liver and gall bladder

Question 1

It is a plane fro the gallbladder fossa to the IVC that separates the livers right and left lobe grossly

Answer 1

cantlies line

Question 2

How is the portal vein formed

Answer 2

1. splenic vein

2. superior mesenteric vein

Question 3

This measures the liver’s synthetic function

Answer 3

1. PT
2. Clotting factors (except factor 8)
3. Serum albumin

Question 4

This measures the integrity of hepatocellular membranes

Answer 4

1. AST

2. ALT

Question 5

What is the half life of alkaline phosphatase

Answer 5

7 days

Question 6

It is the diagnostic and therapeutic procedure of choice for stones in the CBD associated with obstructive jaundice, cholangitis, and gallstone pancreatitis

Answer 6

ERCP

Question 7

Parameters of Child Pugh Score

Answer 7

1. Albumin
2. Bilirubin
3. clotting factors (INR)
4. encephalopathy
5. Ascites

Question 8

Scoring of Child Pugh Score

Answer 8

5 - 6 - 10 %
7 - 9 30%
10 - 15 - 75 - 80%

Question 9

What is the normal venous pressure

Answer 9

5 - 10 mmHg

Question 10

What is the pressure in diagnosing portal hypertension

Answer 10

1. > 5 mmHg than the IVC pressure
2. splenic pressure > 15 mmHg
3. portal venous pressure at surgery is > 20 mmHg

Question 11

What is the portal pressure needed to form varices

Answer 11

> 12 mmHg

Question 12

Most common cause of portal hyptertension?

Answer 12

Liver cirrhosis

Question 13

Most accurate method in determining portal hypertension

Answer 13

hepatic venography

Question 14

treatment of portal hypertension

Answer 14

1. CTP A - surgical shunt

2. CTP B and C - TIPS

Question 15

It is a distal splenorenal shunt

Answer 15

Warren shunt

Question 16

An uncommon congestive hepatopathy characterized by the obstruction of hepatic venous outflow due to endoluminal venous thrombosis or compressive lesion external to the veins

Answer 16

Budd Chiari Syndrome

Question 17

What is the common site of pyogenic liver abscess

Answer 17

right lobe of liver

Question 18

Treatment of pygenic liver abscess

Answer 18

1. correction of underlying cause
2. percutaneous needle aspiratio
3. IV antibiotic therapy for 8 weeks

Question 19

Most common location of amebic abscess

Answer 19

superior anterior aspect of the right lobe

Question 20

Treatment of amebic abscess

Answer 20

1. metronidazole 750 mg TID for 7 to 10 days

Question 21

What is the most common location of hydatid disease

Answer 21

anterior inferior or posterior inferior segment of the right lobe of the liver

Question 22

Treatment of hydatid cyst

Answer 22

Surgery and instillation of scolicidal agent

Question 23

Milan critera for liver transplantation

Answer 23

1. single < 5 cm
2. 2 or 3 nodulers < 3 cm
3. no vascular invasion or extrahepatic spread

Question 24

Treatment option for liver cancer

Answer 24

1. hepatic resection

2. liver transplantation

Question 25

Most common site of metastasis of liver cancer

Answer 25

lungs

Question 26

Types of Cholangiocarcinoma

Answer 26

1. intrahepatic | 2. extrahepatic (klatskin tumor)

Question 27

What is the manifestation of klatskin tumor

Answer 27

Obstructive and painless jaundice

Question 28

Most important risk factor for gallbladder carcinoma

Answer 28

cholelithiasis

Question 29

Most USEFUL radiologic test for diagnosing acute cholecystitis

Answer 29

UTZ 1. thickening of GB 2. pericholecystic fluid 3. sonographic murphy's sign

Question 30

most ACCURATE radiologic test for diagnosis acute cholecystitis

Answer 30

HIDA scan

Question 31

Gold standard for diagnosing choledocholithiases

Answer 31

endoscopic cholangiography

Question 32

What is charcot's triad

Answer 32

1. fever 2. RUQ pain 3. Jaundice

Question 33

What is reynaud's pentad

Answer 33

1. fever 2. RUQ pain 3. Jaundice 4. Septic shock 5. mental status changes

Question 34

Most common type of choledochal cyst

Answer 34

Type I - cystic dilatation of the extrahepatic bile duct

Question 35

Types of choledochal cyst

Answer 35

``` Type I - extrahepatic duct Type II - common bile duct Type III - distal duct into the duodenum Type IV - intrahepatic and extrahepatic duct Type V - intrahepatic duct ```

Question 36

Treatment of choledochal cyst

Answer 36

complete cyst excision with roux en Y hepaticojejunostomy