Question

A 46-year-old man with a long history of heavy alcohol consumption presents with jaundice, right upper quadrant pain and malaise. Blood tests show ALT 80 units per litre, AST 250 units per litre, bilirubin 140 micromol per litre, prolonged prothrombin time and leucocytosis. He is confused with flapping tremor. What is the most appropriate immediate management priority?

Accepted Answer

Admit urgently, treat as acute severe alcoholic hepatitis and manage complications

Answer

Start high-dose Prednisolone in the community

Answer

Urgent referral for liver transplant assessment only

Answer

Start long-term Propranolol for portal hypertension

Answer

Arrange routine outpatient hepatology review

Practice question