Case study

Dr. S. Kandasamy
 Questions

• What is the probable diagnosis/

• What defect is responsible
• Why rise in unconjucated bilirubin ?
• What is the biochemical basis of heamolysis in this condition?
• What is the relevant of HMP shunt pathway in RBCs?
• Why Hb is reduced?
• How will you diagnose?
 Case study-2

• A 41 years old women presented with yellow discolouration of the eye and complains pain abdomen on
right upper quadrant . History of loss of appetite, vomiting , malaise pruritus and H/ O passing clay
coloured stools and high coloured urine
• Her biochemical parameters as follows
• Total bilirubin = 20 mg/dl
• Direct bilirubin = 17 mg/dl
• AST = 68 IU/L, ALT= 72IU/l, ALP =522 IU/L
• Total protein= 6.5 g/dl Albumin = 2.8 g/dl
• Urine bile pigment : positive , bile salt= positive, uobilinogen = negative.
 Questions

• What is the probable diagnosis?

• Give some causes of this condition?
• Name the bile salts..and the test to detect their presence in urine
• Name the bile pigment and test to detect their presence in urine
• What is the reason of pale - coloured stool in this condition
• Name the test done for bilirubin and its principle.