While attending a 21 years old male black patient who complains of abdominal pain, you observe a pale light yellow color of the skin and sclerotics. You suspect that the patient has jaundice; urine dipstick test is negative for bilirrubin but positive for urobilinogen.
When laboratory reports of blood tests arrive, they show the following results:
– Hematocrite: 28% (reference range from 41% to 53%)
– Hemoglobin: 8 g/dL (13.5-17.5 g/dL)
– Alanin aminotransferase (ALT) : 12 U/L (reference range 8-20 U/L)
– Aspartate aminotransferase (AST): 18 U/L (reference range 8-20 U/L)
– Alkaline Phosphatase (ALP): 80 U/L (reference range: 44-147 U/L)
– Total Bilirrubin: 3.5 mg/dL (normal = 0.1 to 1 mg/dL)
– Direct bilirrubin 0.2 mg/dL (normal from 0 to 0.3 mg/dL).
Which of the following options are compatible with the results shown above?
a) jaundice of prehepatic cause
b) jaundice of hepatic cause because of deficiency in the intake of bilirrubin
c) jaundice of hepatic cause because of deficiency in the conjugation of bilirrubin
d) jaundice of hepatic cause because of deficiency in the excretion of bilirrubin from the hepatocyte.
e) jaundice of posthepatic cause (extrahepatic biliary obstruction)