Heme Degradation and Jaundice Flashcards

Objectives: Hemedegradation and jaundice •Outline the steps in the degradation of hemeto bilirubinin the macrophages. •Explore the relationship of serum albumin and the transport of bilirubin •Explain the biochemical consequence of a block in each of the steps in the uptake and conjugation of bilirubinin liver. Distinguish the activity of UDP-glucuronyltransferasein adults versus premature babies. •Analyze the steps in the processing of conjugated bilirubinin the intestine and its excretion

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1
Q

What is the enzyme that begins heme degradation?

A

Heme Oxygenase

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2
Q

What transports bilirubin in the blood?

A

Albumin

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3
Q

What three drugs displace bilirubin from albumin in the blood?

A

Salicylate
Asprin
Sulfanomides

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4
Q

Once bilirubin is within the hepatocyte, what does it bind to?

A

Ligandin (intracellular protein)

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5
Q

What is used to conjugate biliruibin?

A

UDP-glucuronic acid

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6
Q

What is another name for conjugated bilirubin?

A

Bilirubin diglucuronide

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7
Q

What is defective in Dubin-Johnson syndrome?

A

MRP2 transporter (ABC transporter) that transports conjugated biirubin from the hepatocyte into the biliary caniliculus.

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8
Q

Why are the feces of newborns of a clayish gray color?

A

There is no urobilinogen in the gut of fetuses and urobiligen is what leads to stericobilinogen (which leads to brown color)

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9
Q

(T/F) Bilirubin is covalently bound to albumin

A

False

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10
Q

What reagent is used in lab tests to detect conjugated bilirubin?

A

Diazo reagent

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11
Q

Which enzyme deficiency leads to the physiological jaundice of the newborn?

A

Bilirubin UDP-glucuronyl transferase

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12
Q

What is the clinical sign of jaundice?

A

Yellowish discoloration of the:
skin
mucous membranes,
sclera
and nail beds

(due to: bilirubin binds to connective tissue)

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13
Q

How is posthepatic Jaundice different from

A

Post: no increase in unconjuated bilirubin

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14
Q

What is the injury marker for complete obstructive jaudice?

A

serum ALP
color of urine is orange/reddish/brown

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