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': 'True about amoebic liver abscess -a) Frequently associated with diarrhea at presentationb) Most common in right lobe liverc) Can rupture into pleural cavityd) Almost never respond to metronidazole \nSelect and explain. \nA. a, B. bc, C. ac, D. ad', 'role': 'user'}, {'content': 'Answer: B \nExplanation: Amoebic Liver abscess \n\nCaused by Entamoeba histolytica whose cysts are acquired through the feco-oral route and their trophozoites reach the liver through portal venous system.\nLike pyogenic abscess they are also common in rt. lobe of liver.\n\nClinical Picture\n\nthe typical clinical picture is of a patient 20-40 yrs of age who has travelled to an endemic area, presents with fever, chills, anorexia, rt. upper quadrant pain.\nalthough liver abscess results from an obligatory colonic infection, a recent history of diarrhoea is uncommon.\njaundice is rare. (c.f. in pyogenic abscess jaundice is seen in -.25% of pts.)\nLiver function tests may show mild abnormalities, hyperbilirubinemia is uncommon.\nCT > U/S are the mainstay of investigation.\nDiagnosis is confirmed by serological tests (enzyme immuno assay) for antiamoebic antibodies.\nCultures of amoebic abscess are usually negative.\n\nTreatment\n\nMetronidazole is the mainstay of t/t and is curative in over 90% of patients.(other nitroimidazoles i.e. secnidazole, tinidazole, are also effective)\nTherapeutic needle aspiration is avoided. Done only when\npt. fails to respond to metronidazole\nhigh risk of rupture\nabscess secondarily infected with pyogenic organism.\nComplications may occur uncommonly; these are\nrupture into the peritoneum, pleural cavity or pericardium.', 'role': 'assistant'}]