Podcast
Questions and Answers
What is the formula for calculating total bilirubin?
What is the formula for calculating total bilirubin?
- A Sample x 11.0
- A Sample x 10.8 (correct)
- A Sample x 10.5
- A Sample x 11.5
What is the normal range of total bilirubin in serum?
What is the normal range of total bilirubin in serum?
- Up to 1.0 mg/dL (correct)
- Up to 2.0 mg/dL
- Up to 0.5 mg/dL
- Up to 1.5 mg/dL
What type of jaundice is caused by liver cell damage?
What type of jaundice is caused by liver cell damage?
- Pre-hepatic jaundice
- Hepato-cellular jaundice (correct)
- Obstructive jaundice
- Haemolytic jaundice
What happens to conjugated bilirubin in obstructive jaundice?
What happens to conjugated bilirubin in obstructive jaundice?
What is the main characteristic of haemolytic jaundice?
What is the main characteristic of haemolytic jaundice?
What is the effect of liver cell damage on bilirubin conjugation?
What is the effect of liver cell damage on bilirubin conjugation?
What is the most common type of jaundice?
What is the most common type of jaundice?
What is the cause of increased conjugated bilirubin?
What is the cause of increased conjugated bilirubin?
What is the treatment for newborn jaundice?
What is the treatment for newborn jaundice?
What happens to bilirubin when exposed to direct sunlight?
What happens to bilirubin when exposed to direct sunlight?
At what temperature is serum or plasma stable for 3 months if frozen immediately?
At what temperature is serum or plasma stable for 3 months if frozen immediately?
What is the effect of very high bilirubin levels?
What is the effect of very high bilirubin levels?
What type of jaundice is common in newborns aged 1-3 days?
What type of jaundice is common in newborns aged 1-3 days?
What is the purpose of protecting bilirubin specimens from ambient light?
What is the purpose of protecting bilirubin specimens from ambient light?
Which of the following is NOT a source of heme in the body?
Which of the following is NOT a source of heme in the body?
What is the primary function of bile?
What is the primary function of bile?
Which type of bilirubin is water-soluble and can be found in urine?
Which type of bilirubin is water-soluble and can be found in urine?
What is the relationship between total bilirubin, conjugated bilirubin, and unconjugated bilirubin?
What is the relationship between total bilirubin, conjugated bilirubin, and unconjugated bilirubin?
Which of the following is NOT a symptom of jaundice?
Which of the following is NOT a symptom of jaundice?
What does the term 'LFT' stand for?
What does the term 'LFT' stand for?
Which of the following enzymes is NOT typically included in a Liver Function Test (LFT) profile?
Which of the following enzymes is NOT typically included in a Liver Function Test (LFT) profile?
What is the main purpose of measuring bilirubin levels in a blood test?
What is the main purpose of measuring bilirubin levels in a blood test?
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Study Notes
Liver Function Test (LFT) Profile
- Integrity of liver cells, excretory function, and synthetic function are measured in LFT profile
- Clinical lab tests include:
- Liver enzymes (AST, ALT, GGT, ALP)
- Proteins (TP, Alb, A/G ratio)
- Bilirubin
Bilirubin
- Bilirubin is the water-insoluble breakdown product of normal heme catabolism
- It's a yellow pigment present in bile, urine, and feces
- Heme is found in hemoglobin (80%) and other hemo-proteins (20%)
- There are two types of bilirubin:
- Direct bilirubin (conjugated, water-soluble)
- Indirect bilirubin (unconjugated, water-insoluble)
- Total bilirubin = Direct + Indirect bilirubin
Jaundice
- Jaundice is a medical term that describes the elevation of bilirubin in blood, resulting in yellow color of skin and sclera
- Symptoms include nausea, vomiting, dark-colored urine, and fatigue
- Types of Jaundice:
- Pre-hepatic jaundice
- Hepatic jaundice
- Post-hepatic jaundice (most common type)
Clinical Significance
- Increased Conjugated Bilirubin indicates:
- Biliary obstruction
- Cancer of the head of the pancreas
- Increased Unconjugated Bilirubin indicates:
- Autoimmune hemolysis
- Crigler-Najjer syndrome
- Gilbert's syndrome
- Hemolytic transfusion reaction
- Hepatitis
Newborn Jaundice
- High bilirubin levels are common in newborns (1-3 days)
- Factors affecting bilirubin levels in newborns:
- Rate of bilirubin level increase
- Premature birth
- Age of the baby
- Treatment: phototherapy to break down bilirubin (ID → D) and convert it to the photoisomer form
Bilirubin Toxicity
- Very high bilirubin levels are dangerous and toxic, causing:
- Brain damage
- Effects on muscles, eyes, and leading to death
Specimen and Storage
- Fasting for at least 4 hours before the test is recommended
- Bilirubin is sensitive to light and heat, so specimens should be protected from ambient light
- Storage conditions:
- 1 day at 15-25°C
- 7 days at 2-8°C
- 3 months at -20°C (if frozen immediately)
Procedure for Total Bilirubin
- Calculation: Total bilirubin (mg/dL) = A Sample x 10.8
- Serum bilirubin levels:
- Normal: up to 1.0 mg/dL
- Unconjugated (indirect): 0.2-0.7 mg/dL
- Conjugated (direct): 0.25 mg/dL
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