Which findings were never followed up?

AKAnna Keller, 47 · Hypertension, prediabetes, LDL 162 mg/dl · 14 documents, read 16 September 2026

Answered on 16 September 2026

Vitamin D 21 ng/ml (May 2026): noted, no supplementation prescribed. Lab 08.05.2026 Visit 12.05.2026
Mild hepatic steatosis (May 2026): no FIB-4, no follow-up interval documented. Ultrasound 12.05.2026 J Hepatol
Fatigue reported today: TSH and blood count from May are normal, ferritin 48 ng/ml is low-normal; sleep of six hours is documented; no further work-up planned. Ambient note 16.09.2026 Lab 08.05.2026
Simvastatin intolerance (March 2024): no rechallenge, no alternative. Visit 14.03.2024
Lipoprotein(a) recommendation (May 2026): discussed, not ordered. Visit 12.05.2026

The first two become today's decisions if you confirm them: vitamin D3 1,000 IU daily, and the FIB-4 from the May values, which is 0.8 (age 47, AST 28, ALT 41, platelets 246), below the 1.3 threshold, so no fibrosis work-up is needed now; repeat in one to three years. Lab 08.05.2026 J Hepatol

Open findingsBuilt from the chart, in the record

Documented more than once, never followed up

Four open items across three years of record
Each with the document that raised it and the step that never followed
Two of them are today's decisions if you confirm them

Every line carries the document it was read from

From the patient record5 of 14 documents

Laboratory report, 8 May 2026Laboratory
Visit note, check-up discussion, 12 May 2026Clinical note
Abdominal ultrasound report, 12 May 2026Imaging
Ambient note of today's consultation (draft, unsigned), 16 September 2026Ambient note
Visit note, simvastatin stopped, 14 March 2024Clinical note

1.EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD).Journal of Hepatology. 2024;81:492-542. European Association for the Study of the Liver, European Association for the Study of Diabetes, European Association for the Study of Obesity.Guideline
SummarySteatotic liver disease with at least one cardiometabolic risk factor is MASLD. In primary care, patients with steatosis or metabolic risk should have non-invasive fibrosis assessment with FIB-4: below 1.3 rules out advanced fibrosis with repeat testing in one to three years; 1.3 or above calls for elastography or referral. Treatment is weight reduction, physical activity and control of the metabolic risk factors.
Source
Issuing body: EASL, EASD, EASO
Published: September 2024
Grading system: GRADE
Scope
Target population: Adults with steatotic liver disease and metabolic risk factors
Scope: Case finding, fibrosis assessment, management

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1Which of our patients meet a criterion in their record without the step that follows?2Which preventive care is due for her?3Draft a patient plan from today's decision

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Anna Keller, 47Mosaic