This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
[{'content': 'True about Extrahepatic binary atresia – \nSelect and explain. \nA. Acholic stool, B. Conjugated hyperbilirubinemia, C. Absence of nucleide in duodenum in HIDA scan, D. All of these', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Extrahepatic binary atresia \n\nBiliary Atresia is the absence of patent bile duct draning the liver.\nThe abnormality found most commonly is complete atresia of extrahepatic biliary structures.\nInfants with biliary atresia often has an uneventful neonatal course until jaundice is noted at 2-3 weeks of age.\nConjugated hyperbilirubinemia occurs.\nUrine is dark in colour\nStools may be normal or clay coloured (acholic).\nThe liver may be of normal size early, but it becomes enlarged with time.\nLiver becomes hard as a consequence of progressive cirrhosis\nSplenomegally is usually seen\n\nLaboratory findings\n\nDirect bilirubin levels over 3 mg/dl\nAlkaline phosphatase elevated to 500-1000 units/L\nGamma Glutamyl transpeptidase levels > 300 units/L\n\nImaging studies\n\nAbsence or inability to visualize a contracted gall bladder on USG\nSerial Scintiscans of right upper abdomen should be obtained after injection of Technitium Tc 99m. labeled iminodiacetate. Compounds (IDA, HIDA, PIPIDA) --> Liver fails to secret these compounds into the duodenum due to biliary obstruction.\nNeedle biopsy of the liver - If bleeding and clotting tests are normal.', 'role': 'assistant'}]