Which statement correctly differentiates hepatocellular injury from cholestatic injury on liver function tests?

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Multiple Choice

Which statement correctly differentiates hepatocellular injury from cholestatic injury on liver function tests?

The main idea is how liver injury types change the enzyme pattern on liver function tests. In hepatocellular injury, when liver cells (hepatocytes) are damaged, their cytosolic enzymes—especially ALT (more liver-specific) and AST—are released in large amounts, so AST/ALT rise markedly while ALP and GGT stay relatively modest. In cholestatic injury, blockage or impairment of bile flow causes bile-duct–related enzymes to rise, with alkaline phosphatase (ALP) and GGT increasing markedly, while AST/ALT elevations are comparatively smaller. Bilirubin can rise in both patterns, but the characteristic signal is high AST/ALT in hepatocellular injury and high ALP (with GGT) in cholestasis.

The main idea is how liver injury types change the enzyme pattern on liver function tests. In hepatocellular injury, when liver cells (hepatocytes) are damaged, their cytosolic enzymes—especially ALT (more liver-specific) and AST—are released in large amounts, so AST/ALT rise markedly while ALP and GGT stay relatively modest. In cholestatic injury, blockage or impairment of bile flow causes bile-duct–related enzymes to rise, with alkaline phosphatase (ALP) and GGT increasing markedly, while AST/ALT elevations are comparatively smaller. Bilirubin can rise in both patterns, but the characteristic signal is high AST/ALT in hepatocellular injury and high ALP (with GGT) in cholestasis.

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