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DEFECTIVE BILIRUBIN METABOLISM & LIVER FUNCTION TEST, Classification,…
DEFECTIVE BILIRUBIN METABOLISM & LIVER FUNCTION TEST
TLOS
Explain HYPERBILIRUBINEMIA
&
its CONSEQUENCES
Classify LIVER FUNCTION TESTS
Explain BILIRUBIN TRANSPORT
&
METABOLISM
in
LIVER
&
INTESTINE
Describe
the
USES
&
INTERPRETATIONS
of
different commonly USED LIVER FUNCTION TESTS
Describe BILIRUBIN METABOLISM
in the body
BILIRUBIN METABOLISM
Albumin + UB => UB ~ Albumin Complex
Hepatic bilirubin transport
Conjugation
Biliary excretion
Hepatic uptake
Bilirubin formation
Enterohepatic circulation
Bilirubin
level in the
blood
exceeds
2 mg/dL
=>
JAUNDICE / ICTERUS
HYPERBILIRUBINEMIA
Liver Function Test
Test based on
Excretory Function
Test based on
Synthetic Function
Major Functions of Liver
Detoxification
Excretory
Metabolic
Storage & Homeostasis
Synthetic
Test based on
Metabolic Function
Test based on
Detoxification Function
Determinations
of
Serum Enzymes
Classifications
Based on
Laboratory Findings
Group ii
Enzymes
AST
ALP
ALT
Group iii
Plasma Proteins
Albumin & Globulin
Prothrombin time
Total protein
Group i
Serum
Bilirubin-CB, UB
Urine
Bile salts
Bile pigment
Urobilinogen
Group iv
Special test
Ferritin
Alpha-1 antitrypsin
Ceruloplasmin
Alpha fetoprotein
Based on
Clinical Aspects
Marker of
Hepatocellular Injury
ALT
AST
Marker of
Cholestasis
ALP
GGT
Marker of
Liver Dysfunction
Total proteins-Albumin & Globulin
Urine-Bile salts & pigments
Serum bilirubin
Prothrombin time
Blood ammonia
Classification
Acquired
Hepatic (Hepatocellular jaundice)
Post-hepatic (Obstructive jaundice)
Pre-hepatic (Hemolytic jaundice)
Congenital
Physiological
Congenital jaundice due to genetic error
Bilirubin
level in the
blood
exceeds
1 mg/dL
Example
Bilirubin
Ammonia