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GI (Y1) > Focal liver lesions - Week 6 > Flashcards

Focal liver lesions - Week 6 Flashcards

1
Q

Solid liver lesions in chronic liver disease patients is most likely…

A

Primary liver cancer

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2
Q

Cancer in the absence of liver disease is more likely to be…

A

Metastases

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3
Q

In non cirrhotic patients, the most common solid liver tumour is…

A

Haemangioma

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4
Q

Name 4 benign liver lesions.

A

Haemangioma, Focal nodular hyperplasia, Adenoma, Liver cysts

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5
Q

Name 2 primary liver cancers.

A

Hepatocellular carcinoma, cholangiocarcinoma

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6
Q

What is the most common liver cancer?

A

Haemangioma

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7
Q

What are the common symptoms of haemangioma?

A

Usually asymptomatic

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8
Q

Is haemangioma benign or malignant?

A

Benign

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9
Q

How is haemangioma usually diagnosed?

A

CT/MRI

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10
Q

What is meant by focal nodular hyperplasia?

A

Benign nodule formation - hyperplastic response to abnormal arterial flow.

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11
Q

In which group is focal nodular hyperplasia (FNH) most common?

A

Young to middle aged women

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12
Q

Which symptoms usually present with focal nodular hyperplasia (FNH)?

A

Usually asymptomatic

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13
Q

Is focal nodular hyperplasia (FNH) benign or malignant?

A

Benign

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14
Q

Which focal liver lesion is associated with sex hormones?

A

Hepatic Adenoma

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15
Q

What are the symptoms of Hepatic Adenoma?

A

Asymptomatic, potentially RUQ pain

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16
Q

What is the significance of sex in Hepatic Adenoma?

A

Women 10 times more likely to develop it but progresses much more quickly in men

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17
Q

What is the treatment for Hepatic Adenoma?

A

Remove in men, scan & remove if over 5cm in women

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18
Q

Is there a malignant risk with Focal Nodular Hyperplasia?

A

No

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19
Q

Is there a malignant risk with Hepatic Adenoma?

A

Yes

20
Q

What is meant by a simple cyst?

A

Liquid collection lined by an epithelium

No biliary tree communication

21
Q

Echinococcus granulosus suggests…

A

Hydatid cyst

22
Q

How is a Hydatid cyst diagnosed?

A

detection of anti-Echinococcus antibodies

23
Q

Where are Hydatid cysts endemic?

A

Eastern Europe Central America and South America, Middle East and North Africa

24
Q

How are Hydatid cysts treated?

A

Percutaneous drainage or surgery

25
Q

How is polycystic liver disease (PLD) characterised?

A

Embryonic ductal plate malformation of the intrahepatic biliary tree
Numerous cysts throughout liver parenchyma

26
Q

What is the link between Polycystic liver disease (PCLD) and autosomal dominant polycystic kidney disease (ADPKD)?

A

Polycystic liver disease almost always causes renal failure but polycystic kidney disease often has little effect on the liver

27
Q

Give the clinical features of a liver abscess.

A

High fever
Leukocytosis
Abdominal Pain
Complex liver lesion

28
Q

Which aspects of history are particularly important in suspected liver abscesses?

A

Abdominal or biliary infection

Dental procedure

29
Q

How are liver abscesses managed?

A

Initial broad spectrum antibiotics
Potentially percutaneous drainage/surgery
4 weeks specific antibiotic treatment with repeated scanning

30
Q

What is the most common malignant liver cancer?

A

Hepatocellular carcinoma (HCC)

31
Q

What is the most important risk factor for HCC?

A

Cirrhosis

32
Q

What are the clinical features of HCC?

A

Weight loss & RUQ pain, most asymptomatic, worsening of pre-existing chronic liver disease

33
Q

Where may HCC spread to?

A 
Rest of the liver
Portal vein
Lymph nodes
Lung
Bone
Brain
34
Q

Name a HCC tumour marker.

A

AFP (Alfa fetoprotein)

35
Q

What is the best available treatment for HCC?

A

Liver transplantation

36
Q

HCC resection is possible for…

A

Small tumours with preserved liver function

37
Q

What is a disadvantage of resection for HCC?

A

Large recurrence rate

38
Q

Which treatments are used for patients with non-resectable HCC?

A

Radiofrequency ablation/ethanol injection

39
Q

Which treatment option for HCC is useful in patients with early cirrhosis?

A

Chemoembolization

40
Q

What is meant by Chemoembolization?

A

Inject chemotherapy selectively in hepatic artery

41
Q

Fibro-Lamellar Carcinoma is most common in which group of patients?

A

Aged 5-35

42
Q

Is Fibro-Lamellar Carcinoma related to Cirrhosis?

A

No

43
Q

CT shows typical stellate scar with radial septa showing persistent enhancement. Which cancer is present?

A

Fibro-Lamellar Carcinoma

44
Q

What is the standard treatment for Fibro-Lamellar Carcinoma?

A

Surgical resection or transplantation

45
Q

Where is the most common site for blood born metastases?

A

Liver

46
Q

Give some common primaries which cause secondary liver metastases.

A

colon, breast, lung, stomach, pancreas and melanoma

GI (Y1) (79 decks)

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