Question

Laboratory investigations of a patient being evaluated for jaundice show elevated bilirubin and alkaline phosphatase levels. Levels of the remaining liver enzymes are normal. What is the likely diagnosis?

• A. Obstructive jaundice
• B. Hemolytic jaundice
• C. Hepatic jaundice
• D. Prehepatic jaundice

Answer 1

The Correct Option is A

The patient presents with jaundice and laboratory findings show elevated bilirubin and alkaline phosphatase levels, while other liver enzymes remain normal. In understanding jaundice, it is crucial to interpret these specific markers.

1. Bilirubin: Bilirubin elevation is a common indicator of jaundice but does not determine the specific type alone.
2. Alkaline Phosphatase: This enzyme's elevation is typically associated with cholestasis, a condition where bile flow is obstructed, often seen in obstructive jaundice.
3. Normal other liver enzymes: The absence of elevated transaminases (like AST and ALT) usually suggests that the liver cells are not directly damaged, which is characteristic of hepatic or intrahepatic causes. This points away from hepatic jaundice, where liver cell damage would elevate these enzymes.

The combination of elevated bilirubin and alkaline phosphatase with normal liver enzymes is indicative of obstructive jaundice. This condition occurs due to a blockage in the bile duct system, preventing bilirubin from being excreted into the intestine, often seen in conditions like gallstones or tumors that obstruct bile flow.