Clinical Conundrum Flashcards

(30 cards)

0
Q

where do RBC’s get broken down?

A

spleen, liver, bone marrow

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1
Q

when RBC’s are broken down, the heme is acted upon by _____ which converts it to ___

A

heme oxygenase, Fe CO and Biliverdin

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2
Q

bilirubin is created by the enzyme _____

A

biliverdin reductase

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3
Q

how does bilirubin get transported through the blood?

A

by linking on to albumin

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4
Q

in the liver, the enzyme ___ conjugates bilirubin making it ___

A

UDP glucuronosyl-transferase (UGT), hydrophilic

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5
Q

enterohepatic circulation

A

the secretion and reuptake of bile

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6
Q

unconjugated bilirubin is called:

A

indirect bilirubin

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7
Q

conjugated bilirubin is called:

A

direct bilirubin

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8
Q

someone with O blood type has anti ____ antibodies

A

A and B

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9
Q

someone with an A blood type has anti ___ antibodies

A

B

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10
Q

a thick meconium is associated with ___

A

cystic fibrosis

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11
Q

in physiologic jaundice, what kind of bilirubin builds up in the baby?

A

unconjugated

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12
Q

why does breast-feeding cause jaundice?

A
  1. it has beta-glucoronidase, an inhibitor of glucoronidase 2. it increases the reuptake of unconjugated bilirubin
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13
Q

other causes of jaundice in infants:

A

ABO incompatibility hypothyroidism-UGT needs thyroid hormone

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14
Q

Crigler-Najjar syndrome type I

A

have no UGT

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15
Q

Crigler-Najjar syndrome type II

A

have reduced amount of UGT

16
Q

Gilbert’s syndrome

A

reduced activity of UGT

17
Q

Dubin-Johnson

A

impaired canalicular export of conjugated bilirubin

18
Q

Rotor syndrome

A

impaired canalicular export of conjugated bilirubin

19
Q

what’s the problem with jaundice? (also disease name)

A

neurological defects (Kernicterus)

20
Q

if they have normal colored urine, the bilirubin is _____

21
Q

what is the main purpose of phototherapy?

A

convert the bilirubin to hydrophilic bilirubin so that the baby can pee it out

22
Q

scleral icterus

A

yellowing of the sclera due to jaundice

23
Q

at what level of bilirubin do people tend to look jaundiced?

24
a high alkaline phosphatase level is associated with \_\_\_
a biliary problem
25
prothrombin time is a measure of \_\_\_\_
clotting, and therefore function of the liver (liver makes clotting factors)
26
if conjugated is \> 1/3 of total, we have a \_\_\_\_\_
conjugated hyperbilirubinemia
27
endoscopic retrograde cholangiopancreatography (ERCP)
put a catheter into the mouth and put in contrast to look back up to the biliary tree
28
HIDA
tag the bilirubin
29
Kasai procedure
carve out the biliary tree and connect a piece of the small intestine to it