Portal Hypertension MCQs

Conjunctival injection mainly affects the posterior conjunctival blood vessels. Because these vessels are more superficial than the ciliary arteries, they produce more redness, move with the conjunctiva, and constrict with the application of topical vasoconstrictors. Reference: Robbins, 10 th edition Page number - 822

Budd-Chiari syndrome is an uncommon condition induced by thrombotic or nonthrombotic obstruction to hepatic venous outflow.The classic triad of abdominal pain,ascites, and hepatomegaly is observed in the vast majority of patients but is nonspecific. Ascetic fluid protein may be high or low in Budd Chiari syndrome. Tender hepatomegaly on examination is one of the hallmark signs. Reference : Harrison's Principles of Internal Medicine 21 st Ed, Ch:50, Pg: 323

Non selective beta blockers (propranolol, nadolol) can be used for reducing rebleeding in oesophageal varices. They work by decreasing hepatic venous pressure gradient and thereby decreasing portal hypertension. Reference : Harrison's Principles of Internal Medicine 21 st ed, Ch: 344, Pg: 2630

Octreotide and terlipressin are widely used in acute variceal hemorrhage to reduce the bleeding rate octreotide is often used for emergency treatment of bleeding oesophageal varices in patients with cirrhosis of the liver. It is given intravenously.It acts by causing splanchnic vasoconstriction and should be given for a minimum 48 hours . Propranolol and Nadolol are used for prophylaxis of bleeding in a patient known to have esophageal varices. They should not be used in an acute condition as they can cause hypotension. Vitamin K is used to treat hepatic coagulopathy in acute liver failure, warfarin overdose and vit K deficiency of the newborn. Reference : Harrison's Principles of Internal Medicine , 21 st Ed, Ch: 344 Pg: 2630

Atenolol is a water soluble beta blocker, taken once daily and is not associated with drowsiness/sleep disturbance like the lipid-soluble β-blockers. It is not associated with nausea or hesitancy of micturition and would be unlikely to produce significant postural hypotension in a hypertensive subject. However, fatigue is a frequent side effect which typically is felt two hours and beyond after taking the drug. Reference: Harrison’s Principles of Internal Principles, 20 th edition, ch:271 pg:1903

Answer- A. Hypertension Most common cause of pontine hemorrhage is hypertension.

Portal hypertension is defined as the elevation of the hepatic venous pressure gradient (HVPG) to >5 mm Hg. clinically significant portal hypertension is defined as a HVPG ≥10 mmHg , when there is substantial risk of decompensation with variceal bleeding. Cirrhosis is the most common cause of portal hypertension Reference : Harrison's Principles of internal medicine 21st ed chap 344 pg. 2629

The term resistant hypertension refers to patients with blood pressures persistently >140/90 mmHg despite taking three or more antihypertensive agents, including a diuretic.