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BOF: 63

 A 54 year old female presents with a history of right upper abdominal pain of several months duration. There is no significant past medical history. She admits to consuming 16 units of alcohol per week.

On examination she is obese and her blood pressure is 160 /90. Her liver is enlarged 4 finger breadths.

Investigations

Hb 14.6 g /dL

WBC 7.3 x10⁹/L

Platelets 350 x10⁹/L

ALT 78 U/L

Alkaline phosphatase 184 U/L

Bilirubin 15 µmol/L

Blood glucose 14 mmol/L

Serum cholesterol 7.5 mmol/L

Triglyceride 4.4 mmol/L

Ferritin 380 µg\L

Serum iron 18 µmol/L

Serum iron binding capacity 58µmol/L

Anti SMA negative

AMA negative

Hep Bs Ag neg

Hep C antibody neg

In this patient which one of the following interventions would be of most benefit to this patient?

a)      Weight reduction

b)      Treatment with steroids

c)      Venesection

d)     Immunosuppression  

e)      Insulin therapy

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