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Medicine

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Liver & GIT

Question
8 out of 10
 

Child Pugh classification is based on all the parameter except?(PNQ)



A S. bilirubin
B S. albumin

C PT
D SGOT, SGPT

Ans. D SGOT, SGPT.

Child pugh classfication of cirrhosis (To assess severity of Cirrhosis is based on)

Factor (Ref. Hari-18thed., Pg- 2526)

1. S.Bilirubin (mg%)

2. S.Albumin (g%)

3. Ascites

4. Neurological disorder

5. PT/INR

Recent Advances: (Ref. Hari-18th ed., Pg. 2526)

1. Recently the Child-Pugh system has been replaced by the model for end-stage liver disease (MELD) score for assessing the need for liver transplantation.

2. The MELD score is a prospectively derived scoring system designed to predict prognosis of patients with liver disease and portal hypertension.

3. c. It is calculated using three noninvasive variables— a. PT (INR) b. Serum bilirubin, c. Serum creatinine

Important Points:

Summary of Clinical Features of Hepatic Failure (Ref. Hari-17th ed. Pg. 1920)

Regardless of the cause, the clinical signs of hepatic failure are much the same

Jaundice

Its an almost invariable finding

Hypoalbuminemia

Predisposes to peripheral edema

Hyper ammonemia

Plays a role in cerebral dysfunction

Fetor hepaticus

Characteristic musty or sweet and sour body odour (caused due to production of mercaptans by the action of gastrointestinal bacteria on the sulfur containing amino acids methionine)

Palmar erythema,

Spider angiomas

Caused due to impaired estrogen metabolism (AIPG 09)

Hypogonadism

Gynecomastia

Caused due to hyperestrogenemia

Susceptibility to failure of multiple organ system

Respiratory failure with pneumonia and sepsis may combine with renal failure

Coagulopathy

Attributed to impaired hepatic synthesis of blood clotting factors II, VII, IX and X. The resultant bleeding tendency leads to massive GIT hemorrhage.

Hepatic encephalopathy

- Regarded as a disorder of neurotransmission in the CNS and neuromuscular system and appears to be elevated with blood ammonia level which impair neuronal function and promote generalized edema.

- It is associated with only minor morphologic changes in the brain and encephalopathy is reversible if underlying hepatic condition can be corrected.

Hepatorenal syndrome

Appearance of renal failure in patients with severe chronic liver disease, in whom there are no intrinsic morphological or functional causes of renal failure.

Liver & GIT Flashcard List

10 flashcards