HY USMLE Q #1627 – Gastro

A 78-year-old woman is evaluated in hospital for yellow eyes and skin. She has no overt past medical history apart from a cholecystectomy at age 58. She’s a non-smoker. Laboratory studies show:

Total bilirubin                                        4.0 mg/dL
Conjugated bilirubin                         3.0 mg/dL
Pancreatic amylase                            Normal
Pancreatic lipase                                 Normal

Which of the following is the most likely explanation for this patient’s findings?

A) Choledocholithiasis
B) Cholelithiasis
C) Malignancy
D) Reduced activity of hepatic enzyme
E) Sphincter of Oddi dysfunction

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