<prompt> A 25-year-old woman develops nausea, vomiting, and abdominal pain. On examination, she has tender hepatomegaly and ascites. She was recently staed on oral contraceptives. What shall be the clinical diagnosis ?Budd -Chiari syndromeAcute Viral hepatitisPoal HypeensionAcute cholecystitis  <response>: Budd-Chiari syndrome: Thrombus in hepatic veins - sinusoidal pressure - hepatomegaly - stretching of capsule - RUQ pain Causes: 1. Hematological disorder - Polycythemia vera JAK 2 mutation PNH2. Protein CS, AT III - clotting tendency in body3. High estrogen leads to hypercoagulable state4. Tumors - HCC, RCC, Wilms tumor tumor pressing hepatic vein5. Infections - hydatid cyst6. CTD - Behcet ds, Sarcoidosis, APLAS Anti b2 glycoprotein- intrinsic system activation 