liver and gall bladder Flashcards Preview

Surgery PLE > liver and gall bladder > Flashcards

Flashcards in liver and gall bladder Deck (36):
1

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

cantlies line

2

How is the portal vein formed

1. splenic vein
2. superior mesenteric vein

3

This measures the liver's synthetic function

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

4

This measures the integrity of hepatocellular membranes

1. AST
2. ALT

5

What is the half life of alkaline phosphatase

7 days

6

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

ERCP

7

Parameters of Child Pugh Score

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

8

Scoring of Child Pugh Score

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

9

What is the normal venous pressure

5 - 10 mmHg

10

What is the pressure in diagnosing portal hypertension

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

11

What is the portal pressure needed to form varices

>12 mmHg

12

Most common cause of portal hyptertension?

Liver cirrhosis

13

Most accurate method in determining portal hypertension

hepatic venography

14

treatment of portal hypertension

1. CTP A - surgical shunt
2. CTP B and C - TIPS

15

It is a distal splenorenal shunt

Warren shunt

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

Budd Chiari Syndrome

17

What is the common site of pyogenic liver abscess

right lobe of liver

18

Treatment of pygenic liver abscess

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

19

Most common location of amebic abscess

superior anterior aspect of the right lobe

20

Treatment of amebic abscess

1. metronidazole 750 mg TID for 7 to 10 days

21

What is the most common location of hydatid disease

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

22

Treatment of hydatid cyst

Surgery and instillation of scolicidal agent

23

Milan critera for liver transplantation

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

24

Treatment option for liver cancer

1. hepatic resection
2. liver transplantation

25

Most common site of metastasis of liver cancer

lungs

26

Types of Cholangiocarcinoma

1. intrahepatic
2. extrahepatic (klatskin tumor)

27

What is the manifestation of klatskin tumor

Obstructive and painless jaundice

28

Most important risk factor for gallbladder carcinoma

cholelithiasis

29

Most USEFUL radiologic test for diagnosing acute cholecystitis

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

30

most ACCURATE radiologic test for diagnosis acute cholecystitis

HIDA scan

31

Gold standard for diagnosing choledocholithiases

endoscopic cholangiography

32

What is charcot's triad

1. fever
2. RUQ pain
3. Jaundice

33

What is reynaud's pentad

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

34

Most common type of choledochal cyst

Type I - cystic dilatation of the extrahepatic bile duct

35

Types of choledochal cyst

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

36

Treatment of choledochal cyst

complete cyst excision with roux en Y hepaticojejunostomy