Non-alcoholic fatty liver disease in children — structured clinical encounter

Station brief (candidate)

You are the paediatric registrar in a general paediatric clinic. An eleven-year-old boy is reviewed at a routine visit. His body mass index is on the ninety-second percentile. He drinks two cans of sugar-sweetened soft drink a day, plays no organised sport, and spends most evenings on a screen. His alanine aminotransferase is 34 units per litre, and the laboratory reports its normal range as up to 55 units per litre. His father has type 2 diabetes. The team asks you to interpret the result, state the relevant thresholds, outline the confirmation and exclusion pathway, and deliver the management and family-counselling plan. You have twelve minutes with the team and five minutes for examiner discussion. ^[1]