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Nonalcoholic fatty liver disease — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Nonalcoholic fatty liver diseaseUSMLE Step 3

A 52-year-old man with obesity and type 2 diabetes has mildly elevated ALT for 1 year. Hepatitis B and C testing are negative, alcohol use is minimal, and ultrasound shows hepatic steatosis. FIB-4 score is low. Which of the following is the most appropriate next step in management?

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Reveal the answer and explanation

Correct answer: A — Recommend weight loss and metabolic risk-factor management

Low-risk NAFLD is managed with weight loss, diabetes and lipid management, and periodic fibrosis risk assessment.

Reference: AASLD Practice Guidance on NAFLD