6 Weeks Of Unintentional in Medicine / Internal Medicine — 47yo Man | Hepatology | SMLE Q#7936

SMLE Question #7936

Medicine / Internal Medicine Hepatology

Objective: OBJ-HEP-01

Last updated: February 2026
A 47-year-old man with long-standing heavy alcohol use presents with 6 weeks of unintentional weight loss, intermittent low-grade fever, dull right upper quadrant pain, progressive abdominal distension, and early satiety. He is mildly cachectic with scleral icterus, shifting dullness, and firm nodular hepatomegaly without peritonism. Abdominal ultrasound shows a cirrhotic liver with ascites and a solitary focal hepatic lesion. What is the most likely diagnosis?

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