Caudate lobe anatomy

Posted on

Q) Caudate anatomy, false is :

a) Bile duct supply is by both right  and left hepatic duct

b) Paracaval portion is segment IX

c) Mainly venous drainage to middle and left hepatic vein

4)

Alveolar Hydatid disease

Posted on

Q45)  All are true for alveolar hydatid disease except?

1) Caused by E. Multilocularis

2) Common in liver

Meld score uses and drawbacks

Posted on

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

Posted on

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

Posted on

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