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Hepatobiliary Flashcards

(57 cards)

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1
Q

Differentiate amoebic and pyogenic abscess

A

Amoebic has h/o diarrhoea
Amoebic—Entamoeba
Pyogenic—Ecoli Staph aureus

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2
Q

Tteatment of amoebic liver abscess

A

High dose metronidazole

If decrease in size—Luminal agents

If not—-usg per cutaneous drain

X

Usg percutaneous pigtail catheter—Luminal agents

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3
Q

Mc complication of liver abscess

A

Rupture subdiaphramatic>plural>pericardial

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4
Q

Gharbi vs WHO classification of hydatid cyst

A

Gharbi
2—waterlily
3—honeycomb/rosette

WHO
Reverse

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5
Q

IOC for hydatid cyst
Liver abscess

A

Serology

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6
Q

Benign liver tumours

A

Hemangioma
Hepatic adenoma—usg—mri—stop ocp and HRT

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7
Q

Mc malignant hepatic tumour
Cause

A

Secondary tumour
Mc colorectal>cholangio>neuroendocrine

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8
Q

HCC risk factors

A

HepB C
Alcohol
Smoking
Aflatoxin exposure
Vinylchloride exposure
OCP
NASH
Alpha1 antitrypsin def
Wilsons

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9
Q

CECT finding in HCC

A

Early engancement and rapid washout

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10
Q

Treatment of HCC

A

Sx acc to Milans criteria
RFA
Transarterialchemoembolisation
Sorafinib

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11
Q

Fibrolamellar variant of HCC

A

Young
Not ass with cirrhosis
No AFP
Neurotensin
Good prognosis

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12
Q

Indications of ursodeoxycholic acid

A

<1cm
Radioluscent
No acute symptoms

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13
Q

Indications of ESWL in gb stones

A

<2cm

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14
Q

Prophylactic cholecystectomy

A

> 3cm
Gall stone with polyp
Gall stone pancreatitis
Anamolous PB junction
Porcelin GB

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15
Q

Risk factors of GB stones

A

Fat Fertile Female in Forties

Age
Obese
High fatty
DM
Female
OCP/HRT

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16
Q

Mc GB stones
Mc in asian

A

Mixed stones—Crystalline cholesterol monohydrate

Asian—Pigment stones

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17
Q

Mercedez benz sign

A

Radio opaque gall stones

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18
Q

Complications of gall stones

A

Empyema
Mucocele
Mirrizi syndrome

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19
Q

Diff btw Calculous and Acalculous gb

A

Ecoli
Grade 1 2 sx
Grade 3 usg percutaneous cholecystostomy

High mortality
Same signs
Usg percutaneous cholecystostomy

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20
Q

HIDA findings in cholecystitis

A

Failure of visualisation of gb in acute cholecystitis

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21
Q

Diff btw USG of Acute and Chronic cholecystitis

A

Distended gb
Increased wall thickness
Pericholecystic fluid

Contracted gb
No
No

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22
Q

IOC of cholecystoenteric fistula
Mc site

A

MRCP

Duodenum>TC

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23
Q

Mc site of gall stone ileus
IOC

Study These Flashcards
A

Terminal ileum>duodenum
CT

24
Q

IOC for CBD stone

25
Treatment of CBD stone without cholangitis
Gold standard—Endoscopic extraction papillotomy /spincterotomy If more size distal stricture ampulla impaction Surgery—Choledochotomy with T tube drainage Next cholecystectomy 5th day—T tube cholangiogram If no stone/free flow Remove T tube on 7/8th day
26
Treatment of CBD stone with cholangitis
Endoscopic stenting/Biliary stenting/Biliary decompression
27
Diff btw CBD stone with and without cholangitis
Without ——pain sometimes jaundice With —-charcots triad Clay colour stool Scratch marks
28
Diff btw Retained stone and Recurrent stone
Seen with in 2 yr Seen after 2 yr
29
BSAFE
B-Bile duct S-Rouvier sulcus A-Hepatic artery F-Umbilical fissure E-Enteric(duodenum)
30
Calots triangle Helaticystic triangle
Cystic duct Cystic artery CHD Cystic duct Base of liver CHD
31
Treatment of CBD injury
USG percutaneous drainage MRCP Minor-Endoscopic stenting Major-RNY HJ Most sensitive Ix is HIDA
32
Ca GB presentation
Pain right upper abd Not mass not jaundice. They are late
33
Risk factors of gb ca
Gb stones PSC Porcelin gb Choledochal cyst Anomolous pb junction Not polyp less than 1cm
34
IOC for ca gb
CT
35
Staging of ca GB
1———T1a Lamina b Muscularis 2———T2 Perimuscular connective tissue 3———T3 Liver invasion In extended cholecystectomy Remove 4b 5 lobes of liver
36
Mc site of Cholangioca
Perihilar
37
Todani classification Treatment
1—-Fusiform dilation of CBD 2—-Diverticulim from CBD 3—-Intramural part of CBD in duodenal dilation 4—-Intra and extra hepatic biliary dilation 5—-Intrahepatic biliary dilation Always excision
38
IOC for Biliary atresia Gold standard
MRCP Cholangiogram
39
Treatment of biliary atresia
Kasai surgery Also done in Type 4b choledochal cyst
40
Which type of GB polyp is malignant and non malignant
Adenomatous Cholesterol
41
IOC for any intestinal atresia
UGIE
42
IOC for Annular pancreas
Secretin enhanced MRCP
43
Xray findings of Acute pancreatitis
Gas less abd
44
IOC for pancreatitis
Sr. Lipase
45
Treatment of pseudocyst of pancreas
Internal drainage
46
Mc sequelae of psuedocyst pancreas
Spontaneous resolution
47
Management of severe pain in Chronic pancreatitis
NSAIDS Non opioid analgesics Opioids Celiac axis ganglion block
48
IOC for Chronic pancreatitis
MRCP
49
Chain of lake appearance
MRCP ERCP finding of Chronic pancreatitis
50
Mc complication of Chronic pancreatitis
Pseudocyst Portal vein thrombosis—-GI bleed
51
Structures removed in Whipples procedure It is done for?
CBD GB Whole duodenum Head of pancreas with growth Periampullary ca
52
IOC for pancreatic ca
CT
53
Best inv for staging of pancreatic ca Gold standard for staging
Lap staging EUS guided biopsy
54
Mc site of gastrinoma
Duodenum
55
Pssaro triangle
Junc of cystic duct and CBD 2nd and 3rd part of duodenum Body and tail of pancreas
56
Fasting gastrin levels >1000
Biochemical diagnosis of Gastrinoma
57
Bismuth strasberg classification In detail
For bileduct injuries A(mc)—Cystic duct leak B——Aberrant rt post sectoral duct block C——Aberrant rt post sectoral duct cut D——Lateral injury to CBD E——Circumferential bile duct injury

Surgery (10 decks)

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