INCREASED DIRECT BILIRUBIN Flashcards
prehepatic jaundice
Hemolytic anemia and G-6-PD deficiency
bilirubin transport deficit; hepatic
unconjugated
Gilbert’s Syndrome
conjugation deficit; hepatic
unconjugated
Criggler-Najjar Syndrome
conjugation inhibitor ;
hepatic unconjugated
LUCEY- DRISCOLL SYNDROME
liver; hepatic jaundice
Hepatocellular disease
List of INCREASED INDIRECT BILIRUBIN
- Biliary obstruction (gall stones)
- Pancreatic (head) cancer
- Alcoholic and viral hepatitis
- Biliary atresia
- Hepatocellular disease
INCREASED INDIRECT BILIRUBIN
INCREASE IB
PREHEPATIC
INCREASED INDIRECT BILIRUBIN
INCREASE IB, DB
HEPATIC
INCREASED INDIRECT BILIRUBIN
INCEASE DB
POST
Colorless end product of bilirubin metabolism that is oxidized by intestinal flora to urobilin
UROBILINOGEN
UROBILINOGEN
Collection of sample
avoid light exposure
UROBILINOGEN
decrease in
urobilinogen; B2 can’t go to intestine and cant
oxidize to urobilinogen.
COMPLE BILIARY OBSTRUCTION
UROBILINOGEN
from the liver will go to intestine (converted to
urobilinogen by intestinal flora.
B2
UROBILINOGEN
2-hr freshly collected urine or freshly
collected stool
Specimen
UROBILINOGEN
Method
EHRLICH’S METHOD- p DABA (pdimethulaminobenzaldehyde_
UROBILINOGEN
Reference:
0.1-1.0 Ehrlich Unit/2 hour or 0.54
Ehrlich Unit/day urine
Urine
UROBILINOGEN
Reference:
75-275 Ehrlich Unit/100g of feces.
Stool
UROBILINOGEN
Reference:
1 mg UROBILINOGEN = ?
1 Ehrlich unit
Test for hepatocellular function and potency of
bile duct
BROMSULFONTHALEIN (BSP) BYE EXTRACTION
TEST
Rarely used because it involves administration of
bromsulphthalein dye
BROMSULFONTHALEIN (BSP) BYE EXTRACTION
TEST
BROMSULFONTHALEIN (BSP) BYE EXTRACTION
TEST
Main principal:
inject the dye; it has no
psychologically function because it is only a stain
Double collection method
Rosenthal White Method
Rosenthal White Method
BSP Dose ?
2mg/ Kg body weight
Rosenthal White Method
Specimen collection
after 45 minutes
Rosenthal White Method
Reference value:
50% dye retention
After 5 minutes
Rosenthal White Method
Reference value:
0% dye retention
After 30 minutes
Single collection method
Mac Donald Method
Mac Donald Method
BSP Dose
5 mg/Kg body weight
Mac Donald Method
Specimen collection
after 45 minutes
Mac Donald Method
Reference value:
+/- above or below
5% dye retention
After 45 minutes
