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A ORAL BOARDS 2016 > LIVER > Flashcards

Flashcards in LIVER Deck (32):
1

focal nodular hyperplasia
CT findings
MRI findings

"arterial outside
venous inside"
"like cancer outgrowing its blood supply" blah blah blah cannot double top glass characteristics in clinical transformation this is Lynsey

Stellate

MRI:
peripheral nodular enhancement arterial face

Centripetal enhancement Venus phase


2

Test for focal nodular hyperplasia

Sulfur colloid

3

Where in the liver metastases found

Periphery of the liver

4

What size cystadenoma should be resected

Greater than equal to 3 cm

After trial of discontinuation of birth control

5

CT findings of adenoma

Heterogeneous

6

CT findings of hemangioma

Peripheral AND central enhancement

7

MILAN criteria

Eligible for transplantation for hepatocellular carcinoma

Based on an initial size of tumor (not downsizing)

Less than or equal to three tumors
Less than 3 cm

Or one tumor less than 5 cm

8

fibrolamellar hepatocellular carcinoma

Young patient
No cirrhosis
Not associated with hepatitis B
Can be AFP negative

9

Most likely cause of alter sound showing intrahepatic structure that is cystic and an elevated White blood cell count

Amoebic abscess
Pyogenic

10

Test for a amoebic abscess

Hemagglutinin

11

What does calcification suggest in infected liver picture

Hydatid cyst

12

Organisms identified in pyogenic abscess

E. coli number one
Strep faecalis
Kleb
Proteus
anaerobic colon
B frag

13

What is the usual source of pyogenic abscess

GI

also can be from bili

14

Econ a cockle cyst CT findings

thick wall
Calcifications in debris
Septations– daughter cysts

15

Diagnoses of echinococal cyst

ELISA
Hemagglutinin

16

Medication for pretreating echinococal cyst

Albendazole

17

Cystadenoma CT findings

Complex cyst
mural nodules

18

What does TIPS stand for

Transjugular
intrahepatic
portosystemic
Shunt

19

What kind of shunt is TIPS

Nonselective
Good for stopping bleeding
Bad for encephalopathy(Because no longer clearing toxins through deliver)
Pretty good for ascites

NO for right heart failure

20

Mesocaval shunt

Best for urgent treatment of bleeding varices

really buggers up transplant options though

21

Distal spinal shunt

Time-consuming

Selective shunt

Good for encephalopathy

22

Child's class

Child class a / b / c

Billy Ruben 2/ 2-3 / >3
Albumin >3.5 / 2.8-3.5 / 2.2
Encephalopathy 0 / controlled / uncontrolled
Ascites 0 / controlled / uncontrolled

23

Surgical mortality associated with child score

Child a: 5-6 10%
Charles B: 7-9 30%
Child C: 10-15 75 – 80%!

24

What is the MELD score needed to get on the transplant list

15

25

TIPS is best with MELD less than

24 or greater is contraindication
(uptodate)

26

MELD for major liver surgery

8?

27

Anatomy of portal triad

ant right CBD
left HA
portal vein

28

replaced right hapatic artery

SMA to
posterior portal vein
posterior to pancrease
posterior to cystic artery

29

test to r/u hemangioma if CT scan and MRI are equivocal

Tagged red blood cell scan

30

labs to get for ruling out liver malig

AFP

LFTs / bili / coags

hepatitis panel

31

Basic steps to gain access for a Pringle

Pars flaccid (gastrohepatic ligament) is opened any fingers passed through the foramen of Winslow

Porta hepatis can then be encircled with umbilical tape

32

Treatment of encephalopathy

Decrease aromatic
(can use branch chain amino acids)

Lactulose

neomycin decreased bacteria that makes ammonium