Jaundice Flashcards
https://quizlet.com/239131547/livergallbladderpancreas-cadaver-diagram/
What forms portal triad?
Portal vein
Bile duct
Hepatic artery
Where does haemopoeisis begin?
Haemopoietic bone marrow
How long do RBC last for?
120 days
Where are old RBC broken down?
What occurs to globin?
What occurs to haem?
BM, liver, spleen
Globin- metabolised into aa- reused protein synthesis
Haem- broken into biliverdin transport in blood
- iron bind transferrin for transport
What does iron bind to for transport?
Transferring
What is precursor to erythrocyte?
Reticulocyte
State regions body sections?
What are two forms of bilirubin?
Which is insoluble water?
Unconjugated/conjugated
Unconjugated insoluble water
Explain bilirubin metabolism?
1) Reticuloendothelial cells- macrophages responsible maintenance of blood
2) Metabolise haemoglobin
3) Haemoglobin broken into- haem and globin
4) Globin broken down into amino acids (reused)
5) Haem broken iron and biliverdin
(catalysed haem oxygenase)
Iron- recycled
6) Biliverdin to bilirubin
(catalysed by biliverdin reductase)
Biliverdin reduced form unconjugated bilirubin (toxic)
8) Bloodstream unconjugated bilirubin binds albumin facilitate transport liver
9) Unconjugated bilirubin + Glucuronic acid form conjugated bilirubin (soluble)
(catalysed by glucuronyl transferase)
10) As conjugated blirubin water soluble allows excretion into duodemun in bile
9) In ileum bilirubin deconjugated by intestinal bacteria and converted urobilinogen (remove glucorinic)
10) 80% urobilinogen oxidised and bacteria converted stercobilin- faeces
11) 20% urobilinogen reabsorbed bloodstream- bound albumin- liver- recycled bile production
Small amount kidney- oxidised urobilin- excreted urine
What is haemoglobin broken into?
What occurs to broken down?
Haem- iron and biliverdin
Globin- amino acids
How are RBC produced?
Erythropoeisis
What
Unconjugated
Conjugated
soluble
Unconjugated- lipid sol
Conjugated- water sol
What gives faeces brown colour?
Stercoblin
What does haem break into?
What catalyses?
Biliverdin and iron
catalysed haem oxygenase
What does biliverdin converted into?
Catalysed?
Unconjugated bilirubin (toxic)
Biliverdin reductase
What does unconjugated bilirubin bind to?
Why?
Albumin
Not water soluble just lipid- can’t transported blood
What does unconjugated bilirubin form?
Where
Catalyst?
Unconjugated bilirubin + Glucuronic acid = Conjugated bilirubim
Catalyse- glucuronyl transferase
Liver
What does conjugated bilirubin form?
In ileum bilirubin deconjugated by intestinal bacteria and converted urobilinogen (remove glucorinic)
10) 80% urobilinogen oxidised and bacteria converted stercobilin- faeces
11) 20% urobilinogen reabsorbed bloodstream- bound albumin- liver- recycled bile production
Small amount kidney- oxidised urobilin- excreted urine
What happens to urobilinogen?
1) 80% urobilinogen oxidised- bacteria converts to stercobilin- faeces
2) 20% urobilinogen reabsorbed bloodstream- bound albumin- liver- recycled bile prod
Small amount kidney- urobilin- urine
What gives faeces colour?
Stercoblin
https://www.youtube.com/watch?v=dJ_dasmimE4
https://www.youtube.com/watch?v=dJ_dasmimE4
What is jaundice?
Yellow discolouration sclera and skin
What are 3 main types jaundice?
1) Prehepatic
2) Hepatic
3) Posthepatic
What occurs in prehepatic jaundice?
Excessive RBC breakdown
Overwhelm liver ability conjugate bilirubin
Raised lvls unconjugated bilirubin
Bilirubin that can be conjugated excreted normal but slight excess mean stool dark
Dark urine- conjugated excreted urine
What occurs in hepatic jaundice?
Damage hepatic cells- liver lose ability conjugate bilirubin
Therefore raised conjugated and unconjugated bilirubin in blood
Enlarged liver, dark urine
What occurs post hepatic jaundice?
Obstruction biliary drainage
Raised conjugated (liver works but unable get rid)
Pale stools- no sterocobilin
State diff class of jaundice and what will be raised?
State a cause of each jaundice?
State signs diff jaundice?
Prehepatic- raised unconjugated
- brown stool
- normal/pale urine- no raise conj
Hepatic- raised unconjugated and conjugated
- brown (worse-clay)
- dark urine
Posthepatic- raised conjugated
- pale white stool
- dark urine
Raised conjugated what type jaundice?
Posthepatic
Raised unconjugated what type jaundice?
Prehepatic
Raised conjugated and unconjugated what type jaundice?
Hepatic
