Q13. Which is not a paraneoplastic syndrome for Hepatocellular Carcinoma
a) Hypercalcemia
b) Hypoglycemia
c) Erythrocytosis
d) Hyperglycemia
Q14. Which is the most common cause of Hemobilia
a) Blunt Trauma Abdomen
b) Iatrogenic injury
c) Cholelithiasis
d) Hepatic artery aneyrysm
Q15. Which is not true regarding Haemangioendothelioma of liver?
a) It is a rare tumor
b) It is highly vascular
c) It involves both lobes of the liver
d)) In 50% cases it has extrahepatic spread.
Answers
11.c
Key to the management of encephalopathy is identifying and then eliminating whatever precipitating factors are responsible.
Dietary protein should be restricted, infections should be treated, all sedatives should be discontinued, and intestinal catharsis should be accomplished.
Pharmacologic treatment of encephalopathy is indicated for patients with chronic, intermittent symptoms and for those with persistent, acute psychoneurologic disturbances despite elimination of precipitating factors.
The only drugs with proven effectiveness are neomycin, a poorly absorbed antibiotic that suppresses urease containing bacteria, and lactulose, a nonabsorbable disaccharide that acidifies colonic contents and also has a cathartic effect
Unproven therapies for encephalopathy include the enteral or parenteral administration of branched-chain amino acids and the drug flumazenil, a selective antagonist of benzodiazepine receptors
12. c
Hepatitis B and Hepatitis C have known association with cirrhosis and Hepatocellular Carcinoma.
Other significant risk factors are
Chronic alcohol abuse
Smoking
Aflatoxins
Nitrates, NItrites
Haemochromatosis, Wilson, Aplpha 1 Antitrypsin deficiemcy
Throrotrast
Associations with hormonal manipulations such as the use of oral contraceptive agents and anabolic steroids have been suggested but are weak
Sabiston 17th
13. d
Less than 1% of cases of HCC present as a paraneoplastic syndrome, most commonly hypercalcemia, hypoglycemia, and erythrocytosis
14. b
Earlier Blunt Abdominal trauma was the most common cause of Hemobilia. But recently with the advent of more interventional procedures like PTBD (Percutaneous Transhepatic Biliary Drainage), hemobilia has become more common.
15.d
All the above are true except the fourth choice. In one fourth of the cases extrahepatic spread occurs. Death is usually due to liver failure.
