this dude had a complication aortic valve replacement which he now presents with a decrescendo diastolic murmur at the left sternal border (Aortic Regurg). The RBCs seem to get sheared as they pass thru the faulty opening of the replaced valve causing intravascular hemolysis

When conjugated bilirubin (CB) is less dan, 30% of total bilirubin----> increased the production of unconjugated bilirubin or decreased uptake. Hemolysis is the possible answer choice.

CB is 30%-50% mix-hyperbilirubinemia (Ex. Hepatitis or Alcholol) CB is more than 50% --> Obstruction (intra or extrahepatic)