A 34-year-old woman comes to the physician because of yellow eyes and increasingly severe itching. She does not smoke or consume alcohol. Physical examination shows scleral icterus. Her brother has rheumatoid arthritis. Serum studies show:
Bilirubin (total): 6.1 mg/dL
Bilirubin (direct): 4.9 mg/dL
Alkaline phosphatase (ALP): 420 U/L
γ-Glutamyltransferase (GGT): 170 U/L
Serology for hepatitides is negative. Which of the following is the most likely cause of these findings?
Autoimmune-mediated hemolysis
Bile canalicular obstruction
Enzyme deficiency
Thrombosis (hepatic vein)
Thrombosis (portal vein)
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Cut-to-the-chase Answer (0:33):
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HY USMLE Answer (9:38):
