Question

A 48-year-old man with obesity (BMI 34), type 2 diabetes, ALT 68 U/L, AST 52 U/L, platelets 240 ×10⁹/L, age 48, and ultrasound showing hepatic steatosis is evaluated. His calculated FIB‑4 score is 0.9. What is the most appropriate management strategy now?

Accepted Answer

Manage in primary care with lifestyle intervention targeting ≥7-10% weight loss and repeat FIB‑4 in 1-2 years

Answer

Refer immediately for liver biopsy

Answer

Start vitamin E 800 IU/day regardless of histology

Answer

Order MR elastography now despite low FIB‑4

Answer

Start statin only if ALT normalises

Practice question

A 48-year-old man with obesity (BMI 34), type 2 diabetes, ALT 68 U/L, AST 52 U/L, platelets 240 ×10⁹/L, age 48, and ultrasound showing hepatic steatosis is evaluated. His calculated FIB‑4 score is 0.9. What is the most appropriate management strategy now?