An 11-year-old girl becomes infected with hepatitis A and experiences mild nausea for 1 week. On physical examination, she has minimal right upper quadrant tenderness and scleral icterus. Laboratory findings include a serum AST of 68 U/L, ALT of 75 U/L, and total bilirubin of 5.1 mg/dL. Her laboratory findings most likely result from which of the following changes in her hepatocytes?
High-Yield Explanation
Irreversible cell injury is associated with loss of membrane integrity. This allows intracellular enzymes such as AST and ALT to leak into the serum. All other morphologic changes listed are associated with reversible cell injury, in which the cell membrane remains intact and the cells do not die.