LIVER FX

• Detoxification: the conversion from one harmful molecule to a molecule that is tolerable by the body.
• Biotransformation: toxic to nontoxic subs
• Cholesterol: parent compound of bile acid
• factor 3 or tissue factor: clotting factor that is not included.
• UDPGT: enzyme responsible for the conjugation of bilirubin
• Lucey Driscoll: Presence of circulating bilirubin inhibitors
• Dubin-Johnson: Defect in excretion of B2 by hepatocytes
• Crigler-Najjar Syndrome: No UDPGT
• Gilbert’s Syndrome: Defect of transport of B1 to liver
• 0.2-0.8 mg/dl is the normal range for indirect bilirubin
• bilirubin oxidase: an enzyme responsible for the conversion of bilirubin to biliverdin.
• Bilirubin -----------> oxidized to Biliverdin-----------> decrease in absorbance at 405 to 460 nm
• urobilin colors the urine
• Jendrassik-Grof (Reference Method) End product: blue color in alkaline pH (intensity of the color produced is directly proportional to bilirubin concentration) ◆ Absorption: 600 nm ◆ Dissociating agent or coupling promoter: Caffeine + Sodium benzoate
• lipemic, hemolysed, light: interferences in indirect method
• Diazo reagent composition: HCl, Sulfanilic acid, Na Nitrite
• Evelyn-Malloy method End Product: Red to reddish purple color in acid pH 1.2 ◆ Absorption: 560 nm ◆ Dissociating agent or coupling promoter: Methanol (most common accelerator to solubilize B1) ◆ Interference: Hemoglobin
• transcutaneous Bilirubin Assay Principle: Multiwavelength reflectance photometry
• 0-0.2 mg/dl is the normal value for Direct Bilirubin
• 0.1-1 erhlich’s normal value for urine urobilinogen
• 0.2-1.0 mg/dl normla value for total bilirubin
• transferrin carries Fe3+
• secretion: function of the liver which is responsible for converting of unconjugated to conjugated form.
• endoplasmic reticulum: bilirubin conjugation occurs.
• ALT & AST: hepatocellular enzyme
• ALP & GGT: hepatobiliary enzymes
• heme, iron, globin: RBC is broken down into 3 components.
• hemolytic jaundice or unconjugated hyperbilirubinemia: other name for pre-hepatic jaundice serum: increase B1 urine: -
• hepatic jaundice serum: increase B1 & B2 urine: +
• post-hepatic jaundice serum: increase B2 urine: +
• enzymatic (bilirubin oxidase) ◆At pH 8, both conjugated, unconjugated bilirubin react with the enzyme, but at pH 4 only the conjugated form reacts. ◆ Has advantage over other methods because it is not affected by hemoglobin
• Unconjugated bilirubin is poorly soluble in acid, and therefore, direct bilirubin is assyed using diazotized sulfanilic acid diluted in weak HCl.
• Albumin + B2 = delta bilirubin
• Direct bilirubin: no coupling accelerator is added to initially convert B2 to B1 before the reaction, therefore only direct bilirubin is determined.
• Indirect Methods: A coupling accelerator of reaction is added to make both B1 and B2 react with the reagent.