Jaundice and Bilirubin

Question 1

bilirubin pathway

Answer 1

haemoglobin+myoglobin - spleen
unconjugated bound to albumin - plasma
conjugated bilirubin glucuronides - liver
stercobilinogen in stools and urobilinogen in urine

Question 2

unconjugated/ conjugated

Answer 2

normally 95% of serum of bilirubin is conjugated
important to identify in hyperbilirubinaemia for a diagnosis
clinical and biochemical features overlap
normal level of bilirubin- <17umol/l

Question 3

history and examination

Answer 3

occupation, travel, contact with jaundice or hepatitis, rec drugs, sexual contact, family history, associated symptoms

signs of acute/chronic liver disease, biliary tree surgery, able to feel gall bladder, liver or spleen, drowsiness/ coma, flapping tremor, miscoloured urine/stools- urine will be more yellow with increased presence of bilirubin/ urobilinogen