H - Child-Pugh Score

Question 1

Components of Child-Pugh score

Answer 1

Ascites
Encephalopathy
Bilirubin
Serum albumin
Prothrombin time

Question 2

Significance of Child-Pugh score

Answer 2

• assessment of hepatic reserve

- preducts the surgical risks of intraabdominal operations performed on cirrhotic patients

Question 3

Ascites

Answer 3

2 points for mild

Question 4

Encephalopathy

Answer 4

2 points for grade I-II *

Question 5

Bilirubin

Answer 5

2 points for 2-3mg/dL

Question 6

Albumin

Answer 6

2 points for 2.8-3.5 g/dL

Question 7

Prothrombin

Answer 7

2 points for INR 1.7-2.3

Question 8

SUMMARIZE

Answer 8

2-3 mg/dL

2. 8-3.5 g/dL
3. 7-2.3

Question 9

Mortality

Answer 9

Child A: 5-6 points ~ 10% mortality
Child B: 7-9 points ~ 30% mortality
Child C: 10-15 points ~ 80% mortality

Question 10

Pharmacologic treatment for nonvariceal PUD bleed

Answer 10

Omeprazole 80mg IV bolus, then infusion of 8mg/hour

Question 11

Pharmacologic treatment for variceal bleed

Answer 11

Octreotide 50mcg IV bolus, then 25-50mcg/hr infusion

Question 12

Most common malignant tumor of the liver

Answer 12

Metastatic liver ccancer

Question 13

Most common source of liver mets

Answer 13

Colon CA

Question 14

Management of liver mets

Answer 14

Liver resection
Not irradiation
Not chemotherapy

Question 15

Statistics with esophageal varices

Answer 15

1/3 with varices will bleed
Each bleed = 20 to 30% mortality
70% of survivors (1st bleed) will re-bleed within 1 year