Test your medicine knowledge: 55-year-old man with elevated liver enzymes

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated during a routine examination. He feels well other than mild knee pain. He drinks six to eight cans of beer per night. He has no personal history of liver disease, but his older brother was recently diagnosed with hereditary hemochromatosis. On physical examination, vital signs are normal; BMI is 24. He is tanned on sun-exposed body surfaces. Cardiac examination is normal. Abdominal examination reveals hepatomegaly. Bilateral bony hypertrophy of the knees is noted. Laboratory studies: Alanine aminotransferase 70 U/L Aspartate aminotransferase 160 U/L Ferritin 592 ng/mL (592 µg/L) Transferrin saturation 40% Genetic testing for hemochromatosis reveals heterozygosity for C282Y. Abdominal ultrasound reveals a change in liver echotexture consistent with fatty changes. Which of the following is the most appropriate treatment? A: Administer deferoxamine B: Perform phlebotomy C: Repeat serum iron tests now D: Stop alcohol intake Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions GI Source Type: blogs