Question:medium
A 42-year-old patient presents with obstructive jaundice. Alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and haptoglobin are all increased. The most likely cause is:
A 42-year-old patient presents with obstructive jaundice. Alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and haptoglobin are all increased. The most likely cause is:
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GGT is the enzyme most strongly induced by one of these exposures.
Updated On: Jun 23, 2026
- Alcohol
- Lead
- Chronic renal failure
- None of the above
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The Correct Option is A
Solution and Explanation
Anchor on GGT. Among all the listed exposures, only one is a classic enzyme inducer of gamma glutamyl transferase, and that is alcohol. The triad here, raised ALP, raised GGT, and obstructive jaundice, describes a cholestatic injury, and when GGT climbs to more than double its normal value the clinician should think alcohol first. Remember the companion rule: an AST to ALT ratio of 2 or more alongside a high GGT is one of the most reliable biochemical fingerprints of alcoholic liver disease. Eliminate the distractors: lead poisoning produces basophilic stippling, microcytic anemia, and a wrist or foot drop, not a cholestatic enzyme rise; chronic renal failure raises urea and creatinine and does not obstruct the biliary tree. Haptoglobin behaving as an acute phase reactant simply reflects the inflammatory hepatic insult. Therefore alcohol is the answer.
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