Serum Markers of Liver Pathology

Question 1

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)

Answer 1

“Liver enzymes”

INC in most *liver disease: ALT > AST
INC in *alcoholic liver disease: AST > ALT

AST > ALT in nonalcoholic liver disease suggests progression to advanced fibrosis or cirrhosis

Question 2

Alkaline phosphatase (ALP)

Answer 2

INC in cholestasis (eg, biliary obstruction), infiltrative disorders, bone disease

Question 3

g-glutamyl transpeptidase (GGT)

Answer 3

INC in various liver and biliary diseases (just as ALP can), but *not in bone disease

associated with alcohol use

Question 4

Bilirubin

Answer 4

INC in various liver diseases (eg, biliary obstruction, alcoholic or viral hepatitis, cirrhosis), hemolysis

Question 5

Albumin

Answer 5

DEC in advanced liver disease

Question 6

Prothrombin

Answer 6

INC in advanced liver disease (DEC production of clotting factors)

Question 7

Platelets

Answer 7

DEC in advanced liver disease (DEC thrombopoietin, liver sequestration) and portal hypertension (splenomegaly/splenic sequestration)