10/18/2018

Question 1

secondary liver failure

Answer 1

No pre-existing liver disease. The Liver failure is a result of the patient’s overall critical condition.

Question 2

Lung major fissure separates…

Answer 2

lower lung from middle/upper lung. (also called oblique fissure)

Question 3

Treatment for malignant hyperthermia?

Answer 3

Stop offending anesthetic, Stop surgery, 100% O2, give dantrolene 2.5mg/kg q5min, glucose, HCO3, alternate anesthetic

Question 4

Longest and most variable phase of cell cycle

Answer 4

G1.

Not G0, division stops in G0.

Question 5

Most radiosensitive phase of the cell cycle

Answer 5

G2 and M

Question 6

Most radioRESISTANT phase of the cell cycle

Answer 6

S phase

Question 7

p53 mutations arrest in what phase of cell cycle

Answer 7

G1.

Question 8

Associations with GB cancer

Answer 8

Cholelithiasis (especially > 3cm), limited areas of calcification but not diffuse calcification/porcelain, polyps > 1cm (esp solitary), choledochal cysts

Question 9

Boundaries of the femoral canal

Answer 9

iliopubic tract superiorly,
Cooper ligament inferiorly,
femoral vein laterally,
lacunar ligament medially (junction of the iliopubic tract and Cooper ligament)

Question 10

Hepatic adenoma appearance on imaging?

Tx?

Answer 10

Strong early-phase enhancement, hyperintense on T1 and rapid washout. NO Kupffer cells.
Tx: If < 4cm and asymptomatic then stop OCPs, observe. If persists then resect, malignant potential.
If > 4cm then resect, malignant potential + risk of rupture, 30-50%?

Question 11

FNH appearance on imaging?

Tx?

Answer 11

Nearly isointense on T1 & T2.
Homogeneous mass with maybe central scar that enhances rapidly during arterial phase.
Has Kupffer cells so + on sulfur colloid scan.
Tx: No resection, may stop OCPs as well.

Question 12

Liver hemangioma appearance on imaging?

Tx?

Answer 12

+on Tagged RBC scan (best test)
Peripheral nodular enhancement on CT/MRI/
Tx: Asymptomatic = conservative.
Symptomatic then resect +/- pre-op embolize.
Unresectable? Then steroids or possible XRT.

Question 13

Solitary wall of blue hue on liver during OR?

Answer 13

Solitary liver cyst. Most are left alone.

Question 14

What is may-thurner syndrome?

Answer 14

Left common iliac vein obstruction as is crosses under the right common iliac artery.
> in women.
May need thrombolysis, angioplasty, stenting

Question 15

Difference between chronic and acute liver failure?

Answer 15

Acute liver failure patient will be unstable and coagulopathic.

Question 16

TTP (AKA Moschcowitz syndrome) classic pentad?

Answer 16

Thrombocytopenic purpura, neuro symptoms, renal disease, anemia, fever