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: Pediatrics
[{'content': 'A 7 year old girl from Bihar presented with three episodes of massive hematemesis and melena. There is no history of jaundice. On examination, she had a large spleen, non-palpable liver and mild ascites. Portal vein was not visualized on ultrasonography. Liver function tests were normal and endoscopy revealed esophageal varices. The most likely diagnosis is – \nSelect and explain. \nA. Kala azar with portal hypertension, B. Portal hypertension of unknown etiology, C. Chronic liver disease with portal hypertension, D. Portal hypertension due to extrahepatic obstruction', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Differentiation between Extrahepatic and Hepatic / Post hepatic portal hypertension \n\nPost sinusoidal and hepatic causes of portal hypertension will have\nevidence of Liver parenchymal damage / deranged LFT (jaundice)\na dilated portal vein on ultrasonography\nExtrahepatic presinusoidal obstruction will not have any effect on the Liver and hence there will be no evidence of hepatocellular damage.\nNo jaundice / No raised deranged LFT\n\nAlso non visualization of portal vein is a characteristic of portal vein thrombosis, an Extrahepatic cause.\n\nEsophageal varices and splenomegaly are a manifestation of portal hypertension and will be present in all the above sites of obstruction.', 'role': 'assistant'}]