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• About : Foundation Year 1 Doctor
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• Country : United Kingdom

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The Biochemistry of Jaundice

Apr 05, 2019

550 likes | 2.3k Views

The Biochemistry of Jaundice. A collaborative effort of Group 3 Section 1C2 Members: Animations by: Gerald Fuentes. Formation of Bilirubin. Bilirubin Metabolism. Heme = planar; Others = not anymore. Heme Oxygenase. Bilirubin Diglucoronide. Heme. Urobilinogen. Stercobilin. Urobilin.

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• increased unconjugated
• clinical conditions
• blood liver ligandin prevents
• hyperbilibirunemia
• impaired bile flow

Presentation Transcript

The Biochemistry of Jaundice • A collaborative effort of Group 3 Section 1C2 • Members: • Animations by: Gerald Fuentes

Formation of Bilirubin

Bilirubin Metabolism Heme = planar; Others = not anymore Heme Oxygenase Bilirubin Diglucoronide Heme Urobilinogen Stercobilin Urobilin Biliverdin Bilirubin

Circulation Red Blood Cells

120 days Circulation

Hemoglobin globin globin globin globin heme heme heme heme

I IV II Fe2+ III Heme Oxygenase C NADP H O O O O 2 2

IV III II I Biliverdin

H Bilirubin NADP H

Processing of Bilirubin

Excretion of Bilirubin

3 Steps of Biliverdin Metabolism • Hepatic Uptake • Conjugation • Excretion • Unconjugated bilirubin is presented in the liver cell • The albumin associated with it is dissociated • Ligandin is delivered to prevent efflux of bilirubin back to plasma

3 Steps of Biliverdin Metabolism • Hepatic Uptake • Conjugation • Excretion • Unconjugated bilirubin is presented in the liver cell • The albumin associated with it is dissociated • Ligandin is delivered to prevent efflux of bilirubin back to plasma • Unconjugated bilirubin (water insoluble) is converted to bilirubin diglucoronide (water soluble) • Takes place in the smooth endoplasmic reticulum of the liver • Catalyzed by glucoronyl transferase • Bilirubin which is now water soluble can now be excreted from the liver cell to the biliary system.

COOH COOH Methyl Propionate Propionate Vinyl Methyl Vinyl Conjugation with Glucoronates Glucoronyl transferase BILIRUBIN DIGLUCORONIDE

Albumin Bilirubin Role of Blood Proteins in the Metabolism of Bilirubin Sparingly soluble in Blood 1. Albumin Dissolved in Blood

Albumin Albumin Bilirubin Bilirubin Ligandin (-) charge Ligandin (-) charge Blood Liver Ligandin Prevents bilirubin from going back to plasma

Different Causes of Jaundice • Excessive Production of Bilirubin • Reduced Hepatocyte Uptake • Impaired Bilirubin conjugation • Impaired Bile Flow

Diagnosis of Jaundice • Urine Examination • Qualitative measurement of bilirubin • Either Ictotest or Dipstick method • Foam Test method • Normal Urine – foam is absolutely white • Hyperbilibirunemia – foam is yellow

Diagnosis of Jaundice • Stool Examination • Special Blood Test • Radiological

Classification of Hyperbilirubinemia • Retention – due to overproduction of bilirubin • Regurgitation – reflux of bilirubin into blood

Acholuric Vs. Choluric • CHOLURIC – presence of bile derivatives in the urine • Occurs in regurgitation hyperbilirubinemia • Obstructive type • ACHOLURIC – absence of bile in urine • Retention hyperbilirubinemia • Hemolytic type

Hemolytic vs. Hepatocellular vs. Obstructive

Hemolytic Jaundice CLINICAL Defect in uptake of bilirubin by liver cells Immature hepatic conjugating system BIOCHEMICAL Slight change in liver cells Severe increase of Alkaline Phospholipase (APL)

Obstructive Jaundice CLINICAL • Presence of tumors, structures BIOCHEMICAL • Mild to severe increase of APL

Hepatocellular Jaundice CLINICAL • Liver damage (hepatitis, cirrhosis) BIOCHEMICAL • With marked biochemical change in liver cells • Marked increase in APL

Clinical Conditions Related to Increased Unconjugated Hyperbilirubinemia • Gelbert’s Syndrome • Crigler-Najjar Syndrome (Type I) • Crigler-Najjar Syndrome (Type II) • Neonatal Jaundice

Clinical Conditions Related to Increased Conjugated Hyperbilirubinemia

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Introduction

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BIOCHEMISTRY

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Neonatal Jaundice Disease

It seems that you like this template, neonatal jaundice disease presentation, free google slides theme, powerpoint template, and canva presentation template.

We know that being a mom or a dad is hard and scary, but when it comes to Jaundice, we recommend you not to panic. If your newborn’s eyes turn a bit yellow, it could be Jaundice, a condition that is common in babies and that is usually non-threatening. It happens because your kids’ body is still not efficient enough to handle all the bilirubin it creates. Speak about it with this template for health professionals!

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The Biochemistry of Jaundice - PowerPoint PPT Presentation

The Biochemistry of Jaundice

The biochemistry of jaundice a collaborative effort of group 3 section 1c2 members: animations by: gerald fuentes formation of bilirubin bilirubin metabolism ... – powerpoint ppt presentation.

• A collaborative effort of Group 3 Section 1C2
• Animations by Gerald Fuentes
• Conjugation
• Hepatic Uptake
• Unconjugated bilirubin is presented in the liver cell
• The albumin associated with it is dissociated
• Ligandin is delivered to prevent efflux of bilirubin back to plasma
• Unconjugated bilirubin (water insoluble) is converted to bilirubin diglucoronide (water soluble)
• Takes place in the smooth endoplasmic reticulum of the liver
• Catalyzed by glucoronyl transferase
• Bilirubin which is now water soluble can now be excreted from the liver cell to the biliary system.
• Excessive Production of Bilirubin
• Reduced Hepatocyte Uptake
• Impaired Bilirubin conjugation
• Impaired Bile Flow
• Urine Examination
• Qualitative measurement of bilirubin
• Either Ictotest or Dipstick method
• Foam Test method
• Normal Urine foam is absolutely white
• Hyperbilibirunemia foam is yellow
• Stool Examination
• Special Blood Test
• Radiological
• Retention due to overproduction of bilirubin
• Regurgitation reflux of bilirubin into blood
• CHOLURIC presence of bile derivatives in the urine
• Occurs in regurgitation hyperbilirubinemia
• Obstructive type
• ACHOLURIC absence of bile in urine
• Retention hyperbilirubinemia
• Hemolytic type
• Defect in uptake of bilirubin by liver cells
• Immature hepatic conjugating system
• BIOCHEMICAL
• Slight change in liver cells
• Severe increase of Alkaline Phospholipase (APL)
• Presence of tumors, structures
• Mild to severe increase of APL
• Liver damage (hepatitis, cirrhosis)
• With marked biochemical change in liver cells
• Marked increase in APL
• Gelberts Syndrome
• Crigler-Najjar Syndrome (Type I)
• Crigler-Najjar Syndrome (Type II)
• Neonatal Jaundice

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