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275 BCH Miss Tahani Al-Shehri

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Presentation on theme: "275 BCH Miss Tahani Al-Shehri"— Presentation transcript:

1 275 BCH Miss Tahani Al-Shehri
Bilirubin & Jaundice 275 BCH Miss Tahani Al-Shehri

2 Objective The aim of the experiment is to determine : Total bilirubin
Direct bilirubin Indirect bilirubin , Contents of human serum .

3 Introduction The liver responsible for many important metabolic functions > 100 lab tests associated with liver function Major hepatic functions Protein synthesis Regulation of carbohydrate metabolism Regulation of lipoproteins Detoxification of drugs and chemicals Excretion of bile Formation of bilirubin

4 Introduction Alkaline phosphatase SGOT ( AST) SGPT ( ALT)
These enzymes are released from dameged liver cells

5 Extravascular Pathway for RBC Destruction
(Liver, Bone marrow, & Spleen) Phagocytosis & Lysis Hemoglobin Globin Heme Bilirubin Amino acids Fe2+ Amino acid pool Recycled Excreted

Bilirubin is the main pigment derived from heme catabolism 75% is derived from RBCs In normal adults this results in a daily load of 200 mg of bilirubin Normal plasma concentrations are less then 1 mg/dL Hydrophobic – transported by albumin to the liver for further metabolism prior to its excretion P450 cytochrome “unconjugated” bilirubin

7 Unconjugated bilirubin Reticuloendothelial system
Heme Biliverdin Unconjugated bilirubin Reticuloendothelial system Unconj.bilirubin/albumin complex Systemic circulation Hepatocytes Unconj. bilirubin Bilirubin diglucuronide Small intestine Large intestine Bilirubin Urobilinogen Stercobilins Kidney urine

8 HYPERBILIRUBINEMIA -- elevated bilirubin in serum (above 3mg/dL) occur when there is imbalance between production and excretion -- can be conjugated or unconjugated or both depending on the situation -- elevated bilirubin can diffuse into tissues, making them appear yellow (jaundice)

9 Clinical Consequences:
HYPERBILIRUBINEMIA Clinical Consequences: -- Conjugated hyperbilirubinemia: benign -- Unconjugated hyperbilirubinemia: benign at concentrations < 25 mg/dL (albumin capacity) -- At concentrations >25 mg/dL, unconjugated bilirubin is free (uncomplexed) and can enter the brain. bilirubin encephalopathy (kernicterus)

10 Causes of JAUNDICE ( per-hepatic_ the pathology is occurring prior to the liver ) Ex. Hemolytic anemia --  destruction of erythrocytes ( hepatic _ the pathologyis located within the liver ) a)Hepatitis b) cirrhosis --  conjugation and excretion of bilirubin c) Neonatal “physiological jaundice” -- immature hepatic system of the newborn:  uptake, conjugation, excretion of bilirubin 3) ( post-hepatic _ _ the pathology is occurring poster to the liver ) Bile duct obstruction -- conjugated bilirubin not delivered to intestine; it backs up, spills over into the blood

11 principle Direct bilirubin water soluble Bilirubin + Diazo reagent
Red –blue color * Only direct bilirubin react .

12 principle Direct bilirubin water soluble
Bilirubin + Diazo reagent + caffeine Red –blue color Direct + indirect bilirubin react .

13 Total bilirubin = Conjugated + Un conjugated Bilirubin.

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