A 62-year-old woman with long standing history of pruritis and fatigue presented to the clinic with a 2-months history of jaundice and abdominal swelling. On examination, scratch m... A 62-year-old woman with long standing history of pruritis and fatigue presented to the clinic with a 2-months history of jaundice and abdominal swelling. On examination, scratch marks seen. She was jaundiced with clubbing of her fingers. Abdominal examination revealed splenomegaly with ascites (see lab results and report). US Abdomen: Showed coarse liver with 3 cm focal lesion at rt lobe. Which of the following is the most appropriate next step? A. Alpha-fetoprotein B. Biopsy for the lesion C. Doppler ultrasound of liver D. Triphasic CT scan of the abdomen
Understand the Problem
The question is a clinical case scenario about a 62-year-old woman with various symptoms and lab results. Based on that information, we need to determine the most appropriate next diagnostic step.
Answer
The answer is D. Triphasic CT scan of the abdomen
The most appropriate next step is a Triphasic CT scan of the abdomen. Thus, the answer is D.
Answer for screen readers
The most appropriate next step is a Triphasic CT scan of the abdomen. Thus, the answer is D.
More Information
The patient's symptoms (jaundice, abdominal swelling, splenomegaly, ascites) and lab results (elevated alkaline phosphatase, ALT, and AST) suggest a liver issue. The ultrasound reveals a coarse liver with a focal lesion. A triphasic CT scan is useful for characterizing focal liver lesions.
Tips
Be aware of the normal lab values to identify abnormalities.
Sources
- Common Characteristics of Liver Disease | Johns Hopkins Medicine - hopkinsmedicine.org
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