2. ALP greater than AST and ALT → Cholestatic Pattern This pattern points to problems in bile flow or bile ducts. Common causes include: • Biliary obstruction (gallstones, strictures) • Primary Biliary Cholangitis (PBC) • Primary Sclerosing Cholangitis (PSC) Cholestasis leads to elevated ALP, and often bilirubin if the obstruction is significant.