You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is A 56 year old man presents to his internist with jaundice. The patient is receiving no medication and his only symptomatic complaints is mild fatigue over the past 2 months. Physical examination is remarkable only for the presence of scleral icterus. The patient has no significant past medical history. Analysis of serum chemistry reveals the following: SGOT : 0.58 microkat/L (35U/L) SGPT : 0.58 microkat/L (35U/L) Total bilirubin : 91.7 micron mol/L (7 mg/dL) Direct Bilirubin : 85.5 micron mol/L (5mg/dL) Alkaline phosphatase:12 micron kat/L (720U/L) Which of the following is the next appropriate diagnostic step? and explain in detail?
Answer is A (Ultrasound): Initial investigation of choice in a case of obstructive jaundice is: ULTRASONOGRAPHY The patient in question has an obstructive form of jaundice, as is indicated by marked elevation of conjugated hiliruhin together with a significant rise is Alkaline phosphatase. Patient: should therefore be next subjected to ultrasonography to confirm the diagnosis and if possible locate the site of block.