In obstructive jaundice, which of the following enzyme patterns is MOST characteristic and helps distinguish it from hepatocellular jaundice?

• A Disproportionately elevated ALT and AST with normal ALP
• B Markedly elevated ALP and GGT with modest transaminase rise ✓
• C Elevated LDH with normal ALP and GGT
• D Elevated AST:ALT ratio greater than 2 with high GGT

Explanation

Obstructive (cholestatic) jaundice is characterized by marked elevation of alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) due to biliary epithelial induction and regurgitation of canalicular enzymes into serum, with only modest rise in transaminases. Hepatocellular jaundice predominantly elevates ALT and AST. Option D (AST:ALT > 2 with high GGT) is typical of alcoholic liver disease, not pure obstruction. LDH elevation (option C) is nonspecific.

Reference: Harper's Illustrated Biochemistry, 32nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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