A patient with obstructive jaundice has ALP 900 U/L, GGT 800 U/L, ALT 90 U/L. The ALP:ALT ratio is 10. This pattern is most consistent with:

• A Alcoholic hepatitis
• B Acute hepatocellular necrosis
• C Cholestatic liver disease ✓
• D Autoimmune hepatitis

Explanation

A predominantly elevated ALP (with concurrent GGT elevation confirming hepatic origin) and relatively modest ALT rise is the hallmark of cholestatic liver disease. Alcoholic hepatitis shows AST:ALT >2 with modest ALP. Acute hepatocellular necrosis elevates ALT and AST disproportionately over ALP. Autoimmune hepatitis raises transaminases markedly.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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