Perioperative care: early postoperative jaundice: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Surgery · Perioperative care: early postoperative jaundice

Sample item

On the second day after major trauma surgery requiring massive transfusion and a large retroperitoneal haematoma, a patient is mildly jaundiced. Liver enzymes and ALP are near normal and the bilirubin is unconjugated. What is the most likely cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Pigment load from transfused cells and resorbing haematoma

A large load of haem pigment from stored red cells with reduced survival and from the breakdown of haematomas overwhelms conjugation capacity. Ductal injury gives a conjugated picture with raised ALP.

Option by option

  • A. Hepatic artery thrombosis

    Hepatic artery thrombosis causes marked enzyme elevation and mainly follows transplantation.

  • B. Viral hepatitis

    Hepatitis would raise transaminases markedly.

  • C. Common bile duct injury

    Duct injury gives conjugated hyperbilirubinaemia with raised ALP.

  • D. Pigment load from transfused cells and resorbing haematoma (correct)

    Correct. Pigment overload causes self-limiting unconjugated hyperbilirubinaemia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Pigment load from transfused cells and resorbing haematoma. A large load of haem pigment from stored red cells with reduced survival and from the breakdown of haematomas overwhelms conjugation capacity.

Why is "Hepatic artery thrombosis" not the answer?

Hepatic artery thrombosis causes marked enzyme elevation and mainly follows transplantation.

Why is "Viral hepatitis" not the answer?

Hepatitis would raise transaminases markedly.

Why is "Common bile duct injury" not the answer?

Duct injury gives conjugated hyperbilirubinaemia with raised ALP.

What concept does this question test?

It tests Perioperative care: early postoperative jaundice in General Surgery. Ductal injury gives a conjugated picture with raised ALP.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Perioperative care: early postoperative jaundice?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.