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Medicine

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Liver & GIT

Question
8 out of 10
 

Following liver transplantation, recurrence of primary disease in the liver most likely occuresin : (AIIMS Nov. 08)



A Wilson disease

B Autoimmune hepatitis

C Alpha - I antitrypsin deficiency

D Primary biliary cirrhosis

Ans. B Autoimmune hepatitis

End Stage Liver Disease

i. The Model for End-Stage Liver Disease (MELD) score.

ii. The MELD score is based upon a mathematical model that includes

a. Bilirubin b. Creatinine c. Prothrombin time expressed as international normalized ratio (INR).

PELD score (Pediatric End-Stage Liver Disease) (Younger than 12)

a. Age b. Serum Bilirubin c. Albumin d. INR

Table 304-1 Indications for Liver Transplantation (Ref. H-18th ,Table-310.1, Pg 2607)

Children

Adults

Biliary atresia

Primary biliary cirrhosis

Neonatal hepatitis

Secondary biliary cirrhosis

Congenital hepatic fibrosis

Primary sclerosing cholangitis

Alagille's disease

Autoimmune hepatitis (Recurrence common)

Byler's disease

Caroli's disease

alpha 1-Antitrypsin deficiency

Cryptogenic cirrhosis

Inherited disorders of metabolism

Chronic hepatitis with cirrhosis

Wilson's disease

Hepatic vein thrombosis

Tyrosinemia

Fulminant hepatitis

Glycogen storage diseases

Alcoholic cirrhosis

Lysosomal storage diseases

Chronic viral hepatitis

Protoporphyria

Primary hepatocellular malignancies

Crigler-Najjar disease type I

Hepatic adenomas

Familial hypercholesterolemia

Nonalcoholic steatohepatitis

Primary hyperoxaluria type I

Familial amyloid polyneuropathy

Hemophilia

Extra Edge:

Rapamycin, an inhibitor of later events in T cell activation, is approved for use in kidney transplantation but is not used for use in liver transplant recipients because of the association with an increased frequency of hepatic artery thrombosis in the first month posttransplantation.

Extra Edge:

1. Focal nodular hyperplasia

i. Occurs at all ages and is not caused by oral contraceptives.

ii. It is often asymptomatic and appears as a hypervascular mass, often with a central hypodense “stellate” scar on CT scan or MRI.

iii. It is not a true neoplasm but a nonspecific reaction to altered blood flow is associated with an elevated angiopoietin 1/angiopoietin 2 mRNA ratio and may also occur in patients with cirrhosis, with exposure to certain drugs such as azathioprine, and in antiphospholipid syndrome.

2. Hepatic adenoma occurs most commonly in the third and fourth decades of life and is usually caused by oral contraceptives.

Liver & GIT Flashcard List

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