MLT 130 Final Endocrinology, Body Fluids, Toxicology
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What fraction(s) of bilirubin is/are increased in a hemolytic disorder?
unconjugated total
Which fraction might be expected to be increased in a hepatic disorder?
conjugated; direct
In severe hemolytic jaundice, what would be expected results for bilirubin and urobilinogen in the urine, feces, and blood?
Urine - greatly increased urobilinogen Feces - increased urobilinogen and urobilin Blood - increased unconjugated bilirubin
Where and from what substance is urobilinogen formed?
bilirubin Bacteria from intestines
Another name for prehepatic jaundice is _______.
hemolytic
Another name for posthepatic jaundice is _______.
obstructive
Another name for FREE (indirect) bilirubin is _______.
unconjugated
Another name for direct bilirubin is _______.
conjugated
What is the normal range for direct bilirubin?
0.0-0.2 mg%
Indirect bilirubin is converted to direct bilirubin by conjugation with _______ ____ by the ____ ____.
glucuronic acid liver cells
In what condition is conjugated bilirubin increased?
biliary obstruction
In the Evelyn-Malloy method for bilirubin, quantitation of the bilirubin is made by measuring _______.
azobilirubin
In the Jendrassik-Grof method for bilirubin determination, bilirubin reacts with what reagent to form the purple compound azobilirubin? In this method, what reagent is used to dissolve free bilirubin?
diazotized sulfanilic acid caffeine
What reagents are used in the Watson-Schwartz test?
Ehrlich's reagent Chloroform N-Butanol Sodium acetate (NOT Diethyl ether)
How are porphobilinogen and urobilinogen distinguished from each other since both form a colored compound with p-aminobenzaldehyde?
Porphobilinogen is extracted by chloroform
In the synthesis of heme, what is the direct precursor of porphobilinogen?
Delta-aminolevulinic acid (Delta ALA)
Why is the stool clay-colored in obstructive jaundice?
urobilinogen is absent due to blockage
To what compound is free bilirubin in the plasma attached?
albumin
What compound is the precursor of uroporphyrin, coproporphyrin, and protoporphyrin?
porphobilinogen
If you know the total bilirubin and the conjugated bilirubin values, how can you determine the value for the unconjugated bilirubin?
total - conjugated
Name the three enzymes involved in heme synthesis that are inhibited by lead.
Delta ALA synthase Porphobilinogen deaminase Ferrochelatase
What is the composition of Erhlich’s reagent?
*Diazotized sulfanilic acid
Why is unconjugated bilirubin NOT found in the urine?
NOT water soluble
What color is urine which contains large amounts of porphyrins?
port wine; magenta