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Surgery
A 73-year-old woman is evaluated for obstructive jaundice after an injury to the CBD, 7 months previously at laparoscopic cholecystectomy. The alkaline phosphatase is elevated. In obstructive jaundice, which of the following statements is true regarding alkaline phosphatase?
Its level increases before that of bilirubin.
Its level is unlikely to be increased in pancreatic malignancy.
Its elevation indicates bone metastasis.
Its elevation excludes hepatic metastasis.
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