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Bilirubin Metabolism - Pathophysiology • Conjugated Bilirubin • Unconjugated Bilirubin By Dr. Khushboo Gala @LouLectures #Bilirubin #Metabolism #Pathophysiology
Bilirubin Metabolism ... • Conjugated Bilirubin ... • Unconjugated Bilirubin ... LouLectures #Bilirubin ... Pathophysiology #hepatology #Liver
Liver Chemistry Tests - AST, ALT, Alkaline Phosphatase and Bilirubin Metabolism AST and ALT: • AST: liver
Liver Chemistry ... Phosphatase and Bilirubin ... initial insult Bilirubin ... transports conjugated bilirubin ... ASTALT #AlkPhos #Bilirubin
Liver Function Tests (LFTs) - Normal Values and Interpretation Alanine aminotransferase (ALT/SGPT) - Liver, cardiac & skeletal
Liver Function Tests ... nucleotidase - Liver ... in bone Total bilirubin ... TBili) Direct bilirubin ... Indirect bilirubin
Liver Function Tests (LFTs) - Aspartate aminotransferase (AST) - Alanine aminotransferase (ALT) - Alkaline
Liver Function Tests ... transpeptidase (GGT) - Bilirubin ... Prothrombin #Liver
Liver Disease in Pregnancy Intrahepatic Cholestasis of Pregnancy (ICP) • Onset/Trimester: 25-32 weeks • Typical clinical features:
Liver Disease in ... fold elevation, Bilirubin ... Hemolysis, Elevated Liver ... fold elevation, Bilirubin ... but variable ++, Bilirubin
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Liver Chemistries ... Identify Acute Liver ... hepatocellular injury • Bilirubin ... week • Direct bilirubin ... Elevation: • Bilirubin
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Acute Liver Injury ... Causes of Acute Liver ... hepatocellular injury • Bilirubin ... week • Direct bilirubin ... Elevation: • Bilirubin
Inherited Non-hemolytic Disorders of Hyperbilirubinemia == Disorders of Conjugation == Gilbert Syndrome: • 5-10% of the population
of hemolysis or liver ... birth with serum bilirubin ... associated with bilirubin ... in conjugated bilirubin ... in conjugated bilirubin
Commonly Observed Laboratory Findings in Hepatic / Liver Failure - Elevated conjugated and unconjugated bilirubin -
Findings in Hepatic / Liver ... and unconjugated bilirubin ... and excretion of bilirubin ... fold with acute liver ... has exhausted liver
ERCP Management Algorithm for Patient with Symptomatic Choledocholithiasis Predictors of choledocholithiasis Very strong - CBD stone on
cholangitis - Blirubin ... galbladder in situ) - Bilirubin ... Moderate - Abnormal liver ... test other than bilirubin
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