]> 2026-07-31T14:08:26+00:00 WBR0648 0 en Increased hemoglobin breakdown Increased hemoglobin breakdown is seen in patients with hemolysis. Our patient's CBC, retic count and blood smear showed no indication of hemolysis. Increased hemoglobin breakdown is not seen in Gilbert syndrome Absent UDP-Glucuronyltransferase UDP-Glucuronyltransferase is absent or defective in Criggler-Najjar syndrome. The presentation would be more severe in a much younger patient with associated liver dysfunction. Decreased bilirubin uptake by the liver Decreased bilirubin uptake by the liver is the main mechanism behind Gilbert syndrome. Bile outlet obstruction Bile outlet obstruction would usually lead to conjugated hyperbilirubinemia with deranged LFTs. Hydrolysis of conjugated bilirubin Hydrolysis of conjugated bilirubin is one of the mechanisms of neonatal hyperbilirubinemia. Biochemistry A 34-year-old healthy man presents to the primary care clinic for a general check-up. The man has no complaints except minor fatigue during the day, but he relates this to his stressful life style. Physical exam is unremarkable except for mild scleral icterus. The primary care physician decides to order some tests to rule out any serious illness. Lab results return with a normal CBC, reticulocyte count, and blood smear. Transaminases, alkaline phosphatase, and GGT are also all within normal range. Indirect bilirubin is noted to be 2.6 mg/dL with direct bilirubin below the upper limit of normal. The patient remembers that he was noted to have an elevated indirect bilirubin several years earlier but his work-up back then also came back normal. Which of the following pathological mechanisms is involved in this patient's condition? C Gastrointestinal 2020-10-28T01:19:22Z 2459150.5551157 WBR0648