Dont get confused by the absence of signs and

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DONT GET CONFUSED BY THE ABSENCE OF SIGNS AND SYMPTOMS OF LIVER DISEASE. IT SUGGESTS EXTRAHEPATIC PORTAL VEIN OBSTRUCTION. 215
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EXTRAHEPATIC PORTAL VEIN OBSTRUCTION:- IT IS AN IMPORTANT CAUSE OF PORTAL HYPERTENSION IN CHILDHOOD. THE OBSTRUCTION MAY OCCUR AT ANY LEVEL OF PORTAL VEIN. 216
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A 45 - YEAR OLD CIRRHOTIC PATIENT PRESENTED WITH SEVERE HAEMATEMESIS. THE MANAGEMENT OF CHOICE IS- (AIIMS JUNE 99) A) WHOLE BLOOD TRANSFUSION IS THE BEST B) COLLOIDS ARE PREFERRED OVER CRYSTALLOIDS C) NORMAL SALINE INFUSION D) IV FLUID WITH DIURETICS 217
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PATIENTS WITH SIGNIFICANT HEMORRHAGE, ANAEMIA OR INTRAVASCULAR VOLUME DEPLETION REQUIRE BLOOD TRANSFUSION OR COLLOID CONTAINING SOLUTIONS (ALBUMIN, DEXTRAN) BUT WHOLE BLOOD TRANSFUSION IS THE T/T OF CHOICE BECAUSE COLLOIDAL SOLUTIONS ARE EXPENSIVE AND THEY HAVE SOME ADVERSE EFFECT. THE THERAPEUTIC GOALS ARE TO RESTORE NORMOVOLEMIA WITH FLUID SIMILAR IN COMPOSITION TO THAT LOST AND TO REPLACE ONGOING LOSSES. 218
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A 45 - YEAR OLD CIRRHOTIC PATIENT PRESENTED WITH SEVERE HAEMATEMESIS. THE MANAGEMENT OF CHOICE IS- (AIIMS JUNE 99) A) WHOLE BLOOD TRANSFUSION IS THE BEST B) COLLOIDS ARE PREFERRED OVER CRYSTALLOIDS C) NORMAL SALINE INFUSION D) IV FLUID WITH DIURETICS A 220
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Q- H.PYLORI H. PYLORI IS KNOWN TO CAUSE ALL OF THE FOLLOWING EXCEPT- (AI 99) A) GASTRIC ULCER B) DUODENAL ULCER C) GASTRIC LYMPHOMA D) FUNDAL GASTRITIS 221
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HELICOBACTER PYLORI IS A GRAM NEGATIVE SPIRAL SHAPED BACTERIUM. IT IS STRICTLY MICROAEROPHILIC AND IT HAS TUFT OF SHEATHED UNIPOLAR FLAGELLUM. IT IS STRONGLY UREASE POSITIVE. UREASE IS AN ENZYME THAT SPLITS UREA INTO AMMONIA AND CO2. THIS FORMS THE BASIS OF THE UREA BREATH TEST WHICH MEASURES THE OUTPUT OF C02 RESULTING FROM THE SPLITTING OF UREA INTO C02 AND AMMONIA. 222
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TOXIGENIC STRAINS OF H.PYLORI ARE THOSE WHICH HAVE (CAGA) PRESENT IN THEM. INFECTION WITH CAGA POSITIVE STRAINS IS ASSOCIATED WITH: - GREATER NUMBER OF ORGANISMS IN THE TISSUE - MORE SEVERE EPITHELIAL DAMAGE. - GREATER ACUTE AND CHRONIC INFLAMMATION - HIGHER LIKELIHOOD OF PEPTIC ULCERATION AND INCREASED RISK OF GASTRIC CANCER. 223
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CHRONIC GASTRITIS IS OF TWO TYPES – L) H. PYLORI ASSOCIATED GASTRITIS —> ACCOUNTS FOR 90% OF CHRONIC GASTRITIS II) AUTOIMMUNE GASTRITIS —> ACCOUNTS FOR 10% OF CHRONIC GASTRITIS. 224
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THESE GASTRITIS AFFECT DIFFERENT REGIONS OF THE STOMACH. 1) H. PYLORI ASSOCIATED GASTRITIS:- TEND TO AFFECT ANTRAL MUCOSA OR BOTH ANTRAL AND BODY FUNDIC MUCOSA . IT ACCOUNTS FOR 90% OF CHRONIC GASTRITIS. 2) AUTOIMMUNE GASTRITIS:- CHARACTERISTICALLY AFFECT BODY FUNDIC MUCOSA WITH SPARING OF ANTRUM 225
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226
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H. PYLORI IS KNOWN TO CAUSE ALL OF THE FOLLOWING EXCEPT- (AI 99) A) GASTRIC ULCER B) DUODENAL ULCER C) GASTRIC LYMPHOMA D) FUNDAL GASTRITIS D 228
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ALL ARE TRUE REGARDING HELICOBACTER PYLORI EXCEPT - A) LESS PREVALENT IN DEVELOPING COUNTRIES B) TOXIGENIC STRAINS USUALLY CAUSES ULCERS C) UREA BREATH IS POSITIVE D) GRAM NEGATIVE ORGANISM A 229
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  • Winter '16
  • jean grey
  • chronic hepatitis, chronic liver failure

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