Bill is an alcoholic with terminal liver failure His family

Bill is an alcoholic with terminal liver failure. His family is wondering why he has \"yellowing\" of his skin and eyes. You need to explain what is happening inside Bill\'s body that is causing the yellowing. Also, what would you expect tests of Bill\'s blood for the amounts of conjugated and unconjugated bilirubin to reveal?

Solution

Heamoglobin is breakdown to heam and globin.the heam part of the heamoglobin split to biliverdin, that biliverdin reduced to bilirubin. This bilirubin is called as unconjugated bilirubin.which is bound to albumin that prevents the excretion into the urine. On reaching liver the unconjugated bilirubin is converted to conjugated bilirubin.this conjugated bilirubin excreted into the urine. In this patient excessive distruction of the RBC such that even normal liver cannot conjugate all of it resulting in increased serum unconjugated bilirubin. This patient has liver failure, therefore it cannot conjugate all bilirubin efficiently, therefore conjugated bilirubin is Also unable to get excreted completely with bile, that leads to increased levels of both conjugated bilirubin and unconjugated bilirubin.