Final answer:
For an obese patient with transaminitis and a negative hep panel, it's appropriate to consider ordering Liver Function Tests (LFTs) and a Complete Blood Count (CBC) alongside an abdominal ultrasound. These tests are less invasive and can provide valuable information on liver health and potential gallbladder or pancreatic issues.
Step-by-step explanation:
In evaluating a patient who is obese and has transaminitis with a negative hepatitis panel and is asymptomatic, additional testing should be considered to further assess the liver function and to rule out conditions such as gallbladder disease and pancreatitis. An abdominal ultrasound is already being ordered, which is appropriate for visualizing gallstones and other abnormalities within the intra-abdominal organs. Moreover, the following tests can provide valuable information:
- Liver function tests (LFTs): This group of tests includes levels of enzymes such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST), which could indicate liver cell damage if elevated.
- Complete blood count (CBC): A CBC can reveal infections by showing elevated levels of white blood cells and other anomalies in blood cell counts.
- Tests for amylase or lipase levels: To assess for possible pancreatic inflammation indicated by these enzyme levels.
While a liver biopsy and magnetic resonance imaging (MRI) can provide detailed information, they might not be indicated at this stage without further signs of specific liver diseases or abnormalities detected through initial testing. Therefore, initially opting for less invasive tests like LFTs and CBC is a logical and prudent approach.