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Old 01-15-2012
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Urine Sample Increased Urobilinogen in Urine

In which of the following diseases, level of urobilinogen in urine is increased?
A) Choledochal cyst
B) Hereditary spherocytosis
C) Gilbert syndrome
D) Crigler-Najjar syndrome
E) Hepatocellular carcinoma
F) Adenocarcinoma of the head of pancreas
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E)Hepatocellular carcinoma


Increased values:
overburdening of the liver

excessive RBC breakdown

increased urobilinogen production

re-absorption - a large hematoma

restricted liver function

hepatic infection

poisoning

liver cirrhosis

Low values
complete obstructive jaundice or treatment with broad-spectrum antibiotics, which destroy the intestinal bacterial flora. (Obstruction of bilirubin passage into the gut or failure of urobilinogen production in the gut.)
may also result from congenital enzymatic jaundice (hyperbilirubinemia syndromes) or from treatment with drugs that acidify urine, such as ammonium chloride or ascorbic acid.
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Ans: B>

b> increased indirect bilirubin --> increased conjugation by the liver --> incresed conj bilirubin in bile-->increased conversion of CB into urobilinogen

Other choices a> e> f> are obstruction jaundice, decreasing bile flow.

Criggler Najjar there is decreased conjugation.

In Gilbert, there is defective uptake of indirect bilirubin, so the forming urobilinogen in the end is not increased.
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B....is the ans.
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b is the ans.
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Hereditary spherocytosis
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E) Hepatocellular carcinoma ?
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Answer is B.......
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Old 01-16-2012
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What's the answer?
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Correct Answer Answer

Quote:
Originally Posted by khushi.chahal View Post
Whats the answer?
The correct answer is B. Hereditary spherocytosis

In hemolysis, the uroblinogen is increased in urine.

Hereditary spherocytosis --> increased indirect bilirubin --> increased conjugation by the liver --> incresed conj bilirubin in bile-->increased conversion of CB into urobilinogen

Other choices a> e> f> are obstruction jaundice, decreasing bile flow.

Criggler Najjar there is decreased conjugation.

In Gilbert, there is defective uptake of indirect bilirubin, so the forming urobilinogen in the end is not increased.
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Quote:
Originally Posted by Evergreen View Post
The correct answer is B. Hereditary spherocytosis

In hemolysis, the uroblinogen is increased in urine.

Hereditary spherocytosis --> increased indirect bilirubin --> increased conjugation by the liver --> incresed conj bilirubin in bile-->increased conversion of CB into urobilinogen

Other choices a> e> f> are obstruction jaundice, decreasing bile flow.

Criggler Najjar there is decreased conjugation.

In Gilbert, there is defective uptake of indirect bilirubin, so the forming urobilinogen in the end is not increased.
doesn't hepatocellular carcinoma cause conjugated hyperbilirubinemia as well? therefore, you'd see it in the urine?
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