A 67-year-old female with leg and abdominal swelling and scleral icterus from alcohol use, which organ is not functioning properly?

• A. Pancreas
• B. Large intestine
• C. Kidney
• D. Liver

Answer: (D)

Alcohol-related damage to the liver fits best with this presentation. The scleral icterus shows elevated bilirubin, which happens when the liver can’t properly conjugate or excrete bilirubin into the bile. The leg and abdominal swelling reflect edema and ascites from decreased albumin production and from portal hypertension—both classic signs of impaired liver function. Chronic alcohol use can lead to fatty change, hepatitis, and cirrhosis, all of which reduce the liver’s ability to perform these tasks.

The other organs don’t explain both findings together. The pancreas is tied to digestive enzymes and can be affected by alcohol, but it doesn’t cause scleral icterus. The large intestine isn’t responsible for bilirubin metabolism or major fluid shifts that cause ascites. The kidneys can contribute to edema, but scleral icterus points to a liver problem rather than a primary kidney issue.