Hepatobiliary Flashcards

1
Q

Milan criteria

A

Single lesion <5cm or up to 3, 3cm or less
No vascular or extra hepatic dz
AFP <1000ng/mL

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2
Q

Most sensitive modality for detecting small liver mets

A

Intraop US

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3
Q

Pyogenic liver abscess, tx

A

Broad spectrum abxs, and perc drainage

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4
Q

Required future liver remnant

A

> 20% healthy, >40% for cirrhotics

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5
Q

Gold standard to hypertrophy future liver remnant

A

Portal vein embolization

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6
Q

Contraindications to liver txp

A

Unstable CAD, pulm htn, O2 dependence, uncontrolled malignancy/infx, noncompliance

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7
Q

How to prevent tumor growth between PVE and liver resection

A

TACE

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8
Q

Suspected distal cholangiocarcinoma; next step

A

ERCP to visualize and bx, possibly stent

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9
Q

Common organism in SBP

A

Gram neg enteric bacteria, E coli, Klebsiella, PsA

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10
Q

Isolated gastric varices with hx of chronic pancreatitis; dx and tx

A

Splenci vein thrombosis, splenectomy

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11
Q

Blood supply CBD

A

Cystic, hepatic, GDA branches 3 and 9 o’clock

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12
Q

Significant morbidity and mortality in fulminant liver failure; dx and tx

A

Intracranial HTN and cerebral edema, invasive ICP monitoring

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13
Q

Hydatid disease treatment

A

Based on WHO classification: Surgery, puncture-aspiration-injection-reaspiration(PAIR), albendazole or observation

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14
Q

Most common cause of esophageal varices; tx

A

Portal HTN from cirrhosis/hepatitis, Endoscopic/beta-blockade -> TIPS

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15
Q

Unstable with multiple endoscopic attempts at managing esophageal varix bleed

A

Sengstaken-Blakemore or Minnesota tube

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16
Q

Liver lesion, central scar with intense arterial enhancement

17
Q

Liver lesion, Hyperechoic with peripheral nodular enhancement and centripetal fill on delay

A

Hemangioma

18
Q

Liver lesion, cirrhotic with arterial enhancement with wash out

19
Q

Liver lesion, on OCPs with arterial enhancement and isointense delay

20
Q

Budd-Chiari syndrome; diagnostic test

21
Q

Important to improve outcomes for hernia repair in cirrhotics

A

Control ascitic fluid (diuretics, paracentesis, TIPS)

22
Q

Major cause of pyogenic liver abscesses

A

Cholangitis (obstruction due to malignancies/stones)

23
Q

Hemangioma treatment

A

Observed, if symptomatic resect

24
Q

Hepatic amoebic abscess; tx

A

Metronidazole

25
Liver abscess, hx of diverticulitis, appendicitis, diarrhea; dx and tx
Pyogenic, IV broad spectrum abxs +/- drain
26
Liver abscess, hx of travel to tropical under-developed areas; dx and tx
Amoebic (Entamoeba histolytica), Metronidazole
27
Liver abscess, hx of distant exposure to sheep grazing area (Mediterranean, Central Asia) may have daughter cysts; dx and tx
Hydatid (Echinococcus), Albendazole +/- PAIR
28
Bleeding esophageal varices; medical tx
Infusion of vasopressin with nitroglycerin, octreotide and PPI
29
Focal nodular hyperplasia; tx
Conservatively, only resect if persistent symptoms, enlarging size, and dx uncertainty
30
TIPS indication
>2-3 large volume paracenteses/month in spite of optimal sodium restriction and and diuretics
31
Initiating event in the formation of ascites
Sinusoidal hypertension
32
Area of exchange between hepatocyte and blood
Space of Disse
33
Where are most conjugated bile acids absorbed and how
Terminal ileum, active transport