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NAFLD/MASLD — MRCP Part 1 MCQ

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HardGastroenterologyNAFLD/MASLDMRCP Part 1

A patient with metabolic risk factors has ultrasound-confirmed fatty liver. ALT is mildly raised. What first-line non-invasive test should assess advanced fibrosis risk?

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Correct answer: B — Use the enhanced liver fibrosis blood test

The best answer is “Use the enhanced liver fibrosis blood test”. Routine liver enzymes and ultrasound cannot reliably stage fibrosis in NAFLD. NICE recommends the enhanced liver fibrosis test first-line, with repeat testing or specialist referral according to the result. Biopsy is selective rather than universal, while metabolic risk reduction proceeds regardless of ALT.

Reference: NICE NG49: Non-alcoholic fatty liver disease: https://www.nice.org.uk/guidance/ng49/chapter/Recommendations