Alveolar Hydatid disease

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Q45)  All are true for alveolar hydatid disease except?

1) Caused by E. Multilocularis

2) Common in liver

Meld score uses and drawbacks

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Q. All are true about Na-MELD except :

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

Ans c

 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

  1. Patients with cirrhosis going for surgery and patients with fulminant hepatic failure or alcoholic hepatitis.
  2. 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.

ICG retention liver

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Q) Regarding  ICG clearance rate . Which is false..
a) It assess total  liver function

b) Heterogenous uptake in liver may lead to false negative result
c) Measures blood supply 
d) ICG clearance Measured non invasively via spectrophotometry

Small for Size Syndrome

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Q) Which of the following is  not done in small for size syndrome in liver transplant
a) Splenectomy
b) Hemi porto caval shunt


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Q) Normal value of HPVG
a) 2-3mmHg
b) 6-8
c) 10-15
d) 16-20

Variceal Bleed

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Q.  Esophagus varices treatment. All are true except (NEET GI 2019) 

a) Sclerotherapy is preferred over banding
b) 3 mm conservative treatment  beta blockers

c) Sclerotherapy and not  Band ligation  increase portal pressure

d) Vasactive drugs should be started early