Alcoholic liver disease

A 60-year-old man presents with confusion and lethargy. He has a long history of heavy alcohol use. On examination, he is disoriented and has asterixis. His abdomen is distended with fluid. His observations are: heart rate 88 bpm, respiratory rate 18 breaths per minute, blood pressure 110/70 mmHg, and temperature 37.0C. Laboratory results show elevated ammonia levels, elevated liver enzymes, and low albumin.

What is the most appropriate initial treatment for his condition?

A 52-year-old man presents with increasing fatigue, jaundice, and pruritus. He has a history of heavy alcohol consumption. On examination, he has palmar erythema, spider naevi, and an enlarged, firm liver. His observations are: heart rate 80 bpm, respiratory rate 18 breaths per minute, blood pressure 125/80 mmHg, and temperature 36.7C. Laboratory results show: ALT 90 U/L, AST 180 U/L, total bilirubin 5 mg/dL, and albumin 2.5 g/dL.

Which of the following is the most specific investigation for diagnosing the severity of alcoholic liver disease?

A 60-year-old man with a long history of alcohol use presents with fatigue, jaundice, and abdominal distension. On examination, he has palmar erythema, spider angiomas, and gynecomastia.

Which of the following clinical features is most indicative of cirrhosis in alcoholic liver disease?

A 55-year-old woman with a history of heavy alcohol use presents with abdominal pain, jaundice, and ascites. The clinician orders imaging studies to assess her liver.

Which of the following imaging modalities is most appropriate for evaluating the liver in alcoholic liver disease?

A 48-year-old woman with a history of chronic alcohol abuse presents to the emergency department with severe abdominal pain, nausea, and vomiting. She has noted increasing abdominal girth and swelling of her legs. On examination, she has jaundice, ascites, and peripheral edema. Her observations are: heart rate 95 bpm, respiratory rate 20 breaths per minute, blood pressure 120/75 mmHg, and temperature 37.2C. Laboratory results show elevated liver enzymes, prolonged prothrombin time (PT), and elevated serum ammonia.

Which complication of alcoholic liver disease is most likely responsible for her current symptoms?