31 results
Bilirubin Metabolism - Pathophysiology
 • Conjugated Bilirubin
 • Unconjugated Bilirubin

By Dr. Khushboo Gala @LouLectures

#Bilirubin #Metabolism #Pathophysiology
- Pathophysiology ... • Conjugated ... BilirubinUnconjugated ... #Metabolism #Pathophysiology ... #hepatology #Liver
Classification of Jaundice
Unconjugated hyperbilirubinemia (predominantly indirect bilirubin)
 • Increased bilirubin production (eg, hemolytic anemias, hemolytic reactions,
Classification of Jaundice ... drug reactions) Conjugated ... conjugates (eg, ... postoperative jaundice ... neoplasms #Jaundice
Biochemistry and Metabolism of Bilirubin
Hemolysis → Hemoglobin → Heme → Biliverdin → Unconjugated Bilirubin (a.k.a. "indirect
→ Biliverdin → Unconjugated ... Conjugation → Conjugated ... common bile duct Unconjugated ... , and conjugated ... Biochemistry #Metabolism #pathophysiology
Liver Function Tests (LFTs)
 - Aspartate aminotransferase (AST) 
 - Alanine aminotransferase (ALT) 
 - Alkaline
Liver Function Tests ... transpeptidase (GGT) - Bilirubin ... - Unconjugated ... Indirect) - Conjugated ... Prothrombin #Liver
Inherited Non-hemolytic Disorders of Hyperbilirubinemia 

== Disorders of Conjugation ==
Gilbert Syndrome:
 • 5-10% of the population
of hemolysis or liver ... breastfeeding jaundice ... and breastmilk jaundice ... manifest only as jaundice ... an increase in conjugated
Liver Function Tests (LFTs) - Normal Values and Interpretation

Alanine aminotransferase (ALT/SGPT) - Liver, cardiac & skeletal
, biliary epithelium ... (Conjugated/DBili ... ) - Biliary obstruction ... Indirect bilirubin ... (Unconjugated)
Jaundice - Differential Diagnosis Algorithm
Pre-Hepatic - Unconjugated Hyperbilirubinemia
Increased Production
 • Hemolysis
 • Ineffective Erythropoiesis
 • Hematoma
Decreased
Jaundice - Differential ... II) Hepatic - Conjugated ... on Ultrasound Biliary ... Gallstones • Biliary ... Cholangitis #Jaundice
Liver Chemistry Tests - AST, ALT, Alkaline Phosphatase and Bilirubin Metabolism
AST and ALT:
 • AST: liver
Phosphatase and Bilirubin ... cytochromes) • Unconjugated ... MRP2 transports conjugated ... bilirubin into ... #Hepatology #Pathophysiology
Jaundice - Pathophysiology and Causes

- Amy Chung, MD, MSc @AmyChung 

#Jaundice #Pathophysiology #Differential #Unconjugated #Causes #Diagnosis
Jaundice - Pathophysiology ... @AmyChung #Jaundice ... #Pathophysiology ... #Differential #Unconjugated
Approach to Conjugated Hyperbilirubinemia - Differential Diagnosis Algorithm

1. Definition: T.bili elevation + >20% conjugated
2. Obtain RUQ
Approach to Conjugated ... elevation + >20% conjugated ... MRCP, ERCP, liver ... MatthewHoMD #Conjugated ... Hyperbilirubinemia #direct #bilirubin