Bilirubin Metabolism in the GI Tract
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Questions and Answers

What is the primary cause of prehepatic hyperbilirubinaemia?

  • Liver cell dysfunction
  • Obstruction of bile ducts
  • Excess production of bilirubin due to hemolysis (correct)
  • Ineffective erythropoiesis
  • Which type of hyperbilirubinaemia is associated with jaundice becoming clinically apparent when the total serum [bilirubin] exceeds about 50 μmol/L?

  • All types of hyperbilirubinaemia (correct)
  • Hepatic hyperbilirubinaemia
  • Prehepatic hyperbilirubinaemia
  • Posthepatic hyperbilirubinaemia
  • Which laboratory finding is characteristic of prehepatic hyperbilirubinaemia?

  • Increased conjugated (direct) bilirubin in the blood
  • Increased urobilinogen in the urine (correct)
  • Increased alkaline phosphatase in the blood
  • Decreased urobilinogen in the urine
  • Which type of hyperbilirubinaemia is caused by obstruction of bile ducts?

    <p>Posthepatic hyperbilirubinaemia</p> Signup and view all the answers

    Which type of hyperbilirubinaemia is associated with liver cell dysfunction?

    <p>Hepatic hyperbilirubinaemia</p> Signup and view all the answers

    What is the main cause of prehepatic hyperbilirubinaemia in newborns?

    <p>Hemolytic disease of the newborn</p> Signup and view all the answers

    What is the rate-limiting step in bilirubin metabolism?

    <p>Secretion into the small intestine</p> Signup and view all the answers

    What gives faeces its brown color?

    <p>Stercobilinogen</p> Signup and view all the answers

    Which compound is reabsorbed by the intestines and reaches the liver through portal blood supply?

    <p>Urobilinogen</p> Signup and view all the answers

    What is the final product of urobilinogen after oxidation in the large intestine?

    <p>Urobilin</p> Signup and view all the answers

    In cases of severe intrahepatic cholestasis or complete bile duct obstruction, what is absent in urine and stool respectively?

    <p>Urobilin/urobilinogen</p> Signup and view all the answers

    What gives urine its yellow/straw color?

    <p>Urobilin</p> Signup and view all the answers

    What is the most common cause of posthepatic hyperbilirubinaemia?

    <p>Gallstones in the common bile duct</p> Signup and view all the answers

    Which of the following is a characteristic laboratory finding of posthepatic hyperbilirubinaemia?

    <p>Pale stool color</p> Signup and view all the answers

    Which of the following is the most specific liver enzyme for hepatocellular injury?

    <p>Alanine aminotransferase (ALT)</p> Signup and view all the answers

    Which of the following is a true liver function test?

    <p>Prothrombin time</p> Signup and view all the answers

    Which of the following is a characteristic laboratory finding of posthepatic hyperbilirubinaemia?

    <p>Increased conjugated bilirubin in the serum</p> Signup and view all the answers

    Which of the following is a characteristic of intrahepatic hyperbilirubinaemia?

    <p>Occurs in acute hepatocellular cholestasis</p> Signup and view all the answers

    Which enzyme is a sensitive indicator of liver disease and is primarily used for the diagnosis of hepatobiliary diseases?

    <p>GGT</p> Signup and view all the answers

    In biliary obstruction, which enzyme's plasma activity may increase before that of alkaline phosphatase?

    <p>GGT</p> Signup and view all the answers

    Which enzyme's synthesis is induced by ethanol and anticonvulsant drugs, and is mainly found in the kidney and significant amounts in liver, brain, prostate, and pancreas?

    <p>GGT</p> Signup and view all the answers

    Which condition reflects mild cholestasis due to the obstruction of bile canaliculi by swollen hepatocytes & inflammation/necrosis of the ductular lining cells?

    <p>Paget’s disease</p> Signup and view all the answers

    In alcoholic liver disease, which enzyme's serum level shows marked elevation?

    <p>GGT</p> Signup and view all the answers

    Which enzyme is more specific to the liver and a more sensitive marker for cholestatic damage compared to alkaline phosphatase?

    <p>GGT</p> Signup and view all the answers

    Which enzyme activity may exceed that of ALT as more cells are destroyed in Chronic Active Hepatitis?

    <p>AST</p> Signup and view all the answers

    What is the primary cause of Primary Biliary Cirrhosis?

    <p>Autoimmune response</p> Signup and view all the answers

    What condition occurs in Primary Biliary Cirrhosis due to the slow, progressive destruction of small bile ducts?

    <p>Cholestasis</p> Signup and view all the answers

    Which liver enzymes are typically elevated in early stages of Primary Biliary Cirrhosis?

    <p>GGT and ALP</p> Signup and view all the answers

    What is the consequence of further slow damage to liver tissue in Primary Biliary Cirrhosis besides cholestasis?

    <p>Fibrosis</p> Signup and view all the answers

    Which of the following is a characteristic of Chronic Active Hepatitis regarding albumin levels?

    <p>Decreased albumin levels</p> Signup and view all the answers

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