A 52-year-old with metabolic dysfunction-associated steatotic liver disease has FIB-4 2.9, platelets 142 × 10^9/L and preserved synthetic function.

Question

A 52-year-old with metabolic dysfunction-associated steatotic liver disease has FIB-4 2.9, platelets 142 × 10^9/L and preserved synthetic function. Ultrasound shows steatosis without nodularity. What is the best interpretation and next investigation?

Accepted Answer

Treat as high fibrosis risk and arrange liver elastography

Answer

Repeat FIB-4 in ten years without second-line fibrosis assessment

Answer

Commence hepatocellular-carcinoma treatment because FIB-4 exceeds 2.67

Answer

Exclude clinically important fibrosis because albumin and INR remain normal

Answer

Diagnose cirrhosis from FIB-4 alone and commence variceal primary prophylaxis

Perioperative Cardiac Risk — RACP Adult Medicine MCQ

A 52-year-old with metabolic dysfunction-associated steatotic liver disease has FIB-4 2.9, platelets 142 × 10^9/L and preserved synthetic function. Ultrasound shows steatosis without nodularity. What is the best interpretation and next investigation?