Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
Answer b.
The patient has a history consistent with nonalcoholic steatohepatitis (NASH). A population-based study in the United States showed that patients with NASH had a slightly lower survival rate than expected for the general population (standard mortality ratio of 1.34).
In patients with NASH, the progression to cirrhosis over a 7-year period is 8% to 26% (compared with 38%-50% in alcoholic hepatitis over a similar period)
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
i think u cant diagnose NAFLD with out biopsy......
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
Maybe NASH is strictly a 'clinical' diagnosis....biopsy might be used to see how severe it is?
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
THIS IS FROM HARRISON 17 EDITION------The diagnosis of NAFLD requires a careful history to determine the amount of alcohol used. Most investigators in the field of fatty liver disease require that
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
The diagnosis of NAFLD requires a careful history to determine the amount of alcohol used. Most investigators in the field of fatty liver disease require that
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
COULD NOT POST IT......IT SAYS LIVER BIOPSY WILL PROVIDE ULTIMATE DIAGNOSIS...30 T O 40 PERCENT DEVELOP ADVANCE FIBROSIS,WITH CIRRHOSIS IDENTIFIES IN 10 TO 15 PERCENT INDIVIDUAL.(HARRI--17 EDITION-CHAP 303)
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
THANKS pusuitof 99 and everyone, please read the last sentence:
The patient wants to know more about the significance of the increased laboratory values.
Based on history, we know what is wrong with the patient: NASH, everyone got it right, if we are ask about what is the best test for confirmation, liver biopsy is the answer but based on the lab value and history, we can go with answer B.
Nonalcoholic fatty liver disease (NAFLD) is a common cause of abnormal levels of liver enzymes. A subset of NAFLD is nonalcoholic steatohepatitis (NASH), which is characterized histologically by fatty
change and inflammation. Characteristically, patients with NAFLD have at least 1 of the following risk factors: obesity, hyperlipidemia, and diabetes. The aminotransferase levels are mildly abnormal, and the alkaline phosphatase level is increased in about one-third of patients.
..