jaundice

Question 1

various colours in a bruise

Answer 1

the result of the synthesis of various compounds that are produced when the heme group gets broken down

Question 2

bilirubin

Answer 2

• the end product of heme degradation.
• most of which will originate from the spleen.
• yellow in colour

Question 3

properties of bilirubin

Answer 3

-in its free form is highly toxic
- water-insoluble, binds to albumin (a transporting protein)
- metabolises in the liver

Question 4

direct bilirubin

Answer 4

bilirubin conjugated with one or two glucuronic acid molecules

Question 4

urobilinogen

Answer 4

found in the duodenum, deconjugated direct bilirubin

Question 4

enterohepatic circulation

Answer 4

the process of bilirubin transformed into direct and UGB forms into the liver to be deconjugated again. creating a cycle

Question 5

urobilin

Answer 5

oxidized urobilinogen, producing a yellow colour

Question 6

jaundice

Answer 6

hyperbilirubinemia. Accumulation of indirect and direct bilirubin systematically.

Question 6

unconjugated (indirect reacting) bilirubin

Answer 6

• water insoluble
• bound to plasma albumin
• physiologically present in plasma
• does not get filtered

Question 7

conjugated (direct-reacting) bilirubin

Answer 7

• water soluble
• does not bind to plasma albumin
• should not be present in plasma
• if it is, it is filtered and present in urine

Question 8

kernicterus

Answer 8

when indirect bilirubin levels are pathologically high in newborns, the unbound fraction of unconjugated bilirubin passes through the blood brain barrier and causes irreversible neuronal damage

Question 9

prehepatic jaundice

Answer 9

increased haemolysis

Question 9

stercobilin

Answer 9

oxidized bilirubin present in stool, giving it its brown colour

Question 10

post hepatic jaundice

Answer 10

biliary obstruction

Question 11

hepatic jaundice

Answer 11

hepatocellular damage

Question 12

neonatal prehepatic jaundice

Answer 12

• higher heme degradation occurs in babies, increasing bilirubin production.
• due to a babies immature liver, they have a decreased capacity to conjugate bilirubin
• blue light therapy is used to increase conjugation of bilirubin

Question 13

biliary obstruction jaundice

Answer 13

obstruction of the common bile duct. increased pressure onto the bile ducts as bile continues to get produced but not released as it cant enter the duodenum.
- this leads to the bile ducts bursting, due to the pressure and bile enters the blood

Question 14

complications of obstruction jaundice (after ducts burst)

Answer 14

• both indirect and direct bilirubin found in urine
• no UBG can be produced and thus non in urine
• stercobilin cannot be produced, leading to a clay-coloured stool
• bile enters the BV, lipid digestion and absorption are impaired

Question 15

alcoholic liver disease (post hepatic jaundice due to hepatocellular damage)

Answer 15

exposure to alcohol causes hepatocyte steatosis ( a fatty change of the liver) dysfunction of mitochondrial and cellular membranes, hypoxia and oxidative stress
- both types of bilirubin and UBG in the urine

Question 16

factors contributing to the pathenogenesis of cirrhosis

Answer 16

• sex, females are more suseptible
• ethnic and genetic differences, asians typically have an intolerance as they are unable to oxidize acetaldehyde
• comorbid conditions, UP of iron, infections etc..

Question 17

Hepatocellular steatosis

Answer 17

• impaired assembly and secretion of lipoproteins

Question 18

acetaldehyde

Answer 18

the major intermediate metabolite of alcohol

Question 19

Reactive Oxygen Species

Answer 19

they react with cellular proteins, damage membranes and alter hepatocellular function

Question 20

endothelins

Answer 20

a 21-amino acid long peptide that is a vasoconstrictor produced from endothelial cells, impair hepatic blood flow

Question 21

aspartate transaminase (AST)

Answer 21

an enzyme that is found mostly in the liver

Question 22

Alanine transaminase (ALT)

Answer 22

an enzyme that’s mainly found in your liver

Question 23

most likely causes of death in end-stage alcoholics

Answer 23

• hepatic coma
• gastrointestinal haemorrhage
• infection
• hepatocellular carcinoma

Question 23

[ALT] > [AST]

Answer 23

most chronic liver diseases serum

Question 24

[AST] > [ALT] 2:1 ratio

Answer 24

alcoholic liver disease serum