What is the most likely cause of jaundice in the patient given the following lab results: Serum alkaline phosphatase: 4 times normal Serum cholesterol: Increased AST (SGOT): Norma... What is the most likely cause of jaundice in the patient given the following lab results: Serum alkaline phosphatase: 4 times normal Serum cholesterol: Increased AST (SGOT): Normal or slightly increased 5'-Nucleotidase: Increased Total serum bilirubin: 25 mg/dL Conjugated bilirubin: 19 mg/dL Prothrombin time: Prolonged but improves with a vitamin K injection
Understand the Problem
The question presents a case study of a patient exhibiting symptoms like jaundice, right upper quadrant abdominal pain, fever, and chills, along with provided lab results and asks for the most likely cause of the jaundice based on the information given.
Answer
Biliary obstruction is the most likely cause of jaundice, given the lab results.
Based on the lab results (elevated alkaline phosphatase, increased 5'-nucleotidase, high conjugated bilirubin, and prolonged prothrombin time improving with vitamin K), the most likely cause of jaundice is biliary obstruction.
Answer for screen readers
Based on the lab results (elevated alkaline phosphatase, increased 5'-nucleotidase, high conjugated bilirubin, and prolonged prothrombin time improving with vitamin K), the most likely cause of jaundice is biliary obstruction.
More Information
Biliary obstruction prevents bile flow from the liver, leading to a buildup of bilirubin and other substances in the blood. The liver damage can also affect the synthesis of clotting factors, leading to prolonged prothrombin time, which improves with vitamin K.
Tips
It's a common mistake to only focus on one or two elevated lab values. To correctly diagnose, consider all the results in conjunction with the patient's symptoms (jaundice, right upper quadrant pain, fever, and chills).
Sources
- Approach To A Patient With Elevated Serum Alkaline Phosphatase - pmc.ncbi.nlm.nih.gov
- Tests for Hepatotoxicity: Usefulness in Screening Workers - jstor - jstor.org
- [PDF] Lab Test Interpretation Table - BC Cancer - bccancer.bc.ca
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