In a patient with cirrhosis, liver function tests typically show which pattern?

• A. Elevated bilirubin and transaminases with decreased albumin and coagulation factors
• B. Decreased bilirubin with normal transaminases
• C. Elevated albumin and increased coagulation factor production
• D. Normal liver enzymes with hypotension

Answer: (A)

In cirrhosis the liver’s ability to process bilirubin and to synthesize proteins is impaired. This shows up as higher bilirubin because the damaged liver can’t conjugate and excrete bilirubin effectively. At the same time, hepatocyte injury releases enzymes like transaminases, so these enzymes are often elevated. The liver’s synthetic function declines, leading to lower albumin and reduced production of clotting factors, which prolongs coagulation times. So the typical lab pattern reflects both hepatocellular injury (elevated bilirubin and transaminases) and decreased synthetic function (low albumin and decreased clotting factors). The other patterns don’t fit because they either ignore the injury signal, imply preserved synthesis, or suggest something unrelated to liver dysfunction.