Jaundice Quiz: Ace Your Exams

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A 5-month-old female is brought to the pediatrician for evaluation of jaundice that began after a viral upper respiratory tract infection. She was born at 39 weeks gestation to a 27-year-old, gravida 1 para 1, woman via spontaneous vaginal delivery. The patient has been meeting developmental milestones. Family history is noncontributory. Physical examination shows scleral icterus and diffuse jaundice. Abdominal and neurological exams are unremarkable. Blood testing is performed and reveals the following:  
Laboratory value  Result 
Hemoglobin  13.9 mg.dL 
 Leukocyte count  6,800/mm3 
 Total bilirubin  12.7 mg/dL 
 Conjugated bilirubin  0.3 mg/dL 
 Alanine  aminotransferase  15 U/L 
 Aspartate  aminotransferase  16 U/L 
Phenobarbital is administered, and repeat total serum bilirubin is measured at 7 mg/dL. Which of the following best describes the cause of this patient’s condition?

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