Billirubin Question and answer

Questions

 * 1) Which form of bilirubin causes a toxic effect on the basal ganglia ?
 * 2) * A - conjugated bilirubin
 * 3) * B - unconjugated bilirubin bound to albumin by van der Waals forces
 * 4) * C - bilirubin bound to albumin covalently
 * 5) * D - bilirubin "free" (not bound to albumin)
 * 6) Ligandin is a small protein that allows:
 * 7) * A - binding of bilirubin to glucuronic acid to form mono- and diglucuronide
 * 8) * B - transfer of bilirubin within the hepatocyte into the smooth plasma reticulum
 * 9) * C - transfer of conjugated bilirubin via the "bile pole" to the primary bile capillaries
 * 10) * D - covalent bonding of bilirubin with albumin

Patient with jaundice
A 42-year-old patient with severe jaundice, right upper abdominal quadrant pain, pale, with fever and chills.

Laboratory results:


 * ALP = 8.4 μkat / l
 * cholesterol = 7.9 mmol / l (5-nucleotidase - increased value)
 * AST = 0.64 μkat / l
 * total bilirubin = 421 μmol / l
 * prothrombin time: prolonged, adjusted after vitamin K injection

Questions:


 * 1) What is the most likely cause of jaundice in a patient?
 * 2) Why is prothrombin time prolonged?

Patient with nausea and jaundice
Patient admitted with less recent weight loss, nausea, vomiting , who later developed jaundice and enlarged liver.

Laboratory results:


 * total bilirubin = 342 μmol / l
 * conjugated bilirubin = 171 μmol / l
 * ALP = 2.2 μcat / l
 * AST = 12.4 μkat / l
 * ALT = 11.2 μkat / l
 * albumin = 22 g / l
 * γ-globulins = 23.8 g / l (34% of total protein)

Questions:


 * 1) What is the cause of the patient's illness, which examinations supplement?

Links
https://www.wikiskripta.eu/index.php?curid=34699

Related Articles

 * Jaundice
 * Hepatitis
 * Differential diagnosis of jaundice

Source

 * MASOPUST, Jaroslav and Richard PRŮŠA. Pathobiochemistry of metabolic pathways. 1st edition. Prague: Charles University, 1999. 182 pp. 125–126.  ISBN 80-238-4589-6.