Dear Armando, I am a chief physician and manager of an emergency clinic in Norway. In 2 weeks I am spending a whole day teaching our staff in causes of abdominal pain and symptoms from diseases causing abdominal pain. I needed a quick memory refreshener on the complete bilirubin metabolism to explain the aspects of jaundice and saw this.. This video is just simply brilliant! Thank you so much.

as a MS1 I truly appreciate learning this stuff and then coming and watching your videos which allows me finally see how it all comes together and keeps the bigger picture in mind.

This was incredibly helpful, and presented in a much easier way to follow than in class. Thank you very much!

You. Are. Awesome. I used to mug this up every year, all theough four years of medschool. Finally UNDERSTANDING it in my final year. Thank you so much. You have a gift!

I always watch your videos to review material before tests or quizzes, when I'm too tired to read or just don't feel like reading, or just want another take on material that's already familiar to me. You sometimes put things just a bit differently than my teachers do and that can make the material stick to my head much more easily. Your channel is an incredibly valuable complement to my teachers and their class notes.

Thank you Armando! After years of reading text books I finally understand jaundice with your animation.

You do an amazing job sir! The graphics and explanations are terrific! Perfect marriage between science and art :)

You make things so simple. It took me 3 hrs to understand things by myself. What a life saver

thanks a lot! really helped a lot in reviewing for my pathophysiology test. keep up the great work!

one of the best on KZfaq to explain this cycle! good job!

Excellent tutorial! Simple language makes it easy to understand the process. Thank you. - Nitin

So artistic, very well explained and enjoyable to hear too. Thank you so much it was very helpful

Sir you got amazing skills , mind and a great method of teaching ! I am a Med student I found your tutorials very useful specially when Im studying guyton for physio...

Super helpful!! Thank you so much for clearing this up with your amazing illustrations!

Thanks for posting a great video on bilirubin metabolism

amazing videos! keep them coming please :D any on the brain, muscles and neurology? (im a medic and these have helped greatly!)

Dude! Thaaaank u sooooo much for the clarifying vid !!!!!💗💗💗

I love your videos, the drawings look amazing, and you can really see the effort in them. The explanations are amazing. Super grateful for all your work.

I have come back to this video quite often so far in my medical career. Thank you for this concise explanation!

What an explanation. Even a illiterate can understand easily. The uses of different colour and explanations of everything made it so easy to understand. I really appreciate your work from heart and mind. Thank you for sharing such an awesome video.

This was an excellent and succinct explanation, really helpful!

you are such a good teacher.well presented.greetings from Zimbabwe

WATCHING FOR THE 'NTH TIME!!!! YOU'RE AWESOME ARMANDO!!!!! THANK YOU VERY MUCH!! YEARS OF SITTING IN MY CLASS WAS NOTHING FOR EVERY FEW MINUTES SPENT WATCHING YOUR WORK!!!! GREAT JOB!!!!

I was just spending hours to understand bilirubin metabolism, until I saw this video. You do great job.

That good feeling when you get great video of something you want to learn in first attempt . Thankyou for this amazing video and explanation

superb explanation....Fantastic teacher.....awesomely explained...So very very well simplified.....keep up the good work. God bless....cheers....

im so enjoyed with your amazing explanation now I have the final exams and I cannot leave your videos . big thanks for you

Thank you for your videos! They are always so amazing!

Excellent. Very useful video. Explained in simple words , in a clear voice.

Great video and explanation as always! If you ever publish a book of your drawings Iet me know since would purchase it :-)

Good video! Really helped my understanding of bilirubin metabolism!

Very nice video. Just for the sake of some more details, please allow me to further specialise and sum up: RBC when denaturing are taken up by Macrophages located predominantly in the Cords of Billroth in spleen, bone marrow and liver. It is an important point to understand that RBC normally do not undergo intravascular lysis. Billirubin is a breakdown product from Hb. Heme Oxygenase cleaves Heme (the Porphyrin part) into Verdoglobin (if Heme is still attached) or Billiverdin which will finally be reduced by Billiverdin-Reductase into Billirubin. Oppositely, Fe is recycled by Apoferritin in Ferritin and complexes to Hemosiderin. Note: This function of Hb breakdown by HO can occur in virtually every cell and is NOT liver-specific. In liver, hepatocytes release Billirubin-binding-proteins in the circularly system. Those newly formed complexes of Plasma-Protein-Bound-Billirubin are too large large and cannot diffuse back to microcirculatory system. Note: Up to now, we are still talking about unconjungated (indirect) Billirubin which is not water soluble due to intra molecular hydrogen bonds and thus cannot be filtered into urine. This form, still in the circulatory system, is highly toxic, but now trapped. Trough the hepatic artery and the portal system it goes to liver which will take it up. Within hepatic sinusoids, it enters the endoplasmic reticulum and will be conjugated with Glucuronic Acid by GT (Glucuronyltransferase). It became now highly polar and trapped within the hepatocytes. On the canalicular side of the hepatocytes are active transporters that will drain it into biliary ducts. Next it will be concentrated in bile and finally released into GIT. Microbes and enzymes will convert it now into Urobilinogen. Some is reabsorbed and goes back into enterohepatic cycle and since it is highly polar and unbound, it will be renally filtered and passed out by the urinary tract. However, the largest part will remain in the bowl and be converted by bacteria into Stercobilinogen which will be oxidized into Stercobilin that makes the dark color of feces.

You are AMAZING! I'm a visual learner and always follow up my reads by listening to your videos; which immensely aid in the retention of this knowledge. I have vowed to donate in the future! Thank you for all that you do!

Thanks Dr. Armando for your efforts ,you have such a great passion in teaching medicine as if you are playing piano.

Great explanation of metabolism. Of course you missed some parts but that is understandable. I'm curious where did you find that information, that urobilinogen is absorbed by colon ? :O

Uau! This is amazing stuff. What an artist. Thank you so much for such a helpful and visual lecture.

your videos are so sharp and understandable. you are a very enthusiast tutor. keep on the good work.

COOL!! Please keep sharing us the useful knowledge like this, so clear and comprehensive!!

This presentation is amazing. Thank you!

This is a fantastic video!! really informative and helpful! thanks!!

It's the 1st video i am watching on this site.. it's really helpful.thanks sir and keep it up.

excellent explanation, you made it nice and easy ! thank you.

Stunning how all of this is continually happening and each part of the body is doing its part. Amazing mechanism.

You are fabulous !!! Just WOW !!! Keep it up cuz You're the BEST 💪🏻

I am doctor passed out 15yr back.loved ur drawing.needed clarity and revision.so grateful for this.love from India.

Amazing explanations you are one of my best you tube tutors

really easy to understand and your detailed explanation. What a great video!!!!!

As someone who has been diagnosed with Gilbert Syndrome (elevated blood concentrations of unconjugated bilirubin), this is a great video to see. I love what you're doing!

Maravillosa la explicación! Sin palabras . Muchas gracias. Dios te bendiga 🙌🏾🙏🏾🇨🇺🇨🇺

Great Explanation of the process of Bilrubin, examples are excellent and well explained

i agree with christopher! i too would buy those diagrams if they were available. really helpful, so clear, fantastic!!

you are one of the best lecturer ever ...well done

Fantastic piece of work....... Nice explanation in this short time ....

Super simple and creative , thank you very much .. keep going ❤

Thank you very much! All of your videos are brilliant

I am veterinary Student and it is very helpful , clear doubts and gives the image in mind which is remembering in lifetime❤

You are a life saver ! I would not have never understood this without your video. Thank you.

amazing!! great lecture video.. thanks!!

great video man I like all the videos you do. Just to add an extra step when the haeme is converted to bilirubin there is an intermediate step whereby the haeme is cleaved by haeme oxygenase a cytochrome P450 enzyme to biliverdin. This biliverdin is water soluble unlike bilirubin and it is the enzyme reduction of the biliverdin via biliverdin reductase that creates the lipid soluble bilirubin.

thank you armando, you're amazing!

How an amazing teaching video I have ever seen!

Brilliant illustration. Thank you! :D

Very helpful.. thank you so much for this videoo.. you have clarified this in so easy way...

I hope you make another videos about medical, its so helpful for us to understanding the case, or the theory, thank u so much brother.. God bless you..

Love your videos mate. The only thing that you could change that I believe would make it twice as good would be the addition of english subtitles. Any chance of that ever happening? Other than that, I absolutely love your videos!

Nicely done . I enjoyed it . Superb drawings 😁👍

Love your videos, what exactly did you study in college?

YOURE AWESOME ARMANDO!! ITS SUCH ENLIGHTMENT! THANKS SO MUCH FOR MAKING THESE! KEEP UP UR AWESOME WORKS! WE DOCTORS TOBE OWE YOU MUCH!!!

Hey Armando, really blown away with the quality of information on the topic. What software you use for such awesome videos?

He his the best teacher i have seen

oh my god it was really helpful and I enjoyed every second of this vedio... thank you soo much sir ♥

Your videos are the greatest! Nice work.

Perfect video!!! Thank you so much!!!

Thank you for your explaination....good job

Best explanation I’ve seen on this. Thanks.

Thank you so much for this amazing explanation

thank u so much sir ,very nicely explained with good draw,ur great

Thanku so much sir its very clear and easy to understand 🙏

Really very helpful for students like us,gr8 job sir

you made it so easy, I'm very thankful

This is really helpful video sir... informative and easily understandable

Wow !! Thank you so much for your hard efforts, it really helps me a lot.. I checked your website, and it's amazing.. Again, thank you, and keep up the good work !!

Very beautiful😍, thank you doctor شكراا🙏🏻

I Learned a lot, Thank You for the Information.

Great video !! Thank you for this amazing explanation 🙏

thanks great explanation... clear , accurate and precise... help a lot

thanks for this great video. graphic is also very good. please, would be great if you'd mentioned the enzymes as well

thanks a lot Armando Hasudungan for your help

Straightforward and complete, thank you

thaaaaank you so much, that was really helpful!

YOUR THE CHIEF ARTIST!!. YOU'RE AMAZING💖. THANKS

Brilliant work sir

its amazing lecture, tnks bro

This made me want to study medicine again! Great explanation!

such lovely diagrams and wonderful way of teaching ❤️

Very informative video. I wish you taught my patho-physio class. LOL. Thanks for sharing.

thanks alot i really enjoy ur videos,God bless u

Thank you so much for simplifying the pathway

That was awesome 🤗 Keep going ; God bless U 🌻

This video deserves (❤️) button. Well done. 🙌🙌🙌