Clinical enzymology: alkaline phosphatase: practice question

A Biochemistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Biochemistry · Clinical enzymology: alkaline phosphatase

Sample item

A patient with obstructive jaundice has markedly elevated alkaline phosphatase. Which additional enzyme supports a hepatobiliary rather than bone source?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Gamma-glutamyl transferase

GGT rises with cholestasis and helps identify a hepatic source of elevated alkaline phosphatase. Isolated high ALP with normal GGT suggests considering bone disease.

Option by option

  • A. Amylase

    Amylase is associated with pancreatic and salivary disease.

  • B. Gamma-glutamyl transferase (correct)

    Correct. Concurrent GGT supports cholestatic hepatobiliary origin.

  • C. Lactate dehydrogenase-1

    LDH-1 is not used to establish the source of ALP.

  • D. Creatine kinase-MB

    CK-MB reflects myocardial injury.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Biochemistry question

What is the answer to this Biochemistry question?

The best answer is B, Gamma-glutamyl transferase. GGT rises with cholestasis and helps identify a hepatic source of elevated alkaline phosphatase.

Why is "Amylase" not the answer?

Amylase is associated with pancreatic and salivary disease.

Why is "Lactate dehydrogenase-1" not the answer?

LDH-1 is not used to establish the source of ALP.

Why is "Creatine kinase-MB" not the answer?

CK-MB reflects myocardial injury.

What concept does this question test?

It tests Clinical enzymology: alkaline phosphatase in Biochemistry. Isolated high ALP with normal GGT suggests considering bone disease.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Clinical enzymology: alkaline phosphatase?

Build one table of enzyme deficiency, disease, inheritance and key finding, then revise it by spaced recall. Then use the flashcards and the other Biochemistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.