NOT elevated with isolated biliary obstruction.

NOT elevated with isolated biliary obstruction.

• A. AST
• B. ALT
• C. ALP
• D. GGT

Answer: (A)

In biliary obstruction, the pattern of enzyme changes is driven by cholestasis rather than direct hepatocellular injury. Obstruction elevates enzymes that reflect bile flow blockage—primarily alkaline phosphatase and gamma-glutamyl transferase. These indicators rise because bile cannot drain properly and builds up in the liver and biliary system. The liver transaminases, AST and ALT, signal actual liver cell damage. If the obstruction is isolated and there isn’t hepatocellular injury, AST (and ALT) tend to remain normal or only rise modestly. Therefore, in a purely obstructive scenario, AST would not be elevated, making it the best choice for the statement “NOT elevated with isolated biliary obstruction.”

In biliary obstruction, the pattern of enzyme changes is driven by cholestasis rather than direct hepatocellular injury. Obstruction elevates enzymes that reflect bile flow blockage—primarily alkaline phosphatase and gamma-glutamyl transferase. These indicators rise because bile cannot drain properly and builds up in the liver and biliary system. The liver transaminases, AST and ALT, signal actual liver cell damage. If the obstruction is isolated and there isn’t hepatocellular injury, AST (and ALT) tend to remain normal or only rise modestly. Therefore, in a purely obstructive scenario, AST would not be elevated, making it the best choice for the statement “NOT elevated with isolated biliary obstruction.”