In hepatic disease, which laboratory change would indicate impaired liver synthetic function?

In hepatic disease, which laboratory change would indicate impaired liver synthetic function?

• A. Decreased bilirubin
• B. Prolonged prothrombin time
• C. Increased hemoglobin
• D. Decreased creatinine

Answer: (B)

Impaired liver synthetic function shows up as a prolonged prothrombin time because the liver manufactures many clotting factors required for normal blood clotting. When hepatocytes aren’t functioning well, factors II, VII, IX, and X decrease, lengthening the time the blood takes to clot. PT (often reported as INR) directly reflects this synthetic capacity and is a sensitive indicator of liver dysfunction and bleeding risk. Bilirubin is tied to the liver’s ability to conjugate and excrete bile; in liver disease bilirubin often rises rather than falls, so a decrease wouldn’t signal impaired synthesis. Hemoglobin measures red blood cells, not liver protein production. Creatinine reflects kidney function, not liver synthetic output.

Impaired liver synthetic function shows up as a prolonged prothrombin time because the liver manufactures many clotting factors required for normal blood clotting. When hepatocytes aren’t functioning well, factors II, VII, IX, and X decrease, lengthening the time the blood takes to clot. PT (often reported as INR) directly reflects this synthetic capacity and is a sensitive indicator of liver dysfunction and bleeding risk.

Bilirubin is tied to the liver’s ability to conjugate and excrete bile; in liver disease bilirubin often rises rather than falls, so a decrease wouldn’t signal impaired synthesis. Hemoglobin measures red blood cells, not liver protein production. Creatinine reflects kidney function, not liver synthetic output.