summarise
• Staining

Answer 3

• Bilrubin in the tissues - Solute and precipitated to proteins
• Staining the tissues yellow - Conjunctiva, sclera, intima of blood vessels
• Bird liver: Green (Biliverdin)
• Staining method: Forsgren (Reddish blue)

Question 4

Posthepatic jaundice

Answer 4

Stagnation/resorption

• Obstruction to the outflow of bile (Br-I)
• In the blood and urine (BR-II)

Question 5

Prehepatic jaundice

Answer 5

Hyperfunctional or haemolytic

• Intensive haemolysis
• Br-I in blood
• Icterus neonatorum

Question 6

Hepatic icterus

Answer 6

Toxic or retention

• Bilirubin I & II
• In the urine: Br-II & UBG
• Cell necrosis

Question 7

Example of what could lead to posthepatic icterus

Answer 7

Cholelithiasis