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Conjugation And Excretory Function Test Flashcards

1
Q

Bilirubin must be excreted through liver?

A

Yes

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2
Q

It is the end product of hemoglobin metabolism

A

Bilirubin

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3
Q

Heme- containing proteins

A

Myoglobin
Catalase
Cytochrome oxidase

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4
Q

Principal pigment in bile

A

Bilirubin

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5
Q

Formed in destruction of heme- containing

A

Bilirubin

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6
Q

Other names of bilirubin 1

A

Unconjugated
Water insoluble
Non polar
Indirect
Hemoglobilirubin
Slow reacting
Pre hepatic

(WUNSHIP)

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7
Q

Other names of Bilirubin 2

A

Conjugated
Water soluble
Polar
Direct
Cholebilirubin
One minute/ prompt
Post hepatic/ hepatic/ obstructive/ regurgitative

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8
Q

Reference value of conjugated bilirubin

A

0 - 0.2 mg/dl

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9
Q

Reference value of unconjugated bilirubin

A

0.2-0.8 mg/dl

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10
Q

Total bilirubin reference value

A

0.2-1.0

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11
Q

Prolong conjugated bilirubin; bounded to albumin

A

Delta bilirubin

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12
Q

Helps in monitoring the decline of serum bilirubin following cholecystectomy

A

Delta bilirubin

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13
Q

Reference value of delta bilirubin

A

< 0.2 mg/dl

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14
Q

It reacts with diazo reagent

A

Delta bilirubin

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15
Q

Jaundice is caused by hypobilirunemia?

A

No. Hyperbilirubinemia

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16
Q

Characterized by yellow discoloration of the skin, sclera, and mucus membranes

A

Jaundice

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17
Q

Serum/plasma with yellow discoloration due to hyperbilirubinemia

A

Icterus

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18
Q

Jaundice Total Bilirubin

A

3.0-5.0 mg/dl (visible jaundice)

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19
Q

Overt jaundice

A

1.0-1.5 mg/dl

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20
Q

Hemolytic jaundice, unconjugated bilirubin

A

Pre hepatic jaundice

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21
Q

Caused by to much rbc destruction

A

Pre hepatic jaundice

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22
Q

HDN; hemolytic anemia; malaria; BBB

A

Pre hepatic jaundice

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23
Q

Lab findings:
Indirect bilirubin - increase
Direct & urobilinogen - normal
Urine bilirubin - negative

A

Pre hepatic jaundice

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24
Q

Obstructive jaundice

A

Post hepatic jaundice

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25
Q

Failure of bile to flow to the intestine or impaired Bilirubin excretion

A

Post hepatic jaundice

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26
Q

Lab findings:
Indirect - normal
Direct - increase
Urobilinogen - decrease
Urine bilirubin - positive
Alkaphos - increase

A

Post hepatic

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27
Q

Hepatocellular combined jaundice

A

Hepatic jaundice

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28
Q

Caused of disorder of Bilirubin metabolism, transport defects, hepatocellular injury or destruction

A

Hepatic jaundice

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29
Q

Lab findings:
Indirect & direct - increase
Urobilinogen - decrease

A

Hepatic jaundice

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30
Q

Bilirubin transport deficit

A

Gilbert’s syndrome

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31
Q

Impaired cellular uptake of bilirubin due to genetic mutation of UGT1A1 gene (chromosome 2)

A

Gilbert’s syndrome

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32
Q

Mild icterus, no symptoms and predisposed acetaminophen toxicity

A

Gilbert’s syndrome

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33
Q

Lab findings:
Indirect bilirubin: 1.5-3.0 mg/dl

A

Gilbert’s syndrome

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34
Q

Conjugation deficit

A

Crigler-najjar syndrome

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35
Q

Chronic non hemolytic unconjugated hyperbilirubinemia

A

Crigler-najjar syndrome

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36
Q

Complete UDPGT deficiency

A

Crigler-najjar syndrome type 1

37
Q

Lab results of Crigler-najjar syndrome type 1

A

Indirect bilirubin: > 25 mg/dl

38
Q

Symptoms of Crigler-najjar syndrome

A

Kernicterus
Colorless bile

39
Q

Partial deficiency of UDPGT

A

Crigler-najjar syndrome type 2

40
Q

Lab results of Crigler-najjar syndrome type 2

A

Indirect bilirubin: 5-20 mg/dl

41
Q

Presence of conjugation inhibitor

A

Lucey-driscoll syndrome

42
Q

Familial form of unconjugated hyperbilirubinemia caused by circulating inhibitor of Bilirubin conjugation

A

Lucey-driscoll syndrome

43
Q

Bilirubin excretion deficit

A

Dubin - johnson syndrome

44
Q

Conjugated hyperbilirubinemia

A

Dubin - johnson syndrome

45
Q

Defective excretion of direct bilirubin into the canaliculi caused by

A

Hepatocyte membrane defect

46
Q

Intense dark pigmentation of the liver due to accumulation of lipofuscin pigment

A

Dubin - johnson syndrome

47
Q

Similar to Dubin - johnson syndrome without the “black liver”

A

Rotor syndrome

48
Q

Lab findings:
Elevation in direct & total bilirubin
Increase delta bilirubin

A

Rotor syndrome

49
Q

Bilirubin methodology sample

50
Q

Storage in Bilirubin methodology

A

RT : 2 days
Ref (4degC) : 1 week
Freezer (-20 degc) : indefinite

51
Q

Interference in Bilirubin methodology

A

Iipemia - increase
Hemolysis - decrease
30-50%/hr - decrease
Loss if unprotected from light

52
Q

Priniciple of bilirubin assay

A

Van Den Berg reaction

53
Q

Measure conjugation and total bilirubin

A

Bilirubin assay

54
Q

Diazotization of Bilirubin to form azobilirubin

A

Van den berg reaction

55
Q

Methods in Bilirubin Assay

A

Evelyn and Malloy method
Jendrassik and Grof method

56
Q

Inherited disorders of Bilirubin metabolism

A

Gilbert’s
Crigler-najjar
Lucey driscoll
Dubin -johnson
Rotor

57
Q

Evelyn and Malloy method coupling accelerator

58
Q

Evelyn and Malloy method diazo reagent

A

Biuret bilirubin

59
Q

0-1% sulfonilic acid + Hcl

60
Q

0.5% sodium nitrate

61
Q

1-5% HCl

A

Diazo blank

62
Q

pH of diazo reagent

63
Q

Pink to purple azobilirubin

A

Evelyn and Malloy method

64
Q

Most sensitive; popular technique for discreet analyzer

A

Jendrassik and Grof method

65
Q

Accelerator of jendrassik and Grof method

A

Caffeine sodium benzoate

66
Q

Buffer of jendrassik and Grof method

A

Sodium acetate

67
Q

Terminates the accelerator and destroy excess diazo reagent

A

Ascorbic acid

68
Q

Blue azobilirubin measured at 600 nm

A

Jendrassik and Grof method

69
Q

Provides alkaline ph after addition of ascorbic acid

A

Alkaline tartrate solution

70
Q

Increase indirect bilirubin

A

Hemolytic anemia
G6PD Deficiency
Gilbert’s syndrome
Crigler-najjar syndrome
Hepatocellular disease
Lucey-driscoll syndrome

(HEGGCHEL)

71
Q

Increase direct bilirubin

A

Biliary obstruction (gall stone)
Pancreatic cancer
Dubin - Johnson syndrome
Alcoholic and viral hepatitis
Biliary atresia
Hepatocellular disease

PHADBB

72
Q

Colorless end product of Bilirubin metabolism that is oxidized by intestinal flora to urobilin

A

Urobilinogen

73
Q

Urobilinogen collect of sample and specimen

A

Avoid light exposure
2 hr freshly urine or stool

74
Q

Method in urobilinogen

A

Ehrlich method

75
Q

Ehrlich method

A

P-DABA
p - dimethylaminobenzenealdehyde

76
Q

Urobilinogen urine reference value

A

0.1-1.0 Ehrlich unit

77
Q

Urobilinogen stool reference value

A

75-275 Ehrlich unit

78
Q

1 Ehrlich=

A

1 mg of urobilinogen

79
Q

Test for hepatocellular function and potency of bile duct

A

Bromsulfophthalein dye extraction test

80
Q

Principle of BSP dye extraction test

A

Injection of dye

81
Q

Methods of administration of BSP

A

Rosenthal white method
Mac donald method

82
Q

Double collection method

A

Rosenthal white

83
Q

Rosenthal white BSP dose

84
Q

Rosenthal white specimen collection

A

5 mins after BSP admin
30 mins after BSP admin

85
Q

Rosenthal white reference value

A

After 5 minutes: 50% dye retention
After 30 minutes : 0% dye retention

86
Q

Single collection method

A

Mac donald method

87
Q

Mac donald BSP dose

88
Q

After 45 mins

A

Mac donald method

89
Q

Mac donald reference value

A

After 45 mins: +/- 5% dye retention

CC1 (3 decks)

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