Question

A 50-year-old woman with a BMI of 31 kg/m² has persistently mildly elevated liver enzymes and ultrasound evidence of hepatic steatosis. She is Métis and lives in a rural community with limited access to specialist services. She has type 2 diabetes and dyslipidaemia. Viral hepatitis serology is negative. What is the most appropriate initial management approach?

Accepted Answer

Advise weight loss, glycaemic and lipid control, and address social determinants of health including access to nutritious food and safe physical activity spaces, with monitoring of liver function.

Answer

Reassure her that fatty liver is benign and needs no follow-up.

Answer

Start systemic corticosteroids.

Answer

Arrange immediate liver transplantation assessment.

Answer

Avoid any discussion of her cultural identity and focus solely on laboratory values.

Practice question