L11- jaundice

Question 1

what is jaundice

Answer 1

yellow discolouration fo the skin, eye and tissues

due to a buildup of bilirubin in the tissue and blood stream

Question 2

what molecules are increased when a liver disease is present

Answer 2

• AST/ALT - shows dysfunction of hepatocytes

- AP/gGT -shows dysfunction of biliary cells due to biliary disease

Question 3

what is albumin

Answer 3

• protein made in the liver
• keeps the fluid in the bloodstream so it doesn’t leak into other tissues
• carries substances like hormones, Vits, enzymes

Question 4

what is bilirubin

Answer 4

yellow compound formed from haem catabolism

-clears out waste products from destruction of aged or abnormal RBCs

Question 5

ways of diagnosing

Answer 5

• looking at levels of bilirubin, liver enzymes, albumin, total protein
• ABs, viral markers

Question 6

pathway of bilirubin from production of it to being collected into bile

Answer 6

1. bilirubin made and reduced in the macrophage
2. conjugates with albumin and gets transported into the cell
3. conjugates with glucuronic acid to become water soluble
4. collected into bile in the biliary system

Question 7

how does the conversion of heme into bilirubin take place inside the marcophage

Answer 7

• heme converted into biliverdin by heme oxgyenase

- biliverdin reduced into bilirubin by biliverdin reductase

Question 8

what is prehepatic jaundice

Answer 8

• where the bilirubin is unconjugated before entering the liver
• so this molecule accumulates in the blood
• normal levels of AST/ALT and ALP/gGT

Question 9

diseases associated with prehepatic jaundice

Answer 9

-gilberts syndrome where there’s a mutation in the enzyme that helps the conjugation between bilirubin and glucoronic acid

Question 10

what is hepatic jaundice

Answer 10

• causes by damage to the liver like interruption of bile flow
• causes unconjugated and conjugated bilirubin to accumalate in the blood
• due to failure of mechanisms of excretion of conjugated bilirubin

Question 11

disease associated with hepatic jaundice

Answer 11

• viral hepatitis (virus kills the liver cells so the bilirubin leak into the blood rather than into bile duct
• acute or chronic hepatitis

Question 12

are the levels of AST/ALT and ALP/gGT increased and by how much in hepatic jaundice

Answer 12

• raised AST/ALT by 2x to 20x

- mild increase of ALP/gGT

Question 13

what is post hepatic jaundice

Answer 13

caused by obstruction of bile ducts due to gallstones, disease of ducts, compression of ducts

Question 14

how are gallstones cuased

Answer 14

-by imbalance in chemical constituents of bile

Question 15

are the levels of AST/ALT and ALP/gGT increased and by how much in post hepatic jaundice

Answer 15

by 5x in ASL/ALT

->3x in ALP/gGT