Question

A 67-year-old with long-standing T2DM and obesity has ultrasound-confirmed hepatic steatosis. FIB-4 is 2.1 (age 67, AST 55, ALT 60, platelets 150k). What is the next best step?

Accepted Answer

Refer for noninvasive fibrosis assessment (e.g., elastography) or hepatology

Answer

Reassure; repeat FIB-4 in 2 years

Answer

Start vitamin E 800 IU/day

Answer

Start UDCA

Answer

Liver biopsy immediately in all patients

Practice question

A 67-year-old with long-standing T2DM and obesity has ultrasound-confirmed hepatic steatosis. FIB-4 is 2.1 (age 67, AST 55, ALT 60, platelets 150k). What is the next best step?