Abstract
1.Regarding pregnancy in portal hypertension the following are TRUE:1.Pregnancy is more likely in cirrhotic than non-cirrhotic portal hypertension (NCPH)2.Portal hypertension related complications can be seen in 30–50% of such pregnancies3.Pregnancy and portal hypertension have opposing hemodynamic changes4.Abortion rates do not increase in patients with NCPH5.Model for end-stage liver disease (MELD) score can be used to predict complications of pregnancy in cirrhosis2.Regarding variceal hemorrhage in pregnancy the following are TRUE:1.Variceal hemorrhage most commonly occurs in first trimester2.Upto 75% of patients of cirrhosis with varices will bleed during pregnancy3.Mortality rates of variceal bleed in pregnancy with NCPH is very high4.Terlipressin is the drug of choice to control variceal bleed in pregnancy5.Screening endoscopy should be done in the second trimester if not done prior to conception3.Regarding acute fatty liver of pregnancy (AFLP) the following are TRUE EXCEPT:1.AFLP occurs in second to third trimester of pregnancy2.Fetal fatty acid oxidation defects increase the risk of AFLP in the mother3.Hepatic steatosis on ultrasound in necessary for the diagnosis of AFLP4.Liver biopsy is the gold standard for the diagnosis of AFLP5.Delivery should be postponed until improvement in liver functions4.Regarding pre-eclampsia and liver disease the following are TRUE:1.Upto 50% of patients with pre-eclampsia demonstrate abnormalities in liver function test2.Patients with pre-eclampsia do not show increased risk of hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome3.Pathogenesis is related to endothelial dysfunction4.HELLP may occasionally manifest after delivery5.Diagnosis of HELLP often overlaps with that of AFLP5.Regarding role of vitamins and minerals in chronic liver disease the following are TRUE:1.Vitamin A deficiency is uncommon in patients with cirrhosis2.Vitamin D deficiency is common in cirrhosis3.Vitamin E supplementation is useful in alcoholic liver disease4.Selenium deficiency is associated with liver fibrosis in patients with hepatitis C5.Manganese levels are increased in patients with cirrhosis6.Regarding nutrition and complications of cirrhosis the following are TRUE EXCEPT:1.Patients with cirrhosis have higher prevalence of malnutrition than controls2.Malnutrition is associated with poor outcomes even in patients with Child A cirrhosis3.Branched chain amino acids to aromatic amino acid ratio is increased in cirrhosis4.Malnutrition is associated with increased post-transplantation complications5.Obesity is not associated with transplant related complications7.Regarding the epidemiology of hepatitis C virus (HCV) infection in India the following are TRUE:1.High prevalence is defined as anti-HCV positivity in >3.5% of the population2.India is a high prevalence country3.Transfusion related HCV infection in thalassemia patients is rare since 2001 when HCV screening became mandatory in blood banks4.Human immunodeficiency virus-HCV co-infection is more common in patients with low CD4 counts5.Genotype 1 is the most common form in India8.Regarding management of HCV infection in India the following are TRUE EXCEPT:1.HCV viral load should be estimated using assays with a lower limit of detection of at least 50 IU/ml2.Age more than 70 years is an absolute contraindication for interferon therapy3.A urine pregnancy test is mandatory before starting therapy in females of reproductive age group4.IL28B polymorphisms are not relevant to treatment response in Indian patients5.It is appropriate to defer therapy in patients with genotype 1 infection who do not have significant fibrosis9.Regarding NCPH the following are TRUE EXCEPT:1.Non-cirrhotic portal fibrosis (NCPF) may progress to end-stage liver disease needing liver transplantation2.NCPF is an increasingly common cause of portal hypertension in adults3.NCPF characteristically involves medium-sized and preterminal veins resulting in is obliterative portal venopathy4.Extrahepatic portal vein obstruction (EHPVO) is the most common cause of portal hypertension in children5.Majority of patients with portal biliopathy have biliary symptoms10.Regarding genotypes of hepatitis B virus (HBV) the following are TRUE:1.There are 6 different genotypes of HBV2.Less than 8% genomic variability is required to differentiate genotypes3.Genotype B is associated with better outcomes than genotype C4.Genotype A shows best response to nucleotide therapy5.Genotypes determine response to interferon therapy
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