Jaundice causes a yellow discolouration of the skin, mucous membranes and sclera of the eyes. State the bile pigment causing this discolouration.

Explain how the normal production of bile pigments changes with the development of jaundice.

Distinguish between the structure of liver sinusoids and capillaries.

bilirubin

normal production: [2 max]

a. red blood cells/erythrocytes/hemoglobin broken down «in the liver»

b. hemoglobin/heme «from red blood cells» is converted to bilirubin/bile pigment

c. bilirubin/bile pigment transferred to bile and «normally» eliminated in the feces

change with jaundice:

d. «in jaundice» liver does not excrete/eliminate bilirubin/bile pigments

e. caused by immaturity/dysfunction/disease «of the liver»

    OR

    blockage of bile ducts

    OR

    increase in red blood cells breakdown

f. therefore bilirubin/bile pigment accumulates in the blood

[Max 4 Marks]

a. sinusoids have open pores/fenestrations/discontinuous endothelium and capillary endothelium is continuous/does not contain fenestrations

b. Kupffer cells are located inside sinusoids but not in capillaries

c. sinusoids larger in diameter/wider than capillaries

[Max 2 Marks]