Is It a Liver or a Bone?

Sometimes, i've noticed, sometimes patients with chronic, a chronic liver disease, or just like bone mineral disease, are going to have a elevated alkfas for that reason. I might go down checking like vitemind p t ch, sort of that, that kind of work up. And if it's still slightly elevated, i may actually proceed to to write up per quadreant ultra sound se if there's anything there. If that comes back rather unremarkable and it just persists, that i might actually chase down the g g t because at that point, unow, i just don't hae a clear sense of what's going on.