Dieseases Of The Liver,Jaundice

Question 1

Anatomy of liver

Answer 1

Liver has a sphenoid shape
Has superior, posterior, inferior surfaces
Size 25-30 cm in length
15-20 cm in width
10-14 cm in height
Weightin male 1.5kg
Female 1.2kg
Divided into the right and left lobules by the falciform
Liver is divided 8 segments
Hepatic artenes portal veins
Intrahepatic biliary ducts,

Question 3

Functions of the liver

Answer 3

Desintoxication
Barrier-protective
Protein synthesis
Metabolism
glycogen storage
Secretory
Homeostasis regulation
Depository
Regenerative
Bile production

Question 4

Classification of hepatic insufficiency

Answer 4

According to the origin
A. Portal-hypertension
B. Biliary hypertension
C. Cellular

According to severity
Severe, mild average

According to the reversibility to E impairment
Reversible
IrReversible

Question 5

Classification of surgical pathology of the liver

Answer 5

Trauma→ open, closed
Focal lesions → inflammatory, tumors, cystic disease

Question 6

Abscess of liver

Answer 6

Causative agent → bacterial, parasitogenic
Localisation→ left lobule, both lobule, right lobule

According to their number → singular, multiple

Question 7

Portal hypertensio

Answer 7

It’s a pathological process caused by the impairment of blood outflow in the portal vein, hepatic vein and inferior vena cava
Elevated pressure in your portal venous system
More than 12mm/hg

Caused by cirrhosis of the liver , increased portal blood flow

Symptoms
Gastrointestinal bleeding
Vomiting blood
Blacky any stools
Aseltes→ abdominal swelling
Shortness of breath
Encephalopathy
Jaundice
Edema

Diagnosis
Doppler ultrasound
CT Scan
MRI
Biopsy
Laoaroscopy
Angiography

Medication
Beta-blockers
Octreotide
Diuretics

Surgical treatment
Shunt procedures
Portocaval shunt
Mesocaval shunt

Devascularization
Liver transplantation

Question 8

Tumours of the liver Benign and Malignant tumours

Answer 8

B.T → unclear dull pain, sense of heaviness in right hypochondnim, nausea, vomiting
Liver is enlarged, USI,CT, angiography, laparoscopy, biopsy
Complication→ obturation jaundice,ascites, duodenal obstruction
Resection of the liver

Malignant→ risk factors→ males 50 years , viral hepatitis B, C, cirrhosis of liver,

Metases. To stomach, pancreas, large intestine, mammary gland, lung
Liver transplantation

Question 9

Jaundice

Answer 9

Elevated bilirubin
Prehepatic etilogy {stones, Ca}
Intrahepatic etilogy→ ca,PSC, liver
Post hepatic ethology → venous outflow obstruction

Physical exam findings
Hepatomegaly
Palpable mass
Murphy sign
Sclera icterus
Charcot triad

DiagnosticTests
Lab tests
AST ALT Alk
GGT
CBC
LDH
Imaging procedures
ultrasound
HIDA Scan
CT scan

Question 10

Hepatocelleular carcinoma

Answer 10

Trabecular, Fibrotamellar HCC

Macroscopic evaluation
Nodular
Massive
Diffuse

Risk factors
Major
Chronic HBV infection
Chronic HCV
Cirrhosis

Minor
Diabetes, smoking, age

Question 11

Indication for surgery

Answer 11

Cholecystectomy
a. Cholecyst/tis
b. A calculus cholecystitis
c.gallstones without complication
Cholelithiasis