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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
Biochemistry and Metabolism of Bilirubin
Hemolysis → Hemoglobin → Heme → Biliverdin → Unconjugated Bilirubin (a.k.a. "indirect
Metabolism of Bilirubin ... → Unconjugated Bilirubin ... "indirect bilirubin ... and "indirect" bilirubin ... pathophysiology #hepatology
Bilirubin metabolism and pathophysiology of jaundice 

#Bilirubin #metabolism #pathophysiology #jaundice #hepatology
Bilirubin metabolism ... of jaundice #Bilirubin ... pathophysiology #jaundice #hepatology
Liver Chemistry Tests - AST, ALT, Alkaline Phosphatase and Bilirubin Metabolism
AST and ALT:
 • AST: liver
Phosphatase and Bilirubin ... initial insult Bilirubin ... transports conjugated bilirubin ... ASTALT #AlkPhos #Bilirubin ... #Hepatology #Pathophysiology
Inherited Non-hemolytic Disorders of Hyperbilirubinemia 

== Disorders of Conjugation ==
Gilbert Syndrome:
 • 5-10% of the population
birth with serum bilirubin ... associated with bilirubin ... in conjugated bilirubin ... in conjugated bilirubin ... #hepatology #diagnosis
Approach to Conjugated Hyperbilirubinemia - Differential Diagnosis Algorithm

1. Definition: T.bili elevation + >20% conjugated
2. Obtain RUQ
Hyperbilirubinemia #direct #bilirubin ... gastroenterology #hepatology
Liver Function Tests (LFTs) - Normal Values and Interpretation

Alanine aminotransferase (ALT/SGPT) - Liver, cardiac & skeletal
in bone Total bilirubin ... TBili) Direct bilirubin ... Indirect bilirubin ... Interpretation #diagnosis #hepatology
Liver Disease in Pregnancy
Intrahepatic Cholestasis of Pregnancy (ICP)
 • Onset/Trimester: 25-32 weeks
 • Typical clinical features:
fold elevation, Bilirubin ... fold elevation, Bilirubin ... but variable ++, Bilirubin ... Disease #Pregnancy #hepatology
Commonly Observed Laboratory Findings in Hepatic / Liver Failure
 - Elevated conjugated and unconjugated bilirubin -
and unconjugated bilirubin ... and excretion of bilirubin ... LiverFailure #Hepatic #Hepatology
Inherited forms of Hyperbilirubinemia
Major pathways involved in bilirubin production, conjugation, and excretion. Notes: Both the UB
pathways involved in bilirubin ... transporting unconjugated bilirubin ... pathophysiology #congenital #hepatology