Can you answer the questions about this case ahead of joining Prof Sanyal's session?
Mrs. A.B., a 55-year-old woman of South Asian descent, presents for a routine check-up. She denies any current complaints and reports feeling well overall. Her past medical history is significant for well-controlled type 2 diabetes mellitus (T2DM) managed with metformin, and hypertension managed with lisinopril. She leads a sedentary lifestyle and admits to a diet high in processed foods and sugary drinks. Her family history is positive for cardiovascular disease.
On examination, Mrs. A.B. is overweight with a BMI of 28 kg/m². Vital signs are normal. A routine blood panel reveals mildly elevated liver enzymes (ALT and AST) with normal bilirubin levels.
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Patient needs additional tests (liver ultrasound, fibroscan, CT scan abdomen, others) to rule out this diagnosis or others
Patient needs additional tests (liver ultrasound, fibroscan, CT scan abdomen, others) to rule out this diagnosis or others
Mrs. A.B has medical history of Type 2 diabetes and high levels of liver enzymes. She probably has MASH
Mrs. A.B has medical history of Type 2 diabetes and high levels of liver enzymes. She probably has MASH
This patient has MASLD, but with history of DM, overweight, HTN, and elevated transaminases it is suggestive of progression to MASH
This patient has MASLD, but with history of DM, overweight, HTN, and elevated transaminases it is suggestive of progression to MASH
ALT
ALT
Mash
Mash
Need a little more info
Yes
Need a little more info
Yes
Based on the diagnostic criteria and guidelines for MASH, would you diagnose Mrs. A.B. with MASH? If so, what would be your next steps in terms of management and further investigation?
Based on the diagnostic criteria and guidelines for MASH, would you diagnose Mrs. A.B. with MASH? If so, what would be your next steps in terms of management and further investigation?
How would you interpret the results of these tests in the context of Mrs. A.B.'s overall clinical picture and demographic profile?
How would you interpret the results of these tests in the context of Mrs. A.B.'s overall clinical picture and demographic profile?
What additional non-invasive tests and biomarkers would you consider ordering to assess the likelihood of MASH and to rule out other diagnoses?
What additional non-invasive tests and biomarkers would you consider ordering to assess the likelihood of MASH and to rule out other diagnoses?
Which specific risk factors and laboratory findings raise the suspicion of MASH in this case?
Which specific risk factors and laboratory findings raise the suspicion of MASH in this case?
Given Mrs. A.B.'s presentation, what is your initial differential diagnosis?
Given Mrs. A.B.'s presentation, what is your initial differential diagnosis?