Online MCQs in Liver
Q11. Which of the following is not true about shunt encephalopathy?
a) TIPS is associated with 30% risk of encephalopathy in one year.
b) Neomycin and Lactulose have an established role in treating chronic encepahlopathy
c) Flumazenil, a selective antagonist of benzodiazepine receptors has a definite role in management
d) Most of the TIPS encephalopathy can be reversed by Percutaneous techniques.
Key to the management of encephalopathy is identifying and then eliminating whatever precipitating factors are responsible.
All 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
Q12. Which of the following has the weakest association with Hepatocellular Carcinoma (HCC)
a) Hepatitis B
b) Hepatitis C
c) oral contraceptives
Q13. Which is not a paraneoplastic syndrome for Hepatocellular Carcinoma
Q14. Which is the most common cause of Hemobilia
a) Blunt Trauma Abdomen
b) Iatrogenic injury
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.
King's college criteria of Liver Transplantation in Acute Liver Failure
Arterial pH <7.3 (irrespective of the grade of encephalopathy)
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)
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)