Which statement describes a hepatocellular injury pattern on liver enzymes?

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Multiple Choice

Which statement describes a hepatocellular injury pattern on liver enzymes?

Hepatocellular injury is marked by a release of cytosolic enzymes from damaged liver cells, so transaminases rise prominently. ALT is more liver-specific than AST, and they tend to be elevated well above alkaline phosphatase (ALP) in this pattern. ALP comes from bile ducts and rises more with cholestasis or biliary obstruction, so when ALP is higher than transaminases, that suggests a cholestatic pattern rather than hepatocellular injury. Normal transaminases with high bilirubin can occur in various contexts but don’t define the hepatocellular pattern, and low ALT/AST with high ALP again points toward cholestasis. Thus elevations in ALT/AST greater than ALP best describe hepatocellular injury.

Hepatocellular injury is marked by a release of cytosolic enzymes from damaged liver cells, so transaminases rise prominently. ALT is more liver-specific than AST, and they tend to be elevated well above alkaline phosphatase (ALP) in this pattern. ALP comes from bile ducts and rises more with cholestasis or biliary obstruction, so when ALP is higher than transaminases, that suggests a cholestatic pattern rather than hepatocellular injury. Normal transaminases with high bilirubin can occur in various contexts but don’t define the hepatocellular pattern, and low ALT/AST with high ALP again points toward cholestasis. Thus elevations in ALT/AST greater than ALP best describe hepatocellular injury.

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