Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GI > Liver Lesions > Flashcards

Liver Lesions Flashcards

(68 cards)

Start Studying
1
Q

what are solid liver lesions in older patients more likely to be

A

malignant- metastases more common that primary when no liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are solid liver lesions in chronic liver disease patients (cirrhosis or active hep b) more likely to be

A

primary liver cancer- more than metastases or benign tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

in non cirrhotic patients what is the most common solid liver tumour

A

haemangioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are cirrhotic patients screened for

A

hepatoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

when should imaging be done

A

when abdo pain, deranged LFT’s, resp problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are 4 benign liver lesion

A

haemangioma, focal nodular hyperplasia, adenoma, liver cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are 2 primary liver cancers

A

hepatocellular carcinoma, cholangiocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are two types of cholangiocarcinoma

A

fibrolamellar carcinoma, hepatoblastoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the most common liver tumour

A

benign- haemangioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

haemangioma more/less commen in males than females

A

more common in females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the clinical features of haemangioma

A

usually asymptomatic, usually single and small hypervascular tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how do you diagnose haemangioma

A

US: echogenic spot, well demarcated

CT: venous enhancement from periphery to centre

MRI: high intensity area
No need for FNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the treatment for haemangioma

A

no treatment needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is an FNH, describe it

A

focal nodular hyperplasia

  • benign nodule formation of normal liver tissue
  • congenital vascular anomaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what does a FNH classically look like

A

central scar containing a large artery, radiating branches to the periphery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is FNH associated with

A

with Osler-Weber-Rendu and liver haemangioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what causes FNH

A

hyperplastic response to abnormal arterial flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is present in histology of FNH

A

sinusoids, bile ductules and kupffer cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the symptoms of FNH

A

usually asymptomatic, may cause minimal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

who is FNH more common in

A

young/ middle aged women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how is FNH diagnosed

A

US: Nodule with varying echogenicity

CT: Hypervascular mass with central scar

MRI: Iso or hypo intense

FNA: Normal hepatocytes and Kupffer cells with central core

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the treatment for FNH

A

no treatment needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

describe a hepatic adenoma

A

benign neoplasm composed of normal hepatocytes, no portal tract, central veins or bile ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

are hepatic adenomas more common in males or females

A

females 10:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what are hepatic adenomas associated with
contraceptive hormones and anabolic steroids
26
how might hepaic adenomas present
usually asymptomatic but may have RUQ pain present with rupture, haemorrhage or malignant transformation (rare)
27
are males or females at a higher risk of malignant transformation of hepatic adenomas
men
28
what is adenomatosis
multiple adenomas, a rare condition associated with glycogen storage disease
29
how is hepatic adenoma diagnosed
US: Filling defect CT: Diffuse arterial enhancement MRI: Hypo or hyper intense lesion FNA: May be needed
30
how are hepatic adenomas treated
Stop hormones, weight loss Males (irrespective of size) : surgical excision Females : imaging after 6months <5cm or reducing in size - annual MRI >5cm or increase in size - for surgical excision
31
what are the two benign solid liver lesions found in young patients
adenoma, focal nodular hyperplasia
32
what are the different types of cystic lesions
simple, hydrated, atypical, polycystic lesion, pyogenic or amoebic abscess
33
what is a simple cyst, describe
liquid collection lined by an epithelium- no biliary tree communication, solitary and uniloculated
34
when does a simple cyst cause symptoms
intracystic haemorrhage, infection, rupture (rare), compression
35
how is a simple cyst managed
no follow up needed- if doubt/ symptomatic consider imaging in 3/6 months or surgical intervention
36
what is a hydatid cyst
multiple cysts caused by the parasite enchinococcus granulosus
37
how does echinococcus granulosus present
disseminated disease, erosion of cysts into adjacent structures and vessels (IVC)
38
how is hydatid cyst managed
conservative (most common)- open cystectomy, marcupialization radical pericystectomy, lobectomy medical: albendazole percutaneous drainage
39
what are the risks of hyatid cyst surgery
operative mortality, anaphylaxis, dissemination of infection
40
what is polycystic liver disease
when an embryonic ductal plate malformation of the intrahepatic biliary tree causes numerous cysts throught liver parenchyma
41
what are the three types of polycystic liver disease
- von meyeburg complexes (VMC) - polycystic liver disease - autosomal dominant polycystic kidney disease
42
what are von meyenburg complexes
(aka microhamartomas) bengin cyst nodules throughout the liver cystic bile duct malformations originating from the peripheral biliary tree
43
what is the outcome of autosomal dominant polycystic kidney disease
renal failure due to polycystic kidneys and non renal extra hepatic features
44
in what disease is potential massive hepatic enlargement a threat
autosomal dominant polycystic kidney disease
45
how is polycystic liver disease managed
management of; abdo pain, abdo distention and atypical symptoms caused by voluminous cysts compressing adjacent tissues or failure of affected organ conservative treatment to halt cyst growth invasive porcedures (aspiration/ transplant) in advanced cases somatostatin can relieve symptoms and reduce liver volume
46
what are the clinical features of liver abcess
high fever, leukocytosis, abdo pain, complex liver lesions
47
what is the usual history of a liver lesion
abdo or biliary infection or dental procedure
48
how are liver abscesses managed
initial empiric broad spectrum antibiotics aspiration/ drainage percutaneously echocardiogram open drainage/ resection if no clinical improvement 4 weeks antibiotic therapy with repeat imaging
49
what are the 5 main types of malignant liver tumours
``` hepatocellular, fibro-lamellar carcinoma of the liver, hepatoblastoma, intrahepatic cholangiocarcinoma, metastases ```
50
is hepatocellular carcinoma more common in men or women
men
51
cirrhosis is the most important risk factor of HCC, what can cause cirrhosis
hepatitis B and C, alcohol, aflatoxin
52
what are the clinical features of HCC
Wt loss and RUQ pain (most common) Asymptomatic Worsening of pre-existing chronic liver disease Acute liver failure
53
what might be found on examination of HCC
signs of cirrhosis, hard enlarged RUQ mass, liver bruit (rare)
54
where is HCC likely to metastasise to
``` Rest of the liver Portal vein Lymph nodes Lung Bone Brain ```
55
what is AFP (alpha fetoprotein)
HCC tumour marker, values >100ng/ml highly suggestive
56
what does a HCC prognosis depend on
tumour size, extrahepatic spread, underlying liver disease, patient performance
57
what is the requirement for liver transplantation in HCC
single tumour less than 5cm or less than 3 tumours each smaller than 3cm
58
what are the treatment options for HCC
liver transplant, resection, percutaneous ethanol injections/ radio-frequency ablation, transarterial chemoembolism, sorafenib, palliative
59
when is resection possible and what is the downfall
for small tumour with preserved liver function recurrence rate is high
60
when is local ablation done
when non resectable or advanced liver cirrhosis
61
what is trans arterial chemoembolization (TACE)
inject chemotherapy in hepatic artery with embolic agent- only in patients with early cirrhosis
62
what is sorafenib
systemic therapy for HCC
63
who does fibro-lamellar carcinoma present in
young patients 5-35
64
is fibro lamellar carcinoma associated with cirrhosis
no
65
what is the AFP like in fibro lamellar carcinoma
AFP
66
what is the management for fibro-lamellar carcinoma
surgical resection or transplantation TACE for unresectable tumours
67
what is the most common site for blood born metasteses
liver
68
what are the common metastases of the liver
colon, breast, lung, stomach, pancreas and melanoma

GI (64 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions