Question

The etiology of jaundice could be haemolytic anaemia if:

• A. Unconjugated bilirubin is found equal to conjugated bilirubin
• B. Increase in IgE level
• C. Conjugated bilirubin is found more than unconjugated bilirubin
• D. Unconjugated bilirubin is found more than conjugated bilirubin

Answer 1

The Correct Option is D

The correct option is (D): Unconjugated bilirubin is found more than conjugated bilirubin.

Answer 2

The question asks what bilirubin pattern points to haemolytic anaemia as the cause of jaundice. Let's check each option.

1. Unconjugated bilirubin is found equal to conjugated bilirubin: An equal split between the two forms does not point specifically to excess red cell breakdown; it does not match the typical laboratory pattern of haemolytic jaundice.
2. Increase in IgE level: A rise in IgE is linked to allergic reactions and certain parasitic infections, not to the breakdown products of red blood cells, so it has no direct bearing on the type of jaundice present.
3. Conjugated bilirubin is found more than unconjugated bilirubin: A higher conjugated bilirubin points instead to a problem after the liver has already processed the bilirubin, such as a blocked bile duct (obstructive/post-hepatic jaundice), not to excess red cell breakdown.
4. Unconjugated bilirubin is found more than conjugated bilirubin: In haemolytic anaemia, red blood cells break down faster than normal, releasing large amounts of haemoglobin that get converted to unconjugated bilirubin. The liver's capacity to conjugate this bilirubin is overwhelmed, so unconjugated bilirubin builds up in the blood and rises well above the conjugated fraction.

Since haemolytic jaundice starts with excess red cell destruction upstream of the liver, it is the unconjugated (pre-liver) form of bilirubin that piles up and exceeds the conjugated form.

So the correct answer is Unconjugated bilirubin is found more than conjugated bilirubin.