- Joined
- Aug 25, 2010
- Messages
- 161
- Reaction score
- 18
Hey guys...
Can you help me with this and see if my thinking is correct? I am trying to understand a table from FA and half makes sense but the other half does not....Thanks in advance!!
Here is how I think. Please correct me if I am wrong.
1) Hepatocellular jaundice ==> the reason it's both direct and indirect billirubin (Br) is because it can either be an uptake problem, conjugation problem or exit problem from the hepatocyte. The reason it can increase urine Br is based on the assumption that the conjugation has occured (that excluded Crig.Naj and Gilbert syndromes) (am I correct?).. BUT, i don't understand WHY urine uroBr is low in this case (is it based on the assumption that some pathology such as Gilbert did not get conjugated??)
2) Obstructive jaundice ==> obstruction post liver and before MRP2 (correct?), therefore, always direct billirubin (BR) is increased. The reason it has increased urine BR is because direct BR is water soluble and it can pee out. The reason it has low urine uroBR is because of the obstruction (correct?) ==> so I should also expect pale poop??? (correct?) because you are not getting uroBR in the gut (so no stercoBr)..
3) Hemolytic jaundice ==> lots of heme should get you lots of unconjugated Br. Conjugation requires the enzyme UDPGT. WHY is Urine Br absent here??? I would think that UDPGT can conjugate the Br. WHY is urine UroBr increased here????
Can you help me with this and see if my thinking is correct? I am trying to understand a table from FA and half makes sense but the other half does not....Thanks in advance!!
Here is how I think. Please correct me if I am wrong.
1) Hepatocellular jaundice ==> the reason it's both direct and indirect billirubin (Br) is because it can either be an uptake problem, conjugation problem or exit problem from the hepatocyte. The reason it can increase urine Br is based on the assumption that the conjugation has occured (that excluded Crig.Naj and Gilbert syndromes) (am I correct?).. BUT, i don't understand WHY urine uroBr is low in this case (is it based on the assumption that some pathology such as Gilbert did not get conjugated??)
2) Obstructive jaundice ==> obstruction post liver and before MRP2 (correct?), therefore, always direct billirubin (BR) is increased. The reason it has increased urine BR is because direct BR is water soluble and it can pee out. The reason it has low urine uroBR is because of the obstruction (correct?) ==> so I should also expect pale poop??? (correct?) because you are not getting uroBR in the gut (so no stercoBr)..
3) Hemolytic jaundice ==> lots of heme should get you lots of unconjugated Br. Conjugation requires the enzyme UDPGT. WHY is Urine Br absent here??? I would think that UDPGT can conjugate the Br. WHY is urine UroBr increased here????