TESTS FOR CONJUGATION AND EXCRETION Flashcards
T/F. TESTS FOR CONJUGATION AND EXCRETION, Involves the measurement of bilirubin
True
TESTS FOR CONJUGATION AND EXCRETION
Bilirubin
Bromsulfonthalein (BSP) BYE Extraction Test
Urobilinogen
- End product of hemoglobin metabolism (85% came from the heme portion of the hemoglobin)
- Also formed from the destruction of heme-containing protein such as myoglobin, catalase, and cytochrome oxidase (15%)
Bilirubin
- It has no physiologic function and considered as waste product only thus, must be excreted
- Principal pigment of bile
Bilirubin
RBC are phagocytized, releasing Hgb
PREHEPATIC
T/F. Hgb is degraded to iron (binds with transferrin and transported to liver), globin (recycled in liver as amino acid) and heme
True
Heme is converted into biliverdin with the help of enzyme
Heme oxygenase
Biliverdin is converted to unconjugated bilirubin (B1) with the enzyme
Biliverdin reductase
B1 is released in the plasma and attaches to albumin
PREHEPATIC
In the liver, albumin is detached on the surface of hepatocytes
HEPATIC
T/F. B1 will be transferred and bind to ligandin to enter the SER
True
B1 undergo conjugation catalyzed by ____________ (UDPGT) → converting B1 to Bilirubin Monoglucuronide then, to Bilirubin Diglucuronide (B2)
Uridine Diphosphate Glucuronyl Transferase
T/F. B2 in liver is transported to the hepatic duct → combined with secretion from the gallbladder → transported to common bile duct → transported to intestine
True
T/F. In the intestine: B2 is reduced into mesobilirubin → mesobilirubinogen → urobilinogen by intestinal flora
True
formed is oxidized to become stercobilin → stool (responsible for stool pigment: yellow-brown)
80% of urobilinogen
reabsorbed by the extrahepatic circulation and recycled through the liver and then re-excreted in urine in the form of urobilin
20% of urobilinogen
normally present in the blood
B1
not normally present in the blood. In some cases, there’s only 0-very minute amount found
B2
Bilirubin 1
Unconjugated bilirubin
Water-insoluble bilirubin
Non-polar bilirubin
Indirect bilirubin
Hemobilirubin
Slow-reacting
Prehepatic
Bilirubin 2
Conjugated bilirubin
Water soluble bilirubin
Polar bilirubin
Direct bilirubin
Cholebilirubin
One-minute/Prompt bilirubin
Posthepatic/Hepatic/Obstructive/Regurtitative Biliburin
Plasma concentration of bilirubin increases upon birth and reaches its peak on the __th day
5
If bilirubin synthesis > liver clearance rate =
Increase bilirubin level
Conjugated Bilirubin (B2) Reference value:
0-0.2 mg/dL (0-3 umol/L)
Unconjugated Bilirubin (B1) Reference value:
0.2-0.8 mg/dL (3-14 umol/L)
Total Bilirubin Reference value:
0.2-1.0 mg/dL (3-17 umol/L)
- Has longer half-like and formed due to prolonged elevation of conjugated bilirubin
- Conjugated bilirubin bounded to albumin
- Helps in monitoring the decline of serum bilirubin following cholecystectomy
- It reacts with diazo reagent
Delta Bilirubin
Delta Bilirubin Reference Value:
<0.2 mg/dL
Delta Bilirubin Formula:
Total Bilirubin = Direct Bilirubin + Indirect bilirubin
Delta Bilirubin = TB – (DB + IB)
T/F. Delta Bilirubin is NOT perform in neonatal esp. ≤14 days old
True
