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Questions on Jaundice Lab values

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Transformers

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Well...so Im a bit confused about urine bilirubin and urine urobilinogen in the context of obstructive jaundice...Pathoma says you would see INCREASED levels of BOTH conjugated bilirubin (CB) and urobilinogen in the URINE....the CB in the urine part made sense since if a tube is blocked to entry into the GI lumen, backpressure will force the CB into the blood and since CB is water-soluble it will enter the urine.

That part i DONT get is why urine urobilinogen is increased in the urine. After all, it is the intestinal bacteria that convert CB-->urobilinogen, which then eventually gets reuptaken into the portal circulation back to the liver with some entering the systemic blood to be eventually filtered by the kidneys and into the urine....HOWEVER, if you have obstructive jaundice, the CB can't enter the GI lumen and be converted to urobilinogen in the first place so why does Pathoma say the levels of urine urobilinogen are increased?
 

g8orlife

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Well...so Im a bit confused about urine bilirubin and urine urobilinogen in the context of obstructive jaundice...Pathoma says you would see INCREASED levels of BOTH conjugated bilirubin (CB) and urobilinogen in the URINE....the CB in the urine part made sense since if a tube is blocked to entry into the GI lumen, backpressure will force the CB into the blood and since CB is water-soluble it will enter the urine.

That part i DONT get is why urine urobilinogen is increased in the urine. After all, it is the intestinal bacteria that convert CB-->urobilinogen, which then eventually gets reuptaken into the portal circulation back to the liver with some entering the systemic blood to be eventually filtered by the kidneys and into the urine....HOWEVER, if you have obstructive jaundice, the CB can't enter the GI lumen and be converted to urobilinogen in the first place so why does Pathoma say the levels of urine urobilinogen are increased?

The table on p.119 says that it's decreased in obstuctive.
Either you misheard Dr. Sattar or he misspoke.
 

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