Lecture 2 paed liver

Question 1

Where does bilirubin come from?

Answer 1

It is the waste product produced primarily in the normal breakdown of haem which comes from haemoglobin haemolysis of RBCs

Question 2

What is usually the main reason for elevated unconjugated bilirubin?

Answer 2

A: Too much bilirubin is being produced due to an increase in destruction of RBC’s
B: Liver incapable of processing bilirubin due to liver diseases such as cirrhosis or inherited problems

Question 3

What is usually the main reason for elevated conjugated bilirubin?

Answer 3

A: Liver IS capable of processing bilirubin however it cannot be removed from liver adequately/cannot be removed fast enough due to acute hepatitis or blockage of liver’s bile ducts

Question 4

How are RBC’s broken down in the liver?

Answer 4

RBC broken down, ultimately:
Iron recycled
globulin catabolised
haem eliminated:
1. changed to bilirubin in phagocytic kupffer cells and bound to albumin
2. albumin is stripped off in hepatocytes
3. COnjugated by addition of glucouronic acid
4. Excreted in stool as sterobilin