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NBME 22 Answers

nbme22/Block 2/Question#44

A 3-day-old full-term male newborn is brought to ...

Hepatic UDP-glucuronosyltransferase activity

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There is a high indirect bilirubin concentration (8 mg/dl out of the total 10 mg/dl) so there must be a problem with conjugation. the enzyme needed for conjugation is UDP-gluronosyltransferase.

In this case, this is physiological neonatal jaundice. due to immature enzyme that resolves without treatment in 1-2 weeks. pg 387 FA 2019

Babies don't have mature activity of this enzyme when first born...Tx with phototherapy...not same mechanism as enzyme but makes bilirubin more soluble