Pathology of Jaundice

Question 1

RBC break down?

5

Answer 1

1-Haem–>Iron +Protoporphyrin
–>unconjugate bilirubin (UCB)
2-Alubin carries UCB to Hepatocyte
3-UCB becomes conjugated to CB ( which is water soluble )
enzyme name: Uridine Glucuronyl Transferase (UGT)
4-CB –>BILE canaliculi–>Gall bladder–>SI
5-In SI it becomes Urobilinogen which goes on to the kidney to become oxidized and becomes yellow urine.

Question 2

When can jaundice be caused

Answer 2

1-Increased Conjugated Bilirubin
2-Increased UCB
3-BOTH

Question 3

what is the process which occurs when hepatocytes don’t work?

Answer 3

1-(UCB –>CB = INHIBITED )

so increases UCB IN blood = yellow color in skin and eyes

Question 4

how can Jaundice occur ( ONLY when CB increases)

syndrome ?

Answer 4

1-Dubin -johnson syndorme

The conjugated Bilirubin can’t be secreted into the canaliculi

Question 5

How can jaundice occur when only UCB increases?

Answer 5

1-Gilberts syndrome
2-Hepaticytes dont work
3-Extravascualr Haemolytic Anemia

Question 6

How can jaudice occur whe both UCB AND CB increase?

what are the three kinds of jaundice ?

Answer 6

1-Viral Hepatitus

1-Pre-hepatic jaundice ( before the UCB reaches the Hepatocyte , normally due to excessive RBC breakdown (extravascular haemolytic anemia )

2-Hepatic jaundice ( when UGT enzyme doesn’t work )

3-Post hepatic jaundice (after hepatocyte so CB = bile not able to pass out of the gall bladder )

Question 7

Urobilinogen test , what do they indicate?

Answer 7

Urobilinogen is normally found in the urine.

1) This is decreased or absent in cases of obstructive jaundice
2) Increased in cases of prehepatic causes of hyperbilirubinaemia or hepatocellular disease.