OnlineMedEd Shared "Physiology of Bile and Bilirubin" - 8 Picmonics
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Physiology of Bile and Bilirubin
Bile
- Synthesis and Circulation
- Synthesized Continuously By Hepatocytes
- Cholesterol 7 Alpha-Hydroxylase Rate Limiting Step
- Stored In Gallbladder
- Secreted Into Duodenum
- Bile Salts Reabsorbed In Terminal Ileum
- Returned To Liver Via Portal Circulation
- Composition
- Bilirubin
- Bile Salts
- Cholesterol And Phospholipids
- Ions And Water
4 mins
Bile Acid Resins
- Indications
- Hyperlipidemia
- Mechanism of Action
- Bile Acid Reabsorption Prevented
- Slight Increase HDL/Triglycerides
- Decrease LDL
- Drugs
- Colestipol (Colestid)
- Cholestyramine
- Colesevelam
- Side Effects
- Cholesterol Gallstones
- Decreased Absorption of Fat-soluble Vitamins
- Patients Hate It
2 mins
GI Absorption
- Stomach
- Alcohol
- Duodenum
- Iron
- Jejunum
- Folate
- Terminal Ileum
- Vitamin B12
- Bile Resorption
1 min
Small Intestine Digestion
- Brush border enzymes
- Pancreatic Enzymes are secreted via a Duct
- Pancreas secretes bicarbonate
- Brush Border activates Pancreatic Trypsin
- Trypsin activates Chymotrypsin
- Trypsin and Chymotrypsin digest Proteins
- Gallbladder Releases Bile
- Pancreatic Lipase breaks down Lipids
- Goblet cells secrete mucus
- Pancreatic Amylase breaks down Carbohydrates
- Pancreatic Nucleases breakdown DNA/RNA
- Digestion occurs in the Duodenum
2 mins
Hyperbilirubinemia
- Cause/Mechanism
- Increased Unconjugated Bilirubin
- Assessment
- Jaundice
- Kernicterus
- Interventions
- Early Feedings
- Heme Oxygenase Inhibitors
- Phototherapy
- Protect Eyes
- Monitor for Dehydration
- Considerations
- Monitor Bilirubin Levels
3 mins
Jaundice
- General
- Due To Elevated Conjugated Or Unconjugated Bilirubin
- Unconjugated
- Hemolysis
- Crigler-Najjar Or Gilbert's Syndrome
- Physiologic Jaundice Of Newborn
- Conjugated
- Biliary Obstruction From Stone Or Mass
- Cholangitis
- Dubin-Johnson And Rotor Syndrome
- Mixed
- Cirrhosis
- Hepatitis
5 mins
Bilirubin Lab Value
- 0.2-1.2 mg/dL
- Increased Bilirubin Causes Jaundice
54 secs
Crigler-Najjar Syndrome Type 1
- Pathophysiology
- Autosomal Recessive
- Absent UDP-glucuronosyltransferase
- Symptoms
- Neonatal Jaundice
- Kernicterus
- Diagnosis
- Normal Liver Function Tests
- Elevated Unconjugated Bilirubin
- Treatment
- Phototherapy
- Plasmapheresis
- Calcium Phosphate and Orlistat
- Death often by Age 2
- Considerations
- No Response to Phenobarbital
3 mins
