Clinical Conundrum Flashcards
where do RBC’s get broken down?
spleen, liver, bone marrow
when RBC’s are broken down, the heme is acted upon by _____ which converts it to ___
heme oxygenase, Fe CO and Biliverdin
bilirubin is created by the enzyme _____
biliverdin reductase
how does bilirubin get transported through the blood?
by linking on to albumin
in the liver, the enzyme ___ conjugates bilirubin making it ___
UDP glucuronosyl-transferase (UGT), hydrophilic
enterohepatic circulation
the secretion and reuptake of bile
unconjugated bilirubin is called:
indirect bilirubin
conjugated bilirubin is called:
direct bilirubin
someone with O blood type has anti ____ antibodies
A and B
someone with an A blood type has anti ___ antibodies
B
a thick meconium is associated with ___
cystic fibrosis
in physiologic jaundice, what kind of bilirubin builds up in the baby?
unconjugated
why does breast-feeding cause jaundice?
- it has beta-glucoronidase, an inhibitor of glucoronidase 2. it increases the reuptake of unconjugated bilirubin
other causes of jaundice in infants:
ABO incompatibility hypothyroidism-UGT needs thyroid hormone
Crigler-Najjar syndrome type I
have no UGT
Crigler-Najjar syndrome type II
have reduced amount of UGT
Gilbert’s syndrome
reduced activity of UGT
Dubin-Johnson
impaired canalicular export of conjugated bilirubin
Rotor syndrome
impaired canalicular export of conjugated bilirubin
what’s the problem with jaundice? (also disease name)
neurological defects (Kernicterus)
if they have normal colored urine, the bilirubin is _____
unconjugated
what is the main purpose of phototherapy?
convert the bilirubin to hydrophilic bilirubin so that the baby can pee it out
scleral icterus
yellowing of the sclera due to jaundice
at what level of bilirubin do people tend to look jaundiced?
2 or 3
a high alkaline phosphatase level is associated with ___
a biliary problem
prothrombin time is a measure of ____
clotting, and therefore function of the liver (liver makes clotting factors)
if conjugated is > 1/3 of total, we have a _____
conjugated hyperbilirubinemia
endoscopic retrograde cholangiopancreatography (ERCP)
put a catheter into the mouth and put in contrast to look back up to the biliary tree
HIDA
tag the bilirubin
Kasai procedure
carve out the biliary tree and connect a piece of the small intestine to it
