PAEA Surgery End Of Rotation (EOR) Practice Exam

In the Child-Turcotte-Pugh Scoring system, what class may not tolerate a liver resection?

1. Class A

2. Class B

3. Class C

4. Class D

The correct answer is: Class C

The Child-Turcotte-Pugh Scoring system is a clinical scoring system used to assess the severity of chronic liver disease and guide treatment decisions, particularly around surgical interventions like liver resection. This system evaluates several parameters including bilirubin levels, albumin levels, prothrombin time, ascites, and hepatic encephalopathy to categorize patients into classes A, B, or C. Class C represents the most severe level of liver dysfunction in this scoring system. Patients in this category typically have significant portal hypertension, a higher risk of complications, and compromised liver function. As a result, Class C patients often do not tolerate liver resection well due to poor hepatic reserve and a higher likelihood of postoperative liver failure. In contrast, Class A patients have the least severe liver disease and generally have enough hepatic function to tolerate liver surgeries better. Class B patients may have moderate dysfunction, but they can still potentially be candidates for surgery depending on their individual circumstances. Thus, it is primarily patients in Class C for whom a liver resection may pose significant risks, justifying the conclusion regarding their limited tolerance for such surgical interventions.