Welcome to questions on Liver Injury and Hepatic System
Q16. Not a predictive factor in suggesting failure of non operative treatment in liver injuries
a) Higher grade of injury
b) Head Injury
c) Cirrhosis
d) Multiple blood transfusions

Q12. Which of the following has the weakest association with Hepatocellular Carcinoma (HCC)

a) Hepatitis B
b) Hepatitis C
c) oral contraceptives
d) Smoking
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

16.b
There is some evidence that patients with a high Injury Severity Score, severe liver injuries (grade IV-V), multiple transfusions, or associated chronic liver disease, such as cirrhosis, have an increased risk of failure of nonoperative management. The presence of associated severe head trauma initially was thought to be a relative contraindication for nonoperative management, but subsequent studies failed to confirm this


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King's college criteria of Liver Transplantation in Acute Liver Failure

Acetaminophen-induced disease

Arterial pH <7.3 (irrespective of the grade of encephalopathy)


or


Grade III or IV encephalopathy, and

Prothrombin time >100 seconds, and

Serum creatinine >3.4mg/dl (301 ?mol/L)


All other causes of fulminant hepatic failure


Prothrombin time >100 seconds (irrespective of the grade of encephalopathy)


or


Any three of the following variables (irrespective of the grade of encephalopathy)

Age <10 years or >40 years

Etiology: non-A, non-B hepatitis, halothane hepatitis, idiosyncratic drug reactions

Duration of jaundice before onset of encephalopathy >7 days

Prothrombin time >50 seconds

Serum bilirrubin >18 mg/dl (308 ?mol/L)