Bilirubin Metabolism-12 PDF
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University of Sulaimani
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Summary
This document explains the different types of jaundice, including haemolytic, hepato-cellular, and obstructive jaundice. It details the causes and associated tests in each case.
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haemolyticjaundice jaundice Pre-hepatic Due to increase in RBCs breakdown Causes The rate of RBCs lysis and bilirubin production more than ability of liver to convert it to the conjugated form Occur in: Hemolytic anemia ( Thalassemia) hepato-cellular jaundice Post-hepatic obstructivejaundice...
haemolyticjaundice jaundice Pre-hepatic Due to increase in RBCs breakdown Causes The rate of RBCs lysis and bilirubin production more than ability of liver to convert it to the conjugated form Occur in: Hemolytic anemia ( Thalassemia) hepato-cellular jaundice Post-hepatic obstructivejaundice jaundice Hepatic jaundice Due to obstruction of bile duct which prevents passage of bilirubin into intestine. Blilirubin that is conjugated is not efficiently secreted into bile but leaks to blood (D.Bil. ) D.Bil will back to liver and then to circulation elevating its level in blood and urine. Occur in : Occur in: Due to liver cell damage Conjugation of bilirubin decreased (ID.Bil. ). Hepatitis (viral ,drug, alcoholic autoimmune, steatohepatits) Cirrhosis. Biliary stricture Cancer of the head of pancreas or gallbladder Bileduct stones Transfusion reaction Gilbert's disease Type of Bil. Conformational test ID.Bil > D.Bil reticulocyte, K+ ( High) CBC (low Hb), Haptoglobin (Low) D.Bil, ID.Bil, T.Bil all (High) D.Bil (High) ALT, AST (High) ALP, GGT ( High)