Which combination of urinary and fecal findings is most typical of acute hepatitis?

Which combination of urinary and fecal findings is most typical of acute hepatitis?

• A. Urine bilirubin positive; fecal urobilinogen decreased
• B. Urine bilirubin negative; fecal urobilinogen decreased
• C. Urine bilirubin positive; fecal urobilinogen increased
• D. Urine bilirubin negative; fecal urobilinogen increased

Answer: (A)

In acute hepatitis, liver cells are injured and leak conjugated bilirubin into the bloodstream and then into the urine, so urine bilirubin becomes positive. At the same time, hepatocellular dysfunction reduces bile flow into the intestine, leading to less bilirubin reaching the gut to be converted into urobilinogen. With less bilirubin entering the gut, fecal urobilinogen decreases. This combination—positive urine bilirubin and decreased fecal urobilinogen—is typical of hepatocellular jaundice seen in acute hepatitis, reflecting both leakage of conjugated bilirubin into urine and impaired bilirubin delivery to the gut.

In acute hepatitis, liver cells are injured and leak conjugated bilirubin into the bloodstream and then into the urine, so urine bilirubin becomes positive. At the same time, hepatocellular dysfunction reduces bile flow into the intestine, leading to less bilirubin reaching the gut to be converted into urobilinogen. With less bilirubin entering the gut, fecal urobilinogen decreases. This combination—positive urine bilirubin and decreased fecal urobilinogen—is typical of hepatocellular jaundice seen in acute hepatitis, reflecting both leakage of conjugated bilirubin into urine and impaired bilirubin delivery to the gut.