Ischemic Heart Disease in Medicine / Internal Medicine — 50yo Man | Hepatology | SMLE Q#17655
SMLE Question #17655
Medicine / Internal Medicine
Hepatology
Objective: OBJ-HEP-ICU-004
Last updated: February 2026
A 50-year-old man with ischemic heart disease and type 2 diabetes is in the ICU for severe community-acquired pneumonia on broad-spectrum antibiotics. On ICU day 3, he develops septic shock requiring IV fluids and norepinephrine. Liver tests were normal on admission but become markedly abnormal within 12 hours of the shock episode. Abdominal ultrasound shows a normal biliary tree without gallstones or bile duct dilation. What is the most likely diagnosis?
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