AST/ALT > 2 is seen in deficiency of
**Question:** AST/ALT > 2 is seen in deficiency of
A. Cytosine Arabinoside
B. Riboflavin
C. Coenzyme Q10
D. Vitamin D
**Correct Answer:** B. Riboflavin
**Core Concept:** AST/ALT is an acronym for Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST). Both enzymes are part of the liver enzymes family, which help in the process of protein synthesis and energy production within the liver cells.
**Why the Correct Answer is Right:** AST/ALT level greater than 2 is indicative of liver cell damage or dysfunction, as these enzymes are released into the bloodstream when liver cells are damaged or inflamed. Among the provided options, Riboflavin (Vitamin B2) deficiency is a rare condition that can lead to elevated AST/ALT levels.
**Why Each Wrong Option is Incorrect:**
A. Cytosine Arabinoside: It is an antineoplastic agent used in cancer therapy, and elevated AST/ALT levels due to its usage are not related to deficiency.
C. Coenzyme Q10: This is a cofactor involved in cellular respiration and does not directly affect liver enzymes. Elevated AST/ALT levels due to its deficiency are not expected.
D. Vitamin D: Although Vitamin D deficiency can lead to secondary hyperparathyroidism, elevated AST/ALT levels due to its deficiency are not commonly associated.
**Clinical Pearl:** Elevated AST/ALT levels should raise a suspicion for alcohol abuse or viral hepatitis in most cases. However, understanding the role of Riboflavin in liver function and its link to AST/ALT levels can help differentiate between these etiologies and guide further investigation and management strategies.
In conclusion, understanding the role of Riboflavin in liver function and its link to AST/ALT levels can help differentiate between various causes of elevated liver enzymes and guide further investigation and management strategies.