Today's Case A 77-year-old male with a history of sick sinus syndrome status post pacemaker placement, ulcerative colitis, hypertension, and type 2 diabetes mellitus was referred by his primary medical doctor for jaundice and pruritus. His doctor noted newly elevated liver enzymes alkaline phosphatase (ALP) 672 U/L, total bilirubin (BR) 5.0 mg/dL, alanine aminotransferase (ALT) 77 U/L, and aspartate aminotransferase (AST) 63 U/L. When he presented to the liver clinic, his total bilirubin increased to 20 mg/dL. On review of his records, a trend of abnormal liver enzymes was noted with no prior workup. Today's Reader Jared Fehlman is an Internal Medicine Resident at Huntington Health Hospital in Pasadena, California. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠The Dr. Raj Podcast⁠⁠ ⁠⁠Dr. Raj on Twitter⁠⁠ ⁠⁠Dr. Raj on Instagram⁠⁠ Want more board review content? ⁠⁠USMLE Step 1 Ad-Free Bundle⁠⁠ ⁠⁠Crush Step 1⁠⁠ ⁠⁠Step 2 Secrets⁠⁠ ⁠⁠Beyond the Pearls⁠⁠ ⁠⁠The Dr. Raj Podcast⁠⁠ ⁠⁠Beyond the Pearls Premium⁠⁠ ⁠⁠USMLE Step 3 Review⁠⁠ ⁠⁠MedPrepTGo Step 1 Questions⁠⁠ ⁠⁠MedPrepTGo Step 2 Questions⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

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“What did the council decide on item 42?” — answered with the speaker and the moment.

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