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Hyperbilirubinemia - Coggle Diagram

- - - - leads to inc bili produc w/in M0
    - - M0 ingest RBC directly
    - - M0 uptake free Hgb
        
        travel to kidney = hgb-uria
        
        hgb-emia
  - - - regener anemia if enough time has passed for regener to occur
      - RBC morph changes = spherocytes
    - - ALT, AST, SDH
        
        may inc due to secondary hepatocellu hypoxia
      - ALP
        
        WRI or mildly inc
        
        inc secondary to
        
        hepatocellu swell
        
        endog steroid induc
        
        dogs have stress induced elev
      - GGT
        
        WRI or mild inc
        
        inc secondary to
        
        hepatocellu swell
        
        endog steroid induc
- - - - why?
        
        too few func hepatocytes
        
        uptake/conju is impaired
    - - metab: liver failure/dysfunc
        
        def: insuffic func c
        
        causes
        
        dec uptake/conju of bili
        
        end stage liver dz
        
        PSS: atrophy secondary to circ bypass
        
        occ acute, overwhelming c loss
        
        due to severe tox, trauma, hypoxia, rapid neoplasia dev
        
        lab abnorm
        
        see liver failure slides
        
        enz
        
        ALP
        
        GGT
        
        ALT
        
        AST
        
        inc do not have to be sig
      - func hepatic cholestasis
        
        caused by infec - sepsis, lepto, endotoxemia
      - interference w recep-medi bili uptake of excre
        
        causes
        
        anorexia in horses (less in cattle)
        
        lipid metab interferes w uptake
        
        infec
        
        sepsis and endotox
        
        WBC abnorm, low glucose
        
        lepto
        
        renal failure and liver enz elev
        
        cholestatic and hepatocellu damage
- - - - causes regurg into blood
      - Ex: cbili inc
      - if you can't excre bile, you can't excre bili
    - - same as cholestasis
        
        biliary rupture = bile peritonitis, post hepatic cholestasis or hyperbili-emia
    - - same as cholestasis
        
        lipid depos, etc