Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Drafts of absite from online deck > ABSITE Review - Liver > Flashcards

ABSITE Review - Liver Flashcards

(64 cards)

Start Studying
1
Q

What is the #1 and #2 hepatic artery variant?

A 
#1 R hepatic artery off SMA (20%) - courses behind pancreas, POSTEROLATERAL to the CBD
#2 L hepatic artery off L gastric (20%) - found in gastrohepatic ligament
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the falciform ligament?

A

Separates the medial and lateral segments of the L lobe; attaches liver to anterior abdominal wall; extends to umbilicus and carries umbilical vein.

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

What is the ligamentum teres?

A

Carries the obliterated umbilical vein to the undersurface of the liver; extends from the falciform ligament

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

What are the segments of the liver?

A

I - caudate
II - superior left lateral segment
III - inferior left lateral segment
IV - left medial segment (quadrate)
V - inferior right anterolateral segment
VI - inferior right posterolateral segment
VII - superior right posterolateral segment
VIII - superior right anteromedial segment

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

Where is the bare area of liver?

A

Posterior-superior surface of liver not covered by Glisson’s capsule

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

Where the portal triad enters the liver?

A

Segments IV and V

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

What is other name for liver macrophages?

A

Kupffer cells

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

What is in the portal triad and their location within it?

A

Portal vein posteriorly, CBD laterally, hepatic artery medially

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

What is the Pringle maneuver?

A

Porta hepatis clamping; will not stop hepatic vein bleeding

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

What is the positioning of the Foramen of Winslow?

A

Anterior - portal triad
Posterior - IVC
Inferior - Duodenum
Superior - Liver

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

What two veins form the portal vein?

A

Forms from SMv joining splenic vein (no valves)

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

How many portal veins are in the liver and what segment they drain?

A

Left - II, III, IV

Right - V, VI, VII, VIII

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

Where the middle hepatic artery usually comes off?

A

Middle heaptic artery MC a branch off the Left hepatic artery

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

Which segment each hepatic veins drain?

A

Left - II, III, sup IV
Middle - V, inf IV
Right - VI, VII, VIII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the arterial supplay and venous drainage of the caudate lobe?

A

Receives separate right and left portal and arterial blood flow; drains directly into IVC via separate hepatic veins

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

What is the usual energy source of the liver?

A

Ketones

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

Where is urea synthesized?

A

Liver

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

Which factors are not made in the liver?

A

vWF, factor VIII (endothelium)

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

Which is the only water soluble vitamin stored in the liver?

A

B12

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

What are the Mc problems after a hepatic resection?

A

Bleeding and bile leak

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

Which hepatocytes are the most sensitive to ischemia?

A

Central lobular (acinar zone III)

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

How much liver can be safely resected?

A

75%

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

What are the two primary bile acids?

A

Cholic and chenodeoxycholic

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

What are the two secondary bile acids?

A

Deoxycholic and lithocolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the main biliary phospholipid?
Lecithin
26
Where is the first place to look for jaundice?
Under the tongue
27
What is Gilbert's disease?
Abnormal uptake; mildly high unconjugated bilirubin
28
What is Crigler-Najjar disease?
Inability to conjugate; deficiency of glucoronyl transferase; high unconjugated bilirubin --> life-threatening
29
What is physiologic jaundice of newborn?
Immature glucoronyl transferase; high unconjugated bilirubin
30
What is Rotor's syndrome?
Deficiency in storage ability; high conjugated bilirubin
31
What is Dubin-Johnson syndrome?
Deficiency in secretion ability; high conjugated bilirubin
32
What types of hepatitis can cause chronic hepatitis and hepatoma?
B, C and D
33
What is the tyoe of hepatitis that is DNA?
Hepatitis B
34
What is the marker of Hepatitis B vaccination?
Increase anti-HBs antibodies
35
What is the MCC of liver failure?
Cirrhosis
36
What is the best indicator of synthetic function in a patient with cirrhosis?
Prothrombin time
37
What is the treatment for hepatic encephalopathy?
Lactulose - cathartic that gets rid of bacteria in the gut and acidifies colon (preventing NH3 uptake by converting it to ammonium) Limit protein intake Branched-chain amino acids
38
What is the most likely cause of hepatic failure with ascites postpartum?
Hepatic vein thrombosis | Dx - SMA arteriogram with venous phase contrast
39
What is the MC bacteria in SBP?
E coli
40
What is the treatment for esophageal varices?
Sclerotherapy, Vasopressin (splanchnic artery constriction), Octreotide (decrease portal pressure by decrease blood flow), Propanolol
41
What are the three types of portal HTN? Give some examples of each.
Presinusoidal obstruction - schistomiasis, congenital hepatic fibrosis, portal vein thrombosis Sinusoidal obstruction - cirrhosis Postsinusoidal obstruction - Budd-Chiari syndrome (hepatic vein occlusive disease), constrictive pericarditis, CHF
42
What is the normal portal vein pressure?
<12 mmHg
43
When is a TIPS indicated?
Used for protracted bleeding, progression of coagulopathy, visceral hypoperfusion, refractory ascites.
44
What is a splenorenal shunt?
Ligate Left adrenal vein, left gonadal vein, inferior mesenteric vein, coronary vein, and pancreatic branches of splenic vein Used only for Child's A cirrhotics who present just with bleeding
45
What is Budd-Chiari syndrome?
Occlusion of hepatic veins and IVC Dx - angio, CT scan, liver biopsy sinusoidal dilatation, congestion, centrilobular congestion Tx - portacaval shunt
46
What is the MCC of splenic vein thrombosis?
Pancreatitis
47
How is an amebic infection diagnosed? What is the treatment?
Entamoeba histolytica | Tx - Flagyl
48
What are the risk factor for an amebic abscess? Which liver lobe is most commonly involved?
Travel to Mexico, ETOH, fecal-oral transmission | Right lobe of liver
49
What is the agent that cause Hydatid cyst? How it can be diagnosed?
Echinococcus | Dx - Positive Casoni skin test, positive indirect hemagglutination
50
Which animals are carrier of Echinococcus?
Sheeps
51
Can you aspirate a hydatid cyst? What is the treatment?
No!!! It can leak and cause an anaphylactic shock. Tx - Preop ERCP if jaundice, increase LFTs or cholangitis. Preop albendazole Surgical removal (may want to inject cyst with alcohol at time of removal to kill organisms); need to get all the cyst wall
52
In 80% of the liver abscesses, the MCC is?
Pyogenic abscess
53
What are the risk factors for liver adenomas?
Women, steroid use, OCPs, type I collagen storage disease
54
How are liver adenomas diagnosed?
MRI demonstrates hypervascular tumor, has peripheral blood supply No Kupffer cells in adenomas, thus no uptake on sulfur colloid scan (cold)
55
What is the treatment for liver adenomas?
Asymptomatic - stop OCPs, if no regression --> pt needs resection Symptomatic - tumor resection for bleeding and malignancy risk; embolization if multiple and unresectable
56
What is usually describe as a central stellate scar?
Focal nodular hyperplasia
57
How is FNH diagnosed? What is the treatment?
Dx - Abdominal CT; has Kupffer cells, so will take up sulfur colloid on liver scan MRI/CT scan demonstrates a hypervascular tumor Tx- conservative mgmt
58
What is the MC benign hepatic tumor?
Hemangioma
59
How is FNH diagnosed? What is the treatment?
Dx - MRI and CT scan show peripheral to central enhancement, hypervascular lesion Tx - conservative unless symptomatic, then surgery +/- embolization, XRT and steroids for unresectable disease
60
What are the risk factors of HCC?
HBV (#1), HCVm ETOH, hemochromatosis, alpha-1-antitrypsin deficiency, primary sclerosing cholangitis, aflatoxins, hepatic adenoma, steroids, pesticides
61
What marker correlates with HCC tumor size?
AFP
62
What are the risk factors for hepatic sarcoma?
PVC, Thorotrast, arsenic
63
What are the risk factors asocciated with cholangiosarcoma?
Clonorchiasis infection, ulcerative colitis, hemochromatosis, primary sclerosing cholangitis, choledochal cyst
64
What is the difference in vascularity of primary vs metastatic liver tumors?
Primary - hypervascular | Metastatic - hypovascular

Drafts of absite from online deck (62 decks)

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