Hepatic System: Bile, Bilirubin, and Jaundice Basics Flashcards
1
Q
What is Bilirubin and what is its dx value?
A
- Bilirubin is an orange-yellow pigment that occurs normally when part of your red blood cells break down
- It is used to help find the cause of health conditions like jaundice, anemia, and gall bladder and liver disease
2
Q
How is bilirubin made?
A
- When an RBC hits the end of its life cycle, it breaks down into Globin, Heme and Billverdin.
- Biliverdin → Bilirubin, which is then processed for elimination by the liver
3
Q
What is direct bilirubin?
A
- Bilirubin attached by the liver to glucuronic acid, a glucose-derived acid, is called direct, or conjugated, bilirubin.
- Conjugated bilirubin is water-soluble and is excreted into the bile to be cleared from the body through the digestive tract.
4
Q
What is indirect bilirubin?
A
- Bilirubin not attached to glucuronic acid is called indirect, or unconjugated, bilirubin
- Unconjugated bilirubin is a waste product of hemoglobin breakdown that is taken up by the liver, where it is converted into conjugated bilirubin.
5
Q
What is total bilirubin?
A
• All the bilirubin in your blood together is called total bilirubin.
6
Q
What is Urobilinogen?
A
- Conjugated bilirubin is excreted into the duodenum
- Some is converted to urobilinogen by intestinal microorganisms.
7
Q
What happens to urobilinogen when created?
A
- A portion of the urobilinogen is absorbed from the colon, enters the portal circulation, is removed by the liver, and is secreted into the bile.
- That which is not removed from the portal blood by the liver enters the systemic circulation and is excreted by the kidneys.
- Urobilinogen is responsible for the yellow color of urine.
8
Q
What is bile?
A
- Bile is a fluid that is made and released by the liver and stored in the gallbladder.
- Bile helps with digestion by breaking down fats into fatty acids, which can be taken into the body by the digestive tract
9
Q
What is the composition of bile?
A
- 97% water with the remaining 3% consisting of
- Bile salts
- Bilirubin
- Fat (cholesterol, fatty acids lecithin)
- Inorganic salts
10
Q
What is the gallbladder?
A
- A small, pear-shaped organ on the right side of the abdomen, just beneath the liver.
- The gallbladder holds a digestive fluid called bile that’s released into the duodenum
11
Q
What is the flow of bile from liver to duodenum?
A
- Liver → Left & right hepatic ducts → Common hepatic duct
- Cystic duct from gallbladder merges w/ common hepatic duct to form Common bile duct
- Pancreatic duct merges with common bile duct → sphincter of Oddi → Duodenum
12
Q
What is the flow of bile from liver to duodenum?
A
- Liver → Left & right hepatic ducts → Common hepatic duct
- Cystic duct from gallbladder merges w/ common hepatic duct to form Common bile duct
- Pancreatic duct merges with common bile duct → sphincter of Oddi → Duodenum
13
Q
What are the three types of Jaundice?
A
- Hemolytic
- Hepatocellular
- Obstructive
14
Q
What is hemolytic jaundice?
A
• Occurs as a result of hemolysis, or an accelerated breakdown of red blood cells, leading to an increase in production of bilirubin
15
Q
What are the clinical signs of hemolytic jaundice w/ their causes?
A
- Yellow skin, sclera
- Due to unprocessed unconjugated bilirubin in blood stream
- Dark yellow urine
- Due to elevated urobilinogen
- Brown colored stool
- Due to presence of bile, direct bilirubin and urobilinogen
