‘A couple of beers’ the full story?

He smokes a packet of cigarettes a day and says he has a couple of beers every night to relax.

Clinical examination shows moderate obesity and a palpable liver edge.

The full blood count shows a slightly elevated MCV 106 fL (80–98) and the Biochemistry Profile shows the following abnormalities:


Bilirubin    40 μmol/L    (4–20)
AST 330 U/L (3–40)