Acute Liver Failure and Complications of Cirrhosis is part of the Hepatobiliary System section of Medicine. Practise 55 exam-style MCQs for NEET PG, FMGE, INI-CET and NEET SS, each with the correct answer and a detailed explanation.
From paracetamol-induced failure and transplant thresholds to spontaneous bacterial peritonitis diagnosis, cefotaxime timing and Child-Pugh staging, these Acute Liver Failure and Complications of Cirrhosis MCQs drill decompensation decisions — high-yield NEET PG material for INI-CET and FMGE.
Although any portion of the gastrointestinal tract may be affected, the terminal ileum and the cecum are the sites most commonly involved in gastrointestinal TB Reference : Harrison's Principles of Internal Medicine, 21 st Ed, Ch: 178, Pg: 1366
Lactic acidosis is due to decreased hepatic lactate clearance,compounded by poor peripheral perfusion and increased lactate Use of intravenous N-acetylcysteine reduces morbidity and mortality in fulminant hepatic failure. Severe hypoglycemia affects 40% of patients with fulminant liverfailure, which exacerbates encephalopathy. Reference: Harrison 20 th pg. 2370
Prothrombin time > 100 seconds in acute liver failure with paracetamol poisoning is one of the selection criteria for liver transplantation. The remainder of the selection criteria for liver transplantation in acute liver failure with paracetamol overdose are as follows: Arterial pH Creatinine > 2.5 mg/dL Grade III or grade IV encephalopathy. Serum bilirubin > 15 mg/dl is part of the selection criteria for liver transplantation in non-paracetamol induced acute liver failure. Reference : Harrison's Principles of Internal Medicine, 21 st ed, Ch: 340, Pg: 2589
A white cell count of > 250/mm 3 is diagnostic of spontaneous bacterial peritonitis. There is underlying cirrhotic liver disease and this should always be considered related to decompensation. Tuberculous peritonitis will cause lymphocyte predominant ascites with high protein and low glucose. Reference : Harrison's Principles of Internal Medicine, 21 st ed, Ch: 344 Pg: 2632
Child Pugh classification includes: (Mnemonic: A BEAP) A lbumin B ilirubin level E ncephalopathy A scites P rothrombin time AST is not used to assess severity of liver disease. Reference : Harrison's Principles of Internal Medicine, 21 st ed, Ch:345 Pg: 2635
Four of the five hepatic porphyrias present during adult life: acute intermittent porphyria (AIP) hereditary coproporphyria(HCP) variegate porphyria (VP) ALA-dehydratase porphyria (ADP) acute attacks of neurologic manifestations and elevated levels of one or both of the porphyrin precursors, ALA and PBG, and are thus classified as acute porphyrias. Patients with ADP have also presented in infancy and adolescence. Reference: Harrison's principles of internal medicine 20 th Edition, chapter. 409, page number.2989
There is a high chance of spontaneous bacterial peritonitis in this patient with cirrhotic liver disease. When analysis of ascitic fluid reveals a white blood cell count of more than 250 cells/cc, SBP is likely. Cefotaxime should be commenced after a tap is done and blood cultures are sent. Reference : Harrison's Principles of Internal Medicine 21 st ed, Ch: 344 Pg: 2632
This patient has features of chronic liver disease, as evidenced by the presence of ascites and spider angiomas. The patient also gives history of jaundice with deranged SGPT , which indicates an active hepatitis. Acute infection with Hepatitis E or C will cause SGPT elevation of the order of 1000. So from among the options the most probable option is HCC. The risk of HCC is increased as well in patients with chronic hepatitis C almost exclusively in patients with cirrhosis, and almost after at least several decades, usually after three decades of disease. Among such cirrhotic patients with chronic hepatitis C, the annual risk of HCC is ~1-4%. 30% of patients with hepatitis C develop hepatocellular carcinoma over 30 years. 20% develop cirrhosis over 20 years. Reference : Harrison's Principles of Internal Medicine, 21 st Ed, Ch: 82, Pg: 643
From paracetamol-induced failure and transplant thresholds to spontaneous bacterial peritonitis diagnosis, cefotaxime timing and Child-Pugh staging, these Acute Liver Failure and Complications of Cirrhosis MCQs drill decompensation decisions — high-yield NEET PG material for INI-CET and FMGE.
MedLadder includes 55 curated MCQs for Acute Liver Failure and Complications of Cirrhosis under Medicine (Hepatobiliary System), covering NEET PG, FMGE, INI-CET and NEET SS preparation.
