Certified Neuroscience Registered Nurse (CNRN) Practice Exam

What type of gallstones are caused by excess bilirubin, formed from red blood cell breakdown?

1. Cholesterol stones

2. Pigmented gallstones

3. Mineral stones

4. Mixed stones

The correct answer is: Pigmented gallstones

The correct choice is pigmented gallstones, which are primarily formed from excess bilirubin resulting from the breakdown of red blood cells. Bilirubin is a yellow compound that is a byproduct of the normal breakdown of hemoglobin in red blood cells. When there is excessive bilirubin in the bile, as seen in conditions like hemolytic anemia or liver cirrhosis, it can lead to the formation of these types of gallstones. Pigmented gallstones are typically dark in color and can further be categorized into black and brown stones, with black stones being primarily associated with hemolysis, and brown stones often linked to bacterial infections in the bile ducts. The presence of elevated bilirubin levels is the critical factor in the development of these gallstones, as it directly influences their composition. The other options describe different types of gallstones and their causes. Cholesterol stones are mainly composed of hardened cholesterol and are the most common type of gallstones, typically not associated with bilirubin levels. Mineral stones, also less common, arise from various mineral deposits rather than bilirubin. Mixed stones contain a combination of cholesterol, bilirubin, and other components, but the defining feature of pigmented stones is their direct derivation from excess bilirubin due to