A 45-Year-Old Woman Is Noted to Have Abnormal Liver Chemistries

question 1646

Multiple Choice

A 45-year-old woman is noted to have abnormal liver chemistries.  She has no symptoms.  The patient has hypercholesterolemia and her only medication is a statin.  She lives with her husband and 3 children and works in a grocery store.  Temperature is 37 C (98.6 F) , blood pressure is 118/72 mm Hg, pulse is 68/min, and respirations are 12/min.  BMI is 25 kg/m².  Physical examination reveals no abnormalities.  Laboratory results are as follows: Right upper quadrant ultrasonogram shows no abnormalities.  After confirmation of the diagnosis, which of the following is the best next step in management of this patient?

• A)Discontinue statin and repeat testing
• B)Measure serum alpha-fetoprotein level
• C)Refer for liver transplantation
• D)Start glucocorticoids
• E)Start ursodeoxycholic acid

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