The most common clinical manifestation of portal hypertension is what type of bleeding?

A. Urine output <30mL/hour: Oliguria is defined as a markedly reduced urine output, typically less than 400 mL per day or less than 30 mL per hour. It indicates decreased kidney function or perfusion and is common in progressive renal conditions.

B. Absence of urine output: This describes anuria, not oliguria. Anuria is defined as urine output less than 100 mL per day and signifies severe kidney failure or complete urinary tract obstruction.

C. Increased urine output: This describes polyuria, often associated with conditions like uncontrolled diabetes mellitus or diabetes insipidus, not oliguria.

D. Urine output >100mL/hour: This is well above the threshold for oliguria and may suggest diuresis or overhydration. It does not meet the criteria for decreased kidney output.

A. The Somogyi effect results from an excessive insulin dose causing hypoglycemia overnight, triggering a rebound hyperglycemia via release of glucagon, cortisol, and growth hormone. In contrast, the dawn phenomenon is a natural early morning rise in blood glucose due to circadian increases in cortisol and growth hormone without preceding hypoglycemia.

B. The Somogyi effect happens only in type 2 diabetes, while the dawn phenomenon happens only in type 1 diabetes: Both effects can occur in either type 1 or type 2 diabetes depending on insulin therapy and individual physiology.

C. Both the Somogyi effect and the dawn phenomenon occur due to nighttime hyperglycemia: The Somogyi effect starts with nighttime hypoglycemia, not hyperglycemia, while the dawn phenomenon involves a gradual early morning rise in glucose levels.

D. The Somogyi effect is caused by insufficient insulin at night, while the dawn phenomenon is caused by excessive nighttime insulin: The Somogyi effect is caused by excessive insulin leading to hypoglycemia, not insufficient insulin. The dawn phenomenon is unrelated to nighttime insulin dosing and is caused by hormonal changes.