Rosh Internal Medicine Boost Practice Exam

In the management of a patient with a history of hepatic cirrhosis, which option is vital for screening?

1. Hepatitis screening

2. Annual abdominal ultrasound

3. Liver function tests every 6 months

4. Regular EKGs

The correct answer is: Annual abdominal ultrasound

In the management of patients with a history of hepatic cirrhosis, annual abdominal ultrasound is vital for screening primarily due to the increased risk of hepatocellular carcinoma (HCC) in this population. Patients with cirrhosis are at a significantly higher risk for developing liver cancer, and regular imaging assessments allow for early detection of any malignancies, which is crucial for improving outcomes. Surveillance with abdominal ultrasound is recommended every six months for patients with cirrhosis, as it helps identify liver lesions at a stage when they may still be amenable to curative treatment options, such as surgical resection or liver transplantation. While hepatitis screening is important in the context of managing liver disease and liver function tests are critical for monitoring liver health, they do not specifically address the risk of liver cancer associated with cirrhosis. Similarly, regular EKGs are not relevant for screening in the context of cirrhosis unless there is a specific cardiovascular concern. Thus, annual abdominal ultrasound stands out as the most essential tool in the proactive management of patients with hepatic cirrhosis.