Liver: Child-Pugh scoring: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Liver: Child-Pugh scoring

Sample item

A cirrhotic patient has total bilirubin 2.5 mg/dL, albumin 2.9 g/dL, INR 1.5, mild controlled ascites and no encephalopathy. What is his Child-Pugh class?

AClass C, score 10BClass B, score 8CClass A, score 6DClass C, score 12

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Class B, score 8

Each of five parameters scores 1 to 3. Bilirubin 2 to 3 mg/dL scores 2, albumin 2.8 to 3.5 scores 2, INR below 1.7 scores 1, mild ascites scores 2 and no encephalopathy scores 1. The sum is 2 + 2 + 1 + 2 + 1 = 8, which is class B (7 to 9). Class A is 5 to 6 and class C is 10 to 15.

Option by option

A. Class C, score 10
A score of 10 would require at least one more point from worse bilirubin, albumin or INR.
B. Class B, score 8 (correct)
Correct. The parameters sum to 8, which falls in class B.
C. Class A, score 6
A score of 6 would need lower scores on bilirubin, albumin or ascites than this patient has.
D. Class C, score 12
A score of 12 is far above the arithmetic total of 8 and implies severely decompensated disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Class B, score 8. Each of five parameters scores 1 to 3.

Why is "Class C, score 10" not the answer?

A score of 10 would require at least one more point from worse bilirubin, albumin or INR.

Why is "Class A, score 6" not the answer?

A score of 6 would need lower scores on bilirubin, albumin or ascites than this patient has.

Why is "Class C, score 12" not the answer?

A score of 12 is far above the arithmetic total of 8 and implies severely decompensated disease.

What concept does this question test?

It tests Liver: Child-Pugh scoring in General Surgery. Bilirubin 2 to 3 mg/dL scores 2, albumin 2.8 to 3.5 scores 2, INR below 1.7 scores 1, mild ascites scores 2 and no encephalopathy scores 1. The sum is 2 + 2 + 1 + 2 + 1 = 8, which is class B (7 to 9). Class A is 5 to 6 and class C is 10 to 15.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Liver: Child-Pugh scoring?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.