A 55-year-old man with a 30-year history of heavy alcohol use presents to the emergency department with abdominal distension and hematemesis. On examination, he has ascites, spider angiomas on his chest, and a firm, nontender hepatomegaly. Vital signs show BP 95/60 mmHg and HR 110 bpm. Laboratory studies reveal: AST 240 U/L, ALT 85 U/L, ALP 98 U/L, total bilirubin 4.1 mg/dL, albumin 2.5 g/dL, INR 2.2, and platelet count 98,000/μL. Abdominal ultrasound shows a cirrhotic-appearing liver with nodular contours and portal vein flow reversal. Which of the following findings would be most specific for confirming the diagnosis of hepatic cirrhosis?
- A)AST-to-ALT ratio greater than 2
- B)Presence of ascites, spider angiomas, and coagulopathy
- C)Liver biopsy showing bridging fibrosis with nodular regenerationGABARITO
- D)Abdominal ultrasound demonstrating hepatomegaly with heterogeneous echogenicity and portal vein flow reversal
- E)Elevated total bilirubin and low albumin with prolonged INR
Explicação
Liver biopsy showing bridging fibrosis with nodular regeneration (cirrhosis architecture) is the gold standard and most specific diagnostic test for cirrhosis. It directly visualizes the pathologic hallmark: disruption of normal hepatic architecture with fibro... Ver explicação completa e trilha adaptativa →