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Bilirubin Metabolism - Pathophysiology • Conjugated Bilirubin • Unconjugated Bilirubin By Dr. Khushboo Gala @LouLectures #Bilirubin #Metabolism #Pathophysiology
Pathophysiology • Conjugated ... Bilirubin • Unconjugated ... Pathophysiology #hepatology #Liver
Liver Function Tests (LFTs) - Aspartate aminotransferase (AST) - Alanine aminotransferase (ALT) - Alkaline
Liver Function Tests ... Bilirubin - Unconjugated ... Indirect) - Conjugated ... Prothrombin #Liver
Liver Function Tests (LFTs) - Normal Values and Interpretation Alanine aminotransferase (ALT/SGPT) - Liver, cardiac & skeletal
Liver Function Tests ... phosphatase (AlkP) - Liver ... nucleotidase - Liver ... Direct bilirubin (Conjugated ... Indirect bilirubin (Unconjugated
Liver Chemistry Tests - AST, ALT, Alkaline Phosphatase and Bilirubin Metabolism AST and ALT: • AST: liver
Liver Chemistry ... ALT: • AST: liver ... In liver, 80% of ... cytochromes) • Unconjugated ... MRP2 transports conjugated
Commonly Observed Laboratory Findings in Hepatic / Liver Failure - Elevated conjugated and unconjugated bilirubin -
Findings in Hepatic / Liver ... Failure - Elevated conjugated ... and unconjugated ... fold with acute liver ... has exhausted liver
Inherited Non-hemolytic Disorders of Hyperbilirubinemia == Disorders of Conjugation == Gilbert Syndrome: • 5-10% of the population
, intermittent unconjugated ... of hemolysis or liver ... UGT1A1 activity • Unconjugated ... an increase in conjugated ... and unconjugated
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Liver Chemistries ... Identify Acute Liver ... - Specific to liver ... - Assists in liver ... blood cells Unconjugated
Hemolysis - Differential Diagnosis Framework 1) Environment - Fragmentation - MAHA: TTP, HUS, DIC, HELLP
Defects, Drugs, Liver ... Reticulocyte Count ↑ - Unconjugated
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Acute Liver Injury ... Causes of Acute Liver ... artery: Shock liver ... Trauma: Shock liver ... injury: ~ 1 Unconjugated
Bile acids are the end products of cholesterol catabolism. Cholic acid and chenodeoxycholic acid are the
synthesized in human livers ... and are conjugated ... Human liver synthesizes ... small amounts of unconjugated ... circulation to liver
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