A 40-Year-Old Female Presented to the Physician for Evaluation of Worsening

A 40-year-old female presented to the physician for evaluation of worsening fatigue.  She has no other medical problems.  She does not use tobacco, alcohol or drugs.  Vital signs are within normal limits.  Physical examination is within normal limits.  Laboratory evaluation shows an alkaline phosphatase level of 180 U/L.  Which of the following should be checked next?

A) Unconjugated bilirubin level
B) Lactate dehydrogenase level
C) Serum ammonia levels
D) Prothrombin time
E) γ-glutamyl transpeptidase
F) Aspartate aminotransferase

Correct Answer:

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