A 70-year-old man presented with itching, jaundice and mass palpable per abdomen and clay coloured stools. Two tests done in his urine sample is shown here. It gave positive results. What is the type of Jaundice he is suffering from?
**Core Concept**
The patient's symptoms suggest obstructive jaundice, characterized by the presence of a palpable abdominal mass, clay-colored stools, and positive urine tests indicating a specific type of bilirubin conjugation. Obstructive jaundice occurs when there is a blockage in the bile ducts, leading to an accumulation of bilirubin in the blood and tissues.
**Why the Correct Answer is Right**
The patient's symptoms are consistent with obstructive jaundice caused by a tumor in the bile duct, known as a cholangiocarcinoma. The presence of a palpable abdominal mass and clay-colored stools indicates a mechanical obstruction of the bile ducts. The positive urine tests likely indicate the presence of urobilinogen, a byproduct of bilirubin breakdown, which is typically elevated in obstructive jaundice. The bilirubin conjugation pathway is affected, leading to an increase in conjugated bilirubin in the blood.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it would not explain the presence of a palpable abdominal mass or clay-colored stools.
**Option B:** This option is incorrect because it would not account for the positive urine tests indicating urobilinogen elevation.
**Option C:** This option is incorrect because it would not explain the specific symptoms and test results seen in this patient.
**Clinical Pearl / High-Yield Fact**
Obstructive jaundice can be caused by a variety of factors, including gallstones, tumors, and infections. The presence of a palpable abdominal mass and clay-colored stools should raise suspicion for a mechanical obstruction of the bile ducts.
**Correct Answer:** C. Obstructive jaundice