Which test should be ordered to confirm the level of jaundice in suspected cirrhosis?

Which test should be ordered to confirm the level of jaundice in suspected cirrhosis?

• A. Alkaline phosphatase
• B. Serum bilirubin
• C. Alanine aminotransferase (ALT)
• D. Prothrombin time (PT)

Answer: (B)

Jaundice shows up when bilirubin builds up in the blood, so the easiest and most direct way to confirm and gauge its level is to measure serum bilirubin. In cirrhosis, the liver struggles to take up, conjugate, and excrete bilirubin, leading to elevated bilirubin that corresponds to how yellow the skin and eyes appear. Other tests hint at liver injury or function—alkaline phosphatase can rise with bile duct issues, ALT with hepatocellular damage, and prothrombin time with reduced synthetic capacity—but they don’t quantify the pigment causing jaundice as directly as bilirubin does. Measuring serum bilirubin provides the actual level of this pigment and the degree of jaundice.

Jaundice shows up when bilirubin builds up in the blood, so the easiest and most direct way to confirm and gauge its level is to measure serum bilirubin. In cirrhosis, the liver struggles to take up, conjugate, and excrete bilirubin, leading to elevated bilirubin that corresponds to how yellow the skin and eyes appear. Other tests hint at liver injury or function—alkaline phosphatase can rise with bile duct issues, ALT with hepatocellular damage, and prothrombin time with reduced synthetic capacity—but they don’t quantify the pigment causing jaundice as directly as bilirubin does. Measuring serum bilirubin provides the actual level of this pigment and the degree of jaundice.