Which of the following are secondary markers for obstructive jaundice?

• A. GGT
• B. 5'NT
• C. Ornithine Carbamoyl Transferase
• D. GGT, 5'NT, and Ornithine Carbamoyl Transferase

Answer: (D)

In obstructive jaundice, bile flow blockage leads to cholestasis, and certain enzymes leak into the blood more than usual. GGT is a biliary enzyme that rises markedly in cholestasis, making it a sensitive secondary marker of obstructive processes. 5'-nucleotidase is another canalicular enzyme that increases with cholestasis and helps differentiate bile duct obstruction from other liver injuries. Ornithine carbamoyl transferase is a mitochondrial enzyme inside hepatocytes; when hepatocytes are stressed or damaged by cholestasis, OCT leaks into the bloodstream, reflecting hepatocellular injury that can accompany obstruction. Together, these three markers provide a broader signal of obstructive jaundice, with GGT and 5'-NT signaling canalicular/biliary involvement and OCT indicating accompanying hepatocellular injury.