A rise in serum "direct" bilirubin would be expected in:

A. Hemolytic jaundice
B. Absence of glucuronyl transferase as in the newborn
C. Decreased hepatic uptake of bilirubin (Gilbert's Disease)
D. Biliary obstruction
  1. A, B and C
  2. A and C
  3. B and D
  4. D only
  5. All of the above


A-C would increase the concentration of unconjugated (indirect) bilirubin. Unconjugated bilirubin is "indirect" because it is bound to serum albumin, and must be released by an organic solvent before it can react.
D. In this condition bilirubin would be conjugated normally, but not excreted.

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