This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': 'One is not the indication of total parenteral nutrition - \nSelect and explain. \nA. Acute pancreatitis, B. Enterocolic fistula, C. Chronic liver disease, D. Faecal fistula', 'role': 'user'}, {'content': "Answer: C \nExplanation: Parenteral nutrition involves the continuous infusion of a hyperosmolar solution containing carbohydrates, proteins, fat and other necessary nutrients through an indwelling catheter inserted into (usually) the superior vena cava.\nIndications for Total parenteral Nutrition\n\nThe principal indications for parenteral nutrition are found in seriously ill patients when use of the gastrointestinal tract for feeding is not possible. In some instances intravenous nutrition may be used to supplement inadequate oral intake.\n\n(A)As primary therapy\n1.\xa0\xa0\xa0 Gastrointestinal cutaneous fistula including enteroenteric, enterocolic, enterovesical or enterocutaneous fistula.\n2.\xa0\xa0\xa0 Renal failure (Acute tubular necrosis)\n3.\xa0\xa0\xa0 Short bowel syndrome\n4.\xa0\xa0\xa0 Severe burns\n5.\xa0\xa0\xa0 Hepatic failure (acute decompensation superimposed on cirrhosis)\n6.\xa0\xa0\xa0 Crohn's ds\n7.\xa0\xa0\xa0 Anorexia nervosa\n(B) As a supportive therapy\n\nAcute radiation enteritis\nAcute chemotherapy toxicity\nProlonged ileus\nWeight loss preliminary to major surgery\n\n(C) Areas under Intensive study\n\nPatients with cancer\nPatients with sepsis\n\n\nAbout Pancreatitis \xa0TPN was once a preferred route of providing nutritional support to patients with sever acute pancreatitis, but now jejunal enteral feeding is the preferred method with TPN required for few cases when\n\n\nthere is delay in providing jejunal enteral nutrition to patient with significant malnutrition for more than 3- 4 days\nthere is persistent ileus there is exacerbation of pancreatitis after enteral nutrition", 'role': 'assistant'}]