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: Pathology
[{'content': 'A young boy presented with severe hematemesis. On examination, there was no hepatomegaly, Mild splenomegaly is present. Endoscopy shows esophageal varices. The most probable diagnosis - \nSelect and explain. \nA. Veno occlusive disease, B. Budd chiari syndrome, C. Cirrhosis liver, D. Non cirrhotic portal fibrosis', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Splenomegaly, variceal bleeding in the absence of hepatomegaly suggest the diagnosis of non-cirrhotic portal fibrosis.\nNon-Cirrhotic Portal Fibrosis\n\nIts incidence is very high in India accounts for 15% to 18% of all patients with portal hypertension. Aetiology :\n\n\nInfection →\xa0It was suggested that E.coli can cause NCPF\nExposure to chemicals → Chronic ingestion of Arsenic is incriminated in causing NCPE Vinyl Chloride toxicity can also cause NCPF\n\n\nClinical features :\n\nSymptoms :\n\nPatients are usually young in 3rd or 4th decade of life.\nGastrointestinal haemorrhage is the most common presenting symptom seen in 60-90% of patients.\nLump in the left side of Abdomen d/t enlargement of the spleen\nJaundice & Ascites uncommon and if they do occur it is for a short period of time. Signs\nSplenomegaly (usually massive)\nThe liver usually normal in size\nSometimes mild ascites can be seen.\n\nEndoscopy :\n\nEsophageal varices are detected in over 90% of patients\nRectal varices in 70% of patients.', 'role': 'assistant'}]