Focal Lesions In The Liver

Question 1

Polycystic liver disease presentation

Answer 1

Pain (due to conpression of of adjacent tissue or failure of affected organ)
Abdominal distension

Question 2

PLD management

Answer 2

Surgery less

Rare liver transplant and/ kidney transplant

Question 3

Liver abscess presentation

Answer 3

Sepsis
High fever
Increased wbc
Abdominal pain
Gastroenteritis and dental procedure (in the past)

Question 4

LA management

Answer 4

Initial broad spectrum antibiotics

Aspiration/ drainage

Question 5

What are the different types of malignant carcinomas?

Answer 5

.

Question 6

Risk factpr for HCC?

Answer 6

Cirrhosis of any cause:
Hep B
Hep C
Alcohol

Question 7

Lresentation for HCXlC

Answer 7

Chronic liver disease and then de-compensate (ascites)
Rarelt acute liver failure
Signs of cirrhosis
Enlarged roght upper quadrant masd
Ascites

Question 8

Metastases of HCC?

Answer 8

Rest of liver
Portal veon
Lymph nodes
Lung node
Rarely brain

Question 9

Metastases of HCC?

Answer 9

Rest of liver
Portal veon
Lymph nodes
Lung node
Rarely brain

Question 10

Investigations for HCC?

Answer 10

AFP - HCC tumour marker
Values >100ng/ ml highly suggestive of HCC
Ultrasound
Triphasic CT san: very early arterial perfusion
MRI
Biopsy - if it isn’t clear (sealing of hepatocytes if we do biopsy)

Question 11

HCC prognosis

Answer 11

Tumour size
Extraheptaic disease
Compensation in terms of liver function

Question 12

HCC treatment

Answer 12

Liver transplant- best available treatment
Only if single tumour or less than 3 tumours less than 3 cm each

Hard bcuz most found out late with metastases and major

Local ablation: radiofrequency palliative intent
For non- resectable pt
Alcohol/ ethanol injection
TACE - inject chemotherapy in hepatoc artery (for palliative intent, with early cirrhosis)
no systemic chemotherapy

Question 13

HCC systemic therapies

Answer 13

Chemo not that adv.
Sorafenib - median survival of 10.7 months
Multikinase inhibit or egfr and raf
But stop after sometime due to toxicities associated with the medication

Question 14

HCC systemic therapies

Answer 14

Chemo not that adv.
Sorafenib - median survival of 10.7 months
Multikinase inhibit or egfr and raf
But stop after sometime due to toxicities associated with the medication

Question 15

Secondary liver meyastases

Answer 15

Secondary location for blood born metastases from colon, breast, lung, stomach and pancreas cancer

Question 16

Secondary liver meyastases

Answer 16

Secondary location for blood born metastases from colon, breast, lung, stomach and pancreas cancer