A 35 year old man presents with deep jaundice and pruritus over the past 1 month.He has been well previously. His brother requires regular transfusions.
On examination he has a firm spleen.
Serum bilirubin: 20 mg/dL (NR <1.2)
ALT: 45 U/L (NR <40)
AST: 39 U/L (NR <40)
Gamma GT: 420 U/L (NR <65)
Alkaline phosphatase:860 U/L (NR <125)
Hb: 9g/dL
a) What type of jaundice does he have?
b) What is the likely cause of his jaundice?
c) What investigation would you do to confirm the cause in
d) What underlying diagnosis is this patient likely to have?
