Liver

Question 1

Quincke’s triad (Hemobilia)

Answer 1

jaundice
RUQ abdominal pain
upper gastrointestinal hemorrhage

Question 2

characterized by the presence of fibrous septa that leads to hepatic nodules

Answer 2

Liver Cirrhosis

Question 3

Detectable when serum bilirubin > 2.5 to 3 mg/dL

Answer 3

Jaundice

Question 4

Ascites are clinically detectable when they reach this volume.

Answer 4

> 1.5L

Question 5

What comprises your Child-Pugh Score? (6)

Answer 5

Nutritional status
Ascites
Encephalopathy
Serum bilirubin
Serum albumin
Prothrombin Time

Question 6

Laboratory findings for cirrhosis (4)

Answer 6

Mild normocytic normochromic anemia
Reduced WBC and platelet counts
Prolonged prothrombin time (PT)
Decreased serum albumin

Question 7

First line treatment for spontaneous bacterial peritonitis

Answer 7

Empiric antibiotics
Cefotaxime - first line medication

Question 8

Normal portal pressure

Answer 8

5-10mmHg

Question 9

most accurate method of determining portal HTN

Answer 9

Hepatic venography

Question 10

Most significant manifestation of portal HTN

Answer 10

esophageal varices

Question 11

Leading cause of morbidity and mortality

Answer 11

Esophageal Varices

Question 12

NON-SHUNT SURGICAL PROCEDURES:
Ligation of venous branches entering the distal esophagus and the proximal stomach from the level of the inferior pulmonary vein

Transection of esophagus, splenectomy, truncal vagotomy, & pyloroplasty

Answer 12

Sugiura Fukugawa procedure

Question 13

Most definitive form of therapy for complications of portrayal hypertension

Answer 13

Orthotopic liver transplantation

Question 14

Congestive hepatopathy characterized by obstruction to hepatic venous outflow

Answer 14

Budd Chiari syndrome

Question 15

Most frequently affected lobe in liver abscess

Answer 15

Right lobe

Question 16

Most common organism isolated in liver abscess

Answer 16

Gram negative particularly E.coli

Question 17

Presentation of liver abscess

Answer 17

RUQ pain and fever
Jaundice in 1/3 of patients
Elevated WBC, ESR, alkaline phosphatase

Question 18

Necrotic central portion containing reddish brown pus-like material (anchovy paste)

Answer 18

Amebic liver abscess

Question 19

Most common benign solid mass in the liver and common in women

Answer 19

Hemangioma

Question 20

Most frequently encountered liver lesion overall

Answer 20

Hepatic cyst

Question 21

Primary tumor of hepatocytes

Answer 21

Hepatocellular carcinoma

Question 22

Primary tumor of bile ducts

Answer 22

Cholangiocarcinoma

Question 23

Liver metastasis

Answer 23

Most common malignant liver tumor usually from Colorectal carcinoma

Question 24

Hepatocellular carcinoma risk factors (5)

Answer 24

Cirrhosis
Hepatitis B or C
Alcoholic
Hemochromatosis
Non-alcoholic steatohepatitis

Question 25

Milan criteria for liver transplantation (5)

Answer 25

One nodule < 5cm 2 or 3 nodules < 3cm (-) vascular invasion (-) extra hepatic spread Child A, B, C

Question 26

Absolute Contraindications for liver biopsy

Answer 26

Significant coagulopathy Biliary dilatation Suspicion of hemangioma or echinococcal cyst

Question 27

Gold standard treatment for cholangiosarcoma

Answer 27

Resection