20th April 2024

A 34-year-old gentleman presents with acute onset of general malaise, nausea and anorexia

A 34-year-old gentleman presents with acute onset of general malaise, nausea and anorexia. On examination, he is visibly jaundiced and is noted to have tender hepatomegaly. He has no past history of liver disease but does report drinking 6 pints of beer/day for the past 10+ years. Blood tests show Hb 94, MCV 104, Platelets 110 and AST 100. INR is 1.9, bilirubin and PT are raised and Maddrey’s discriminant function is calculated at 40.8.

Which of the following is NOT an important initial aspect of this gentleman’s management?

Select the SINGLE most appropriate option from the list below. Select ONE option only.