urinary bilirubin

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In hemolysis due to inherited disorders, the level of
1)UCB: increase, decrease or normal?
2) conjugated bilirubin: increase, decrease or normal?
3) urinary bilirubin: increase, decrease or normal?

 

[OnePunchBiopsy]

In hemolysis due to inherited disorders, the level of
1)UCB: increase
2) conjugated bilirubin: increase (technically)
3) urinary bilirubin: increase (technically

Here is my reasoning. When your RBC's undergo lysis, they release free hemoglobin. High free Hgd leads to lots of conversion to unconjugated bili. Some of this UCB is picked up by the liver and conjugated, leading to increased CB and urobilinogen.

HOWEVER, the level of UCB will be significantly higher than CB and urobilinogen. This is because UCB is lipid soluble, and therefore less soluble in the blood. Less of it gets to the liver for conjugation, and therefore less CB gets secreted into the GI tract where urobilinogen is made.

 

[Phloston]

In hemolysis due to inherited disorders, the level of
1)UCB: increase, decrease or normal?
2) conjugated bilirubin: increase, decrease or normal?
3) urinary bilirubin: increase, decrease or normal?

In haemolysis, unconjugated is up, conjugated normal, urinary bilirubin normal. Those are the lab values you'd have.

Conjugated in the blood doesn't go up unless there's an intra- or post-hepatic obstruction (e.g., biliary atresia or DJ or Rotor syndromes). Same with urinary bilirubin; it won't go up unless there's more of it in the blood. Now in theory, are there scant increases simply because more unconjugated substrate is present, probably, but the labs wouldn't be abnormal and certainly would not be clinically significant, apart from helping to reaffirm that your path isn't obstructive.

Urinary urobilinogen is increased notably in haemolysis. This reflects greater production of bilirubin, and also signifies that it reaches the intestine without problem.

 

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The answer according to kaplan is

urine urinobilinogen will be increased