Advanced Dental Admission Test (ADAT)

What condition is characterized by increased levels of bilirubin due to impaired hepatocytic uptake?

1. Neonatal jaundice

2. Unconjugated hyperbilirubinemia

3. Conjugated hyperbilirubinemia

4. Cushing's syndrome

The correct answer is: Unconjugated hyperbilirubinemia

Increased levels of bilirubin due to impaired hepatocytic uptake are specifically associated with unconjugated hyperbilirubinemia. This condition arises when there is a disruption in the liver's ability to take up bilirubin from the bloodstream, leading to a buildup of unconjugated (indirect) bilirubin. This can occur in various situations, such as hemolytic anemias or conditions that affect the function of hepatocytes. When bilirubin is produced from the breakdown of hemoglobin, it is initially in an unconjugated form, which is lipid-soluble and cannot be excreted in urine. For bilirubin to be eliminated from the body, it must be taken up by the liver, conjugated to become water-soluble, and then excreted into bile. If there is impaired hepatocytic uptake, as seen in unconjugated hyperbilirubinemia, the liver is unable to effectively process and clear the bilirubin, leading to its accumulation in the bloodstream. Other options do not relate directly to impaired uptake mechanisms. For example, neonatal jaundice is often related to immature liver function and can involve both conjugated and unconjugated bilirubin elevation but typically resolves as the newborn's liver matures.