Hepatobiliary disease

Question 1

the liver is divided into how many segments?

Answer 1

8

Question 2

the left and right liver lobes are divided by what vessel?

Answer 2

middle hepatic vein

Question 3

what are the benign liver lesions?

Answer 3

FNH
simple cyst
hemangioma
adenoma

Question 4

liver cell adenomas are associated with what medication?

Answer 4

oral contraceptives

Question 5

oral contraceptives are associated with what type of liver lesion?

Answer 5

liver cell adenomas

Question 6

what is the morphology of FNH?

Answer 6

nodular hyperplastic parenchyma with one or more macroscopic CENTRAL SCARS

Question 7

how is FNH imaged?

Answer 7

arterial phase CT

Question 8

what types of cells are involved in FNH?

Answer 8

hepatocytes
scar
biliary tracts

Question 9

what is the most common benign tumor of the liver?

Answer 9

hemangioma

Question 10

what is the morphology of hemangiomas?

Answer 10

endothelium lined, blood filled spaces

Question 11

which hepatobiliary malignancies are intrahepatic?

Answer 11

primary hepatoma

bile duct

Question 12

what are the HCC risk factors?

Answer 12

male 
aflatoxin 
hep B and C 
cirrhosis 
hemochromatosis 
wilsons disease 
a1AT deficiency 
NASH

Question 13

what is the leading cause of cirrhosis?

Answer 13

alcohol abuse

Question 14

what is the main diagnostic feature of primary hepatic CA?

Answer 14

increased alpha feto protein

Question 15

is AFP used for screening?

Answer 15

no

Question 16

what are the challenges of liver surgery?

Answer 16

dual blood supply
hepatic reserve
coagulopathy

Question 17

what is the child pugh score?

Answer 17

assessing operative risk of liver resection base on hepatic reserve

Question 18

what makes the best operative candidate?

Answer 18

early stage HCC
child pugh class A
solitary mass
no vascular invasion

Question 19

what are the ablation type therapies for liver cancer?

Answer 19

cryo 
microwave 
radio 
ethanol 
acetic acid injection

Question 20

most liver tumors are fed by which hepatic blood supply?

Answer 20

arterial

Question 21

what is the MOA of sorafenib?

Answer 21

blocks tumors from forming new blood vessels

slows growth of tumors by targeting surface proteins

Question 22

what are the 3 classifications of cholangiocarcinoma? where is the majority of cholangiocarcinomas?

Answer 22

intrahepatic
perihilar
distal

perihilar

Question 23

what are the risk factors for bile duct cancer?

Answer 23

most patients have no known risk factor

Question 24

what is the only cure for bile duct cancer?

Answer 24

surgical resection

Question 25

what is the main clinical presentation for bile duct carcinomas?

Answer 25

signs of biliary tract obstruction

painless jaundice
obstructive pain

Question 26

what markers are elevated in cholangiocarcinomas?

Answer 26

CA 19-9

CEA

Question 27

what type of surgery is performed for a perihilar cholangiocarcinoma?

Answer 27

roux-en-y hepatojejunostomy

Question 28

what is the typical gall bladder cancer population?

Answer 28

elderly women

Question 29

what are the features of gall bladder cancer?

Answer 29

metastasizes early
aggressive
poor prognosis

Question 30

people with what gall bladder cancer diagnosis have the best prognosis?

Answer 30

limited to mucosa and lamina proprita T1a