Q) Lymphoma of the head and neck - False statement is A. Hodgkin’s disease is common in the oropharynx. B. Most are of the B-cell type . C. FNAC of neck lymph nodes is now mandatory. D. For disseminated non-Hodgkin’s lymphoma, systemic chemotherapy is preferred.
Q). 45 yr old Known case of diverticular disease, presents with left lower abdominal pain , on CT sigmoid wall thickening with fat stranding. All of the following can be done except a) Admit and iv antibiotic b) Colonoscopy after resolution c) Elective colectomy after resolution d) Out patient oral antibiotic
a) It corelates with cirrhosis b)Range of sodium value is 125-137 c)It relates to vasoconstriction d) Used for allocation in DDLT patients
MELD was originally developed to predict three-month mortality following transjugular intrahepatic portosystemic shunt (TIPS) placement and was derived using data from a population of 231 patients with cirrhosis who underwent elective TIPS placement.
Range of MELD score is 6-40
MELD Score = 10 x (0.957 x Ln(serum creatinine mg/dL) + 0.378 x Ln(serum bilirubin mg/dL) + 1.120 x Ln(INR) + 0.643 )
For candidates with an initial MELD score greater than 11, the MELD score is then re-calculated as follows: MELDNa = MELD(i) + 1.32*(137-Na) - [0.033*MELD(i)*(137-Na)]
Sodium values less than 125 mmol/L will be set to 125, and values greater than 137 mmol/L will be set to 137.
It is used for allocation in DDLT to assess wait list mortality
MELD score has also proved to be an effective predictor of outcome in other situations, such as
Patients with cirrhosis going for surgery and patients with fulminant hepatic failure or alcoholic hepatitis.
The MELD score does have limitations in situations where the INR or creatinine may be elevated due to reasons other than liver disease, and its implementation for organ allocation purposes does not take into consideration several conditions that benefit from liver transplantation.
Q) Smoking cessation- Not a first line drug option ?
b) Nicotine replacement (patches)
Ans A) clonidine
NRT , varenicline (Chantix), and bupropion (Zyban) are the three principal firstline pharmacotherapies recommended for use either alone or in combination
Clonidine and nortriptyline—as second-line pharmacotherapies for tobacco dependence typically used when a smoker cannot use first-line medications due to either contraindications or lack of effectiveness.