Question

A 48-year-old woman has abnormal liver enzymes: ALT 165 IU/L, ALP 98 IU/L, bilirubin normal. She drinks <7 units/week. What pattern is this, and first step?

Accepted Answer

Hepatocellular; repeat LFTs and assess causes (viral, NAFLD, drugs)

Answer

Cholestatic; start ursodeoxycholic acid

Answer

Mixed; urgent ERCP

Answer

Isolated cholestasis; antimitochondrial antibodies

Answer

Gilbert's; reassure only

Practice question

A 48-year-old woman has abnormal liver enzymes: ALT 165 IU/L, ALP 98 IU/L, bilirubin normal. She drinks <7 units/week. What pattern is this, and first step?