Q) The significance of MELD Scoring in Liver transplant is :
a) Less ill patients are given more priority in liver transplant
b) Set threshold for patients who are too ill to undergo transplant.
c) To access mortality in the waiting list.
d) To list patients in cadaveric deceased donor program
d
MELD score takes into account three factors. Bilirubin, INR and creatinine. Recently MELD Na is also included. Model for end stage Liver Disease (MELD) was initially developed to evaluate three months prognosis in patients undergoing TIPS. It ranges from 6 (3 months survival = 90%) to 40 (3 months survival =7%).
In countries where DDLT is more common MELD Score is used to allot grafts to people in the cadaveric list. More severe is the MELD, earlier is the allotment of cadaveric graft.
Q) In penetrating neck trauma, to help in the management, neck has been divided into zones. Great vessels of thoracic inlet are seen in (#Gen Surgery Trauma)
Respiratory failure is the cause of death in the early phase (7 days). The pulmonary manifestations of pancreatitis include atelectasis and acute lung injury where as infective complications are the cause of death in late phase.
Q) Rupture of Urinary Bladder : False statement is
a) Associated with perineal hematoma
b) Emergency laparotomy is required in most cases
c) Investigation of choice is IVP
d) Blunt urinary bladder trauma is associated with pelvic fractures
Answer c
Both b and c are wrong but the question was like this only.
Rupture of urinary bladder is mostly extraperitoneal (80%) but can also be intraperitoneal (20%). Intra peritoneal rupture is usually when injury occurs in a full distended bladder. Haematuria may or may not be present.