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Obstructive Jaundice — RACP Adult Medicine MCQ

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EasyGastroenterologyObstructive JaundiceRACP Adult Medicine

A 55-year-old man presents with jaundice. LFTs: Bilirubin 180 μmol/L (conjugated 150 μmol/L), ALP 650 U/L, GGT 480 U/L, ALT 85 U/L, AST 70 U/L. Ultrasound shows dilated intrahepatic and extrahepatic bile ducts with a mass in the pancreatic head. What is the most likely LFT pattern?

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Correct answer: C — Obstructive (cholestatic) jaundice

Predominantly conjugated hyperbilirubinaemia with markedly elevated ALP and GGT (disproportionate to transaminases) with dilated bile ducts on imaging defines obstructive (post-hepatic) jaundice. A pancreatic head mass causing bile duct obstruction is the likely cause. MRCP or EUS for further characterisation and ERCP for biliary decompression may be needed.

Reference: eTG Gastrointestinal – 2024 – Jaundice Investigation