FINAL JEOPARDY — WAGER FIRST
A 64-year-old with T2D and BMI 31 has incidental steatosis. AST 68, ALT 54, platelets 115 (×10³/μL), and modest reported alcohol use. They feel well. Estimate FIB-4, identify the risk tier, and write the next TWO actions.
Teams: write one plan in 60 seconds. Your written wager determines the points for this round.
FIB-4 ≈ 5.15 (high risk). Refer promptly to GI/hepatology for advanced-fibrosis evaluation; assess alcohol and alternative liver diseases while initiating cardiometabolic risk reduction. Do not wait for symptoms or repeat ultrasound alone.
Age × AST / (platelets × √ALT) = 64×68 / (115×√54) ≈ 5.15. FIB-4 raises concern; it does not itself diagnose cirrhosis.
Host: Award full credit for the approximate FIB-4, high-risk tier, specialist referral, and appropriate additional management. Add or subtract each team's written wager from its MAIN-GAME score.
Reference: ADA 2026