[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"menu":3,"$fGxEEZbXkoF62yhULUw1rQH4cghTKWTI29ZKFp_7uk-U":210},{"main":4,"mainTranslated":17,"footer":45,"footerTranslated":109},[5,8,11,14],{"title":6,"url":7},"Course library","https:\u002F\u002Fwww.medmastery.com\u002Fcourse-library",{"title":9,"url":10},"Pricing","https:\u002F\u002Fwww.medmastery.com\u002Fpricing",{"title":12,"url":13},"Earn credits","https:\u002F\u002Fwww.medmastery.com\u002Fcme-credits",{"title":15,"url":16},"Institutions","https:\u002F\u002Fwww.medmastery.com\u002Finstitutions",{"de":18,"es":27,"fr":36},[19,21,23,25],{"title":20,"url":7},"Kurse",{"title":22,"url":10},"Preise",{"title":24,"url":13},"CME-Punkte",{"title":26,"url":16},"Organisationen",[28,30,32,34],{"title":29,"url":7},"Biblioteca de cursos",{"title":31,"url":10},"Precios",{"title":33,"url":13},"Gana créditos",{"title":35,"url":16},"Instituciones",[37,39,41,43],{"title":38,"url":7},"Cours",{"title":40,"url":10},"Tarifs",{"title":42,"url":13},"Obtenir des crédits",{"title":44,"url":16},"Établissements",[46,59,79,97],{"title":47,"group":48,"menu":49},"Company",true,[50,53,56],{"title":51,"url":52},"Our teachers","https:\u002F\u002Fwww.medmastery.com\u002Fteachers",{"title":54,"url":55},"About us","https:\u002F\u002Fwww.medmastery.com\u002Fabout-us",{"title":57,"url":58},"Work with us","https:\u002F\u002Fwww.medmastery.com\u002Fwork-with-us",{"title":60,"group":48,"menu":61},"Product",[62,64,67,70,73,76,78],{"title":63,"url":7},"Courses",{"title":65,"url":66},"Magazine","https:\u002F\u002Fwww.medmastery.com\u002Fmagazine",{"title":68,"url":69},"Podcast","https:\u002F\u002Fwww.medmastery.com\u002Fpodcasts",{"title":71,"url":72},"Webinars","https:\u002F\u002Fwww.medmastery.com\u002Fwebinars",{"title":74,"url":75},"Guides","https:\u002F\u002Fwww.medmastery.com\u002Fguides",{"title":15,"url":77},"https:\u002F\u002Fwww.medmastery.com\u002Finstitutions\u002F",{"title":9,"url":10},{"title":80,"group":48,"menu":81},"Legal",[82,85,88,91,94],{"title":83,"url":84},"Imprint","https:\u002F\u002Fwww.medmastery.com\u002Fimprint",{"title":86,"url":87},"Newsletter policy","https:\u002F\u002Fwww.medmastery.com\u002Fnewsletter-privacy-policy",{"title":89,"url":90},"Privacy policy","https:\u002F\u002Fwww.medmastery.com\u002Fprivacy-policy",{"title":92,"url":93},"Cookie Policy","https:\u002F\u002Fwww.medmastery.com\u002Fcookie-policy",{"title":95,"url":96},"Terms","https:\u002F\u002Fwww.medmastery.com\u002Fterms",{"title":98,"group":48,"menu":99},"Customer support",[100,103,106],{"title":101,"url":102},"FAQs","https:\u002F\u002Fwww.medmastery.com\u002Ffaqs",{"title":104,"url":105},"Contact","https:\u002F\u002Fwww.medmastery.com\u002Fcontact",{"title":107,"url":108},"support@medmastery.com","mailto:support@medmastery.com",{"de":110,"es":143,"fr":177},[111,118,128,137],{"title":112,"group":48,"menu":113},"Unternehmen",[114,116,117],{"title":115,"url":52},"Unsere Dozentinnen und Dozenten",{"title":54,"url":55},{"title":57,"url":58},{"title":119,"group":48,"menu":120},"Produkt",[121,122,123,124,125,126,127],{"title":20,"url":7},{"title":65,"url":66},{"title":68,"url":69},{"title":71,"url":72},{"title":74,"url":75},{"title":26,"url":77},{"title":22,"url":10},{"title":129,"group":48,"menu":130},"Rechtliches",[131,133,134,135,136],{"title":132,"url":84},"Impressum",{"title":86,"url":87},{"title":89,"url":90},{"title":92,"url":93},{"title":95,"url":96},{"title":138,"group":48,"menu":139},"Kundenservice",[140,141,142],{"title":101,"url":102},{"title":104,"url":105},{"title":107,"url":108},[144,151,162,171],{"title":145,"group":48,"menu":146},"Empresa",[147,149,150],{"title":148,"url":52},"Nuestros profesores",{"title":54,"url":55},{"title":57,"url":58},{"title":152,"group":48,"menu":153},"Producto",[154,156,157,158,159,160,161],{"title":155,"url":7},"Cursos",{"title":65,"url":66},{"title":68,"url":69},{"title":71,"url":72},{"title":74,"url":75},{"title":35,"url":77},{"title":31,"url":10},{"title":163,"group":48,"menu":164},"Información legal",[165,167,168,169,170],{"title":166,"url":84},"Aviso legal",{"title":86,"url":87},{"title":89,"url":90},{"title":92,"url":93},{"title":95,"url":96},{"title":172,"group":48,"menu":173},"Atención al cliente",[174,175,176],{"title":101,"url":102},{"title":104,"url":105},{"title":107,"url":108},[178,185,196,204],{"title":179,"group":48,"menu":180},"Entreprise",[181,183,184],{"title":182,"url":52},"Nos enseignants",{"title":54,"url":55},{"title":57,"url":58},{"title":186,"group":48,"menu":187},"Produit",[188,189,190,191,192,193,194],{"title":38,"url":7},{"title":65,"url":66},{"title":68,"url":69},{"title":71,"url":72},{"title":74,"url":75},{"title":15,"url":77},{"title":195,"url":10},"Tarification",{"title":197,"group":48,"menu":198},"Mentions légales",[199,200,201,202,203],{"title":197,"url":84},{"title":86,"url":87},{"title":89,"url":90},{"title":92,"url":93},{"title":95,"url":96},{"title":205,"group":48,"menu":206},"Service client",[207,208,209],{"title":101,"url":102},{"title":104,"url":105},{"title":107,"url":108},{"content":211,"related":285,"meta":352,"internal":362},{"title":212,"leadIn":213,"category":214,"elements":217,"becomeAnExpert":252,"author":272,"readDuration":283,"readDurationFormatted":284},"Identifying cholestasis on a liver lab panel","In this video, we'll explore the cholesteric pattern of liver function test abnormalities, discuss which enzymes you need to take seriously, and what you should do if the results aren't clear.",{"id":215,"name":216},1,"Course previews",[218,229,234,239,247],{"type":219,"data":220},"video",{"readDurationInSeconds":221,"video":222},164,{"platform":223,"name":224,"url":225,"size":226},"YouTube","Identifying cholestasis on your liver labs panel","https:\u002F\u002Fwww.youtube.com\u002Fwatch?v=xsjtZ2iyDII",{"width":227,"height":228},200,113,{"type":230,"data":231},"free_text",{"readDurationInSeconds":232,"text":233},13.066666666666666,"\u003Cp>How do you determine the cause of a biliary obstruction from a patient's liver function test panel? In this video, from our Liver Lab Essentials course, we answer this question while exploring the cholesteric pattern of liver function test abnormalities. We'll discuss which enzymes you need to take seriously and outline what you should do if the results aren't clear.\u003C\u002Fp>",{"type":230,"data":235},{"readDurationInSeconds":236,"title":237,"text":238},16.53333333333333,"Join our Liver Lab Essentials course now!","\u003Cp>Interpreting the results of a liver function test can sometimes stump even the most experienced clinicians! In this course, we'll cover which tests to order, the clinical implications of lab abnormalities seen with common liver function tests, and what to do about them. After taking this course, your ability to confidently interpret liver function tests and take the next steps will become second nature!\u003C\u002Fp>",{"type":240,"data":241},"cta",{"readDurationInSeconds":242,"text":243,"buttonText":244,"buttonUrl":245,"teachIllustration":246},3.7333333333333334,"Start the first chapter of our Liver Lab Essentials course for free","Start chapter 1 now","https:\u002F\u002Fwww.medmastery.com\u002Fuser\u002Fregister?target=%2Fcourses%2Fliver-lab-essentials","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55f0a-845c-4dda-9de2-b08117634b81",{"type":230,"data":248},{"readDurationInSeconds":249,"title":250,"text":251},59.199999999999996,"Video transcript","\u003Cp>The cholestatic pattern of liver function test abnormalities indicates biliary obstruction, and occurs when there is a disproportionate elevation in alkaline phosphatase, when compared to ALT and AST. Serum bilirubin may be elevated, and tests for synthetic function, such as prothrombin time, and albumin may be abnormal.\u003C\u002Fp>\u003Cp>Biliary obstruction or cholestasis may be due to intrahepatic obstruction, or extrahepatic obstruction. Causes of intrahepatic obstruction include primary sclerosing cholangitis, primary biliary cholangitis, drugs such as steroids or chlorpromazine, toxins, and infiltrative diseases like tuberculosis, sarcoidosis, and lymphoma.\u003C\u002Fp>\u003Cp>Causes of extrahepatic obstruction include gallstones in the common bile duct, tumors, blocking the bile ducts, pancreatitis and strictures. So how can you determine the possible causes of a biliary obstruction? Biliary obstruction is characterized by elevated levels of alkaline phosphatase, typically three times that of normal.\u003C\u002Fp>\u003Cp>Remember, there are three sources of alkaline phosphatase, liver, bone and placenta. Whenever the source is the liver, gamma glutamyl transpeptidase levels are also raised. Thus, gamma glutamyl transpeptidase can be tested if there is a doubt as to whether the source of the raised alkaline phosphatase is the liver. Note that antimitochondrial antibody levels are raised in primary biliary cholangitis.\u003C\u002Fp>\u003Cp>The next best test for determining the cause of biliary obstruction in individuals with significantly elevated levels of alkaline phosphatase is imaging, usually ultrasonography of the abdomen. Gallstones in the common bile duct, as well as pancreatic lesions are easily diagnosed on ultrasound.\u003C\u002Fp>\u003Cp>Further testing by magnetic resonance cholangiopancreatography, MRCP, or endoscopic retrograde cholangiopancreatography, ERCP, may be required to diagnose the different causes of intrahepatic cholestasis. Lastly, liver biopsy may be required if the cause remains undetermined.\u003C\u002Fp>",{"courses":253,"showAwardsBelow":48},[254],{"id":255,"isFreeCmeCourse":256,"title":257,"type":258,"specialization":259,"teachers":261,"cmeCredits":215,"teacherIllustration":246,"backgroundImage":263,"relativeUrl":264,"lastChanged":265,"created":266,"description":267,"relativeURL":264,"meta":268},6642,false,"Liver Lab Essentials","course",[260],"Gastroenterology",[262],"Md. Amer Wahed, MD FRCPath","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55f0b-52e4-4d34-8b86-076633c7b4f6","\u002Fcourses\u002Fliver-lab-essentials","1763556357","1611544769","Interpreting the results of liver function tests can sometimes stump even the most experienced clinicians. In this course, you’ll learn which tests to order, clinical implications of lab abnormalities seen with common liver function tests, and what to do about them. After attending this course, confidently interpreting liver function tests and taking next steps will become second nature to you.",{"duration":269,"quizzes":270,"lessons":271},2081,3,15,{"id":273,"name":262,"image":274,"profession":275,"relativeUrl":278,"specializations":279},4771,"https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cef9-8e65-4f02-9ac9-35866a9326ea",{"name":276,"description":277},"Pathologist","Amer is a Professor, Chair, and Residency Program Director in the Department of Pathology and Laboratory Medicine at McGovern Medical School, UTHealth Houston, USA.","\u002Fteachers\u002Fmd-amer-wahed-md-frcpath",[280,281,282,260],"Hematology","Nephrology","Clinical pathology",101,"2m",[286,314,333],{"id":287,"title":288,"text":289,"image":290,"author":298,"path":307,"readDuration":308,"readDurationFormatted":309,"internal":310},1351,"Starting statins as first-line therapy for hyperlipidemia","Starting statins: how to choose the right agent for your patient, match statin intensity to cardiovascular risk, and monitor effectively after initiation.",{"alt":291,"title":292,"size":293,"location":295},"Healthcare provider discussing starting statins with a patient and reviewing a medication bottle","",{"width":294,"height":294},660,{"bucket":296,"key":297},"public-drupal-medmastery-assets-production","\u002F2026-05\u002FC121(2)_magazine image.png",{"id":299,"title":300,"relativeURL":301,"image":302,"professionLong":303,"profession":304,"weight":306},1563,"Franz Wiesbauer, MD MPH","\u002Fteachers\u002Ffranz-wiesbauer-md-mph","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cef0-41ee-4005-9e4a-d8711c816401","Franz is the founder and CEO of Medmastery. He is an internist with a specialization in cardiology and a master’s in public health from Johns Hopkins University.",{"name":305},"Internist",4,"\u002Fmagazine\u002Fstarting-statins-first-line-therapy",238,"4m",{"created":311,"updated":312,"published":313},1778960150,1778962081,1778961827,{"id":315,"title":316,"text":317,"image":318,"author":324,"path":326,"readDuration":327,"readDurationFormatted":328,"internal":329},1350,"How to recognize INOCA (ANOCA) on an exercise stress test ","Angina, abnormal stress test, clean coronaries—that's INOCA (or ANOCA), and it carries real risk. Learn to recognize and report it with exercise stress ECG.",{"alt":319,"title":292,"size":320,"location":322},"Illustration of the heart's coronary vasculature showing large coronary arteries and the extensive network of smaller vessels affected in INOCA (ischemia with nonobstructive coronary arteries).",{"width":321,"height":321},1200,{"bucket":296,"key":323},"\u002F2026-05\u002FC17(1)_magazine image_0.png",{"id":299,"title":300,"relativeURL":301,"image":302,"professionLong":303,"profession":325,"weight":306},{"name":305},"\u002Fmagazine\u002Fexercise-stress-ecg-inoca",141,"3m",{"created":330,"updated":331,"published":332},1778115738,1778799792,1778118255,{"id":334,"title":335,"text":336,"image":337,"author":343,"path":345,"readDuration":346,"readDurationFormatted":347,"internal":348},1348,"Hyperlipidemia screening: who, when, & what to measure","Testing for hyperlipidemia can help you mitigate your patients' cardiovascular risk. Learn who to screen and when, which measures to request, and how to stratify risk.",{"alt":338,"title":292,"size":339,"location":341},"Lipid panel blood sample tubes used to test for hyperlipidemia in a laboratory setting",{"width":340,"height":340},600,{"bucket":296,"key":342},"\u002F2026-04\u002FC121_magazine image.png",{"id":299,"title":300,"relativeURL":301,"image":302,"professionLong":303,"profession":344,"weight":306},{"name":305},"\u002Fmagazine\u002Ftest-for-hyperlipidemia",246,"5m",{"created":349,"updated":350,"published":351},1777403036,1777572381,1777412421,{"seo":353,"og":355},{"title":354,"description":213},"Identifying cholestasis on a liver lab panel | Medmastery",{"title":354,"description":213,"image":356},{"alt":292,"title":292,"size":357,"location":360},{"width":358,"height":359},606,364,{"bucket":296,"key":361},"\u002Fmigrated-images\u002F02-Identifying-a-cholestatic-pattern.png",{"id":363,"created":364,"updated":365,"published":364},389,1609344045,1655189586]