MCAT Biology Question 130: Answer and Explanation

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Question: 130

10. Which of the following would NOT likely lead to elevated levels of bilirubin in the blood?

  • A. Cholangiocarcinoma, a cancer of the bile ducts that can ultimately lead to full occlusion of the duct lumen
  • B. Autoimmune hemolytic anemia, a disease in which the red blood cells are attacked by antibodies and are lysed
  • C. Ménétrier's disease, in which rugae thicken and overlying glands lose secretory ability
  • D. Acetaminophen (Tylenol) overdose, in which the accumulation of toxic metabolites can cause rapid liver failure

Correct Answer: C

Explanation:

Elevated bilirubin implies a blockage to bile flow, increased production of bilirubin (from massive hemoglobin release), or an inability of the liver to produce bile. If the bile duct were occluded, as in choice (A), then bile would not be able to flow into the digestive tract and would build up, increasing bilirubin levels in the blood. If many red blood cells were lysed, as in choice (B), then bilirubin levels would rise in accordance with the increased hemoglobin release. If liver failure occurred, as in choice (D), then it would be unable to produce bile, and bilirubin would again build up. Choice (C) refers to a pathology in the stomach—the key word given here is rugae, which are the folds in the stomach wall. Lack of gastric function would have no effect on bilirubin levels, making this the correct choice.

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