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Bilirubin Flashcards

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1
Q

end product of hemoglobin metabolism

A

bilirubin

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2
Q

principal pigment in bile

A

bilirubin

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3
Q

2 sources of bilirubin

A

heme (85%)
myoglobin, cytochrome, peroxidase/catalase (in some books)

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4
Q

circulation (pre-hepatic) steps

A
  1. RBC (old)
    (releases)
  2. hemoglobin
    (degraded)
    - iron
    - heme
    - globin
    (heme oxygenase)
  3. biliverdin
    (biliverdin reductase)
  4. bilirubin (B1)
    (attaches to albumin)
  5. LIVER
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5
Q

the iron are bound to ______ which is the transport protein which will be delivered to other organs

A

transferrin

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6
Q

_____ is where the bilirubin derived. it is degraded to deliver by the action of ______

A

heme
heme oxygenase

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7
Q

_____ are degraded and the amino acids are released or recycled by the body

A

globin

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8
Q

liver (hepatic) steps

A
  1. bilirubin (B1)
    (released by albumin and picked up by ligandins)
    (UDPGT)
  2. bilirubin monoglucoronide
    (UDPGT)
  3. bilirubin diglucoronide/bilirubin 2
  4. INTESTINE
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9
Q

B1 is released by albumin and picked up by a transport protein called _____

A

ligandins

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10
Q

the B1 will be conjugated to _____

A

bilirubin monoglucoronide

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11
Q

UDPGT meaning

A

uridine diphosphate glucoronyl transferase

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12
Q

in some books, UDPGT is _____

A

uridine diphosphate glucoronosyl transferase

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13
Q

UDPGT is the conjugation of B1 to form _____

A

Bilirubin 2

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14
Q

we esterify ______ into the _____ present in the bilirubin molecule

A

glucoronic acid
2 propionic acid

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15
Q

intestine (post-hepatic) steps

A
  1. bilirubin 2
    (will be reduced)
  2. mesobilirubin
  3. mesobilirubinogen
  4. urobilinogen
    - stercobilin
    * stercobilin
    * stool (brown color)
    - reabsorbed
    * urobilin
    (excreted)
    *urine
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16
Q

these are intestinal bacteria

A

mesobilirubin
mesobilirubinogen
urobilinogen

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17
Q

a colorless product

A

urobilinogen

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18
Q

stercobilinogen is ____

A

80%

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19
Q

reabsorbed is ____

A

20%

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20
Q

forms of bilirubin

A

bilirubin 1
bilirubin 2

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21
Q

found in the circulation, in the blood

A

bilirubin 1

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22
Q

unconjugated bilirubin
water insoluble
non-polar bilirubin
indirect bilirubin
hemobilirubin
slow reacting
prehepatic bilirubin

A

bilirubin 1

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23
Q

why bilirubin 1 is water insoluble?

A

bc it is non-polar due to the presence of 2 propionic acid

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24
Q

bilirubin 1 is slow reacting, what should be added?

A

accelator/accelerant

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25
forms of bilirubin that is synthesized in the liver
bilirubin 2
26
conjugated bilirubin water soluble polar bilirubin direct bilirubin cholebilirubin one-minute/prompt bilirubin post-hepatic/hepatic/obstructive/regurgitative bilirubin
bilirubin 2
27
specimen used for bilirubin measurement
serum or plasma
28
RV for unconjugated bilirubin
0.2 - 0.8 mg/dL
29
RV for conjugated bilirubin
0.0 - 0.2 mg/dL
30
RV for total bilirubin
0.2 - 1.0 mg/dL
31
normally present in bilirubin
unconjugated bilirubin
32
normal kahit walang conjugated bilirubin sa serum
conjugated bilirubin
33
it is formed due to prolonged elevation of conjugated bilirubin
delta bilirubin
34
comjugated bilirubin tightly bound to albumin and has longer life compared to any other forms of bilirubin
delta bilirubin
35
type of bilirubin that reacts with diazo reagent
delta bilirubin
36
RV for delta bilirubin
<0.2mg/dL
37
formula for delta bilirubin
delta bilirubin = TB - DB + IB
38
surgical removal of gallbladder
cholecystectomy
39
serum must be stored from light immediately bc it can decreased upto ____
30-50%/hr
40
serum sample for bilirubin measurement (room temp)
2 days
41
serum sample for bilirubin measurement (ref)
4C for 1 week
42
serum sample for bilirubin measurement (freezer)
-20C for indefinite
43
(T/F) fasting sample is preferred but not required in bilirubin measurement
true
44
interferences in bilirubin measurement
lipemia hemolysis
45
falsely increases bilirubin concentration
lipemia
46
decrease reaction of bilirubin with diazo reagent (decreased bilirubin)
hemolysis
47
reaction in bilirubin measurement
Van den Berg reaction
48
diazotization of bilirubin to form azobilirubin
Van den Berg reaction
49
only measure conjugated bilirubin and total bilirubin
Van den Berg reaction
50
(T/F) for unconjugated bilirubin, we add accelerants or accelerators bc masyado syang mabagal
true
51
it has direct action with Van den Berg reaction
conjugated bilirubin total bilirubin
52
2 methods in bilirubin measurement
evelyn & malloy method jendrassik & grof method
53
coupling accelerator of evelyn & malloy method
methanol
54
methanol is used to measure ______
bilirubin 1
55
diazo reagents in evelyn & malloy method
diazo A: 0.1% sulfanilic acid, HCl diazo B: 0.5% sodium nitrite diazo Blank: 1.5% HCl
56
Diazo A is _____
0.1% sulfanilic acid, HCl
57
Diazo B is _____
0.5% sodium nitrite
58
Diazo Blank is _____
1.5% HCl
59
final reaction of evelyn & malloy method
pink to purple azobilirubin (measured @ 560 nm)
60
commonly used method bc it is more sensitive than evelyn & malloy
jendrassik-grof method
61
popular technique for discreet analyzers
jendrassik-grof method
62
main reagent in jendrassik-grof method
diazo reagent
63
accelerator in jendrassik-grof method
caffeine sodium benzoate
64
buffer in jendrassik-grof method
sodium acetate
65
terminates the accelerator and destroys excess diazo reagent
ascorbic acid
66
provides alkaline pH after addition of ascorbic acid
alkaline tartrate solution
67
final reaction of jendrassik-grof method
blue azobilirubin (measured @ 600 nm)
68
increased bilirubin can cause ____
jaundice
69
jaundice is the most common cause of ______ or ______
cholelithiasis or gallstones
70
characterized by yellow discoloration of the skin, sclera, and mucus membranes
hyperbilirubinemia
71
RV for overt jaundice
1.0 - 1.5 mg/dL
72
type of jaundice that is not visible to the naked eye
overt jaundice
73
RV for visible jaundice
3.0 - 5.0mg/dL
74
more commonly termed for serum or plasma with yellow discoloration due to hyperbilirubinemia
icterus
75
RV for icterus
>25mg/dL
76
classifications of jaundice and all of these have increased total bilirubin
pre-hepatic jaundice post-hepatic jaundice hepatic jaundice
77
too much RBC destruction elevated indirect bilirubin
pre-hepatic jaundice
78
failure of bile to flow in the intestine (impaired bilirubin excretion) elevated direct bilirubin
post-hepatic jaundice
79
hepatocyte injury caused by viruses, alcohol, and parasites elevated direct and indirect bilirubin
hepatic jaundice

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