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1. Which of the following condition is associated with unconjugated hyperbilirubinemia?
- Dubin-Johnson syndrome
- Rotor syndrome
- Gilbert syndrome
- Gall stones
ANSWER c
Gilbert syndrome is an autosomal recessive disorder of bilirubin metabolism within the liver.Reduced glucuronidation of bilirubin leads to unconjugated hyperbilirubinemia and recurrent episodes of jaundice.Under normal circumstances, approximately 95% of bilirubin is unconjugated.
2. A patient with unconjugated bilirubinemia has increased excretion of urobilinogen in his urine. This can be seen in all of the following conditions, except:
- G6 PD deficiency
- Hemolytic anemia
- Hereditary spherocytosis
- Biliary cirrhosis
ANSWER d
Biliary cirrhosis is characterized by conjugated hyperbilirubinemia. Rest all the mentioned options cause unconjugated hyperbilirubinemia.
3. In post-hepatic jaundice, the concentration of conjugated bilirubin in the blood is higher than that of unconjugated bilirubin because:
- There is an increased rate of destruction of red blood cells
- The unconjugated bilirubin is trapped by the bile stone produced in the bile duct.
- The conjugation process of bilirubin in liver remains operative without any interference.
- The UDP glucuronyl transferase activity is increased manifold in obstructive jaundice
ANSWER c
Post hepatic jaundice is due to impaired excretion of conjugated bilirubin as a result of obstruction. However, the process of conjugation is not interfered with.
4. Function of hepatic stellate cells is/are:
- Formation of sinusoids
- Vitamin A storage
- Increases blood perfusion
- Phagocytosis
ANSWER b
A Hepatic Stellate Cells. HSCs are resident perisinusoidal cells in the subendothelial space between hepatocytes and sinusoidal endothelial cells (SEC) that contribute to hepatic development, regeneration, immune responses, angiogenesis, and storage of vitamin A.
5. Which of the following diseases is not a cause of indirect hyperbilirubinemia?
- Rotor’s syndrome
- Criggler Najjar syndrome
- Gilbert syndrome
- Hereditary spherocytosis
ANSWER a
Rotor syndrome, also known as Rotor type hyperbilirubinemia, is an autosomal recessive disease and a rare cause of mixed direct (conjugated) and indirect (unconjugated) hyperbilirubinemia. The disease is characterized by nonhemolytic jaundice due to chronic elevation of predominantly conjugated bilirubin.
