GI: Liver Tumours + Hernias

Question 1

Which organism is the most common cause of liver abscesses?

Answer 1

E.Coli

Question 2

What are the symptoms of a liver abscess?

Answer 2

Fever
Lethargy
Abdominal Pain
Weight loss

Question 3

Which investigation is diagnostic of a liver abscess?

Answer 3

CT scan

Question 4

Which other type of micro-organism can cause a liver abscess?

Answer 4

Amoebas - spread from the bowel to the liver via the portal venous system

Question 5

A CT scan of a backpacker returning from India shows a single abscess in the right lobe of the liver. What is the most likely causative organism?

Answer 5

Amoeba

Question 6

What antibiotic is given for an amoebic abscess?

Answer 6

Metronidazole

Question 7

Are primary or secondary tumours of the liver more common?

Answer 7

Secondary- metastasis commonly from breast, bronchus or GI tract

Question 8

What are the symptoms of a hepatocellular carcinoma?

Answer 8

Weight loss
Anorexia 
Fever
Ascites
Abdominal pain

Question 9

Which chronic liver condition is a big risk factor for the development of hepatocellular carcinoma?

Answer 9

Cirrhosis

Question 10

Presence of which substance in the blood indicates a hepatocellular carcinoma?

Answer 10

Alpha feto protein

Question 11

What is the most common benign liver tumour?

Answer 11

Hemangioma

Question 12

Which benign liver tumour is associated with use of the oral contraceptive pill?

Answer 12

Adenoma

Question 13

What condition are multiple adenomas (adenomatosis) associated with?

Answer 13

Glycogen storage disease

Question 14

Parasites from which organism cause hyatid cysts?

Answer 14

Sheep

Question 15

What is a hernia?

Answer 15

An abnormal protrusion of a viscus out-with its normal body cavity

Question 16

What is the most common hernia? What is the least common hernia?

Answer 16

most: inguinal hernia
least: femoral

Question 17

What is the main risk factor for developing a hernia?

Answer 17

Raised intra-abdominal pressure

e.g. lifting, coughing, pregnancy

Question 18

What is a reducible hernia?

Answer 18

A hernia which goes back in and does not reappear

Question 19

How do epigastric hernias arise? Are they more common in males or females?

Answer 19

Congenital weakness of the linea alba

Males

Question 20

Where are femoral hernias usually located? Are they more common in males or females?

Answer 20

Below and lateral to the pubic tubercle

Females (10x more common)

Question 21

Where are inguinal hernias usually located?

Answer 21

Above and medial to the pubic tubercle

Question 22

Are direct inguinal hernias medial or lateral to inferior epigastric vessels?

Answer 22

Medial

Question 23

Are indirect inguinal hernias medial or lateral to inferior epigastric vessels?

Answer 23

Lateral

Question 24

What sex and age group are indirect inguinal hernias most common in?

Answer 24

Young men

Question 25

What is the processus vaginalis?

Answer 25

The peritoneal sac through which the testes descend into the scrotum

Question 26

What does a patent processus vaginalis cause?

Answer 26

Fluid in the scrotum

Indirect inguinal hernia

Question 27

Are vertical or transverse surgical incisions more likely to cause a hernia?

Answer 27

Vertical

Question 28

Are indirect or direct hernias more likely to be reducible?

Answer 28

Direct

Question 29

Are direct or indirect hernias more common in the elderly?

Answer 29

Direct- hernia due to weakness in the posterior wall of the inguinal canal

Question 30

Are direct or indirect hernias more common in children?

Answer 30

Indirect- hernia due to failure of inguinal canal to close properly