Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

True Learn Studying 2021 > Hepatobiliary Disease Review > Flashcards

Hepatobiliary Disease Review Flashcards

1
Q

Most common benign liver tumor?

A
  • Hemangioma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Clinical features of liver hemangioma?

A
  • more common in women (3:1 ratio)
  • most are asymptomatic
  • stable with low risk of rupture
  • 0 reports of malignant degeneration
  • resection should be considered if mass effect is causing symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What kind of liver tumor should be on your differential if patient is on hormonal therapy? (e.g OCPs, steroids)

A
  • hepatic adenoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

CT scan characteristics of hepatic angioma?

- Arterial phase, portal venous phase, delayed phase

A
  • Arterial: peripheral nodular enhancement (non-homogenous)
  • portal venous: centripetal filling
  • delayed: enhancement of entire mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

CT scan characteristics of hepatic adenoma?

- Arterial phase, portal venous phase, delayed phase

A
  • Arterial: peripheral then leading to centripetal enhancement (homogenous)
  • portal venous: isodense or hypodense (compared to surrounding parenchyma)
  • delayed: isodense or hypodense
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

CT scan characteristics of Focal Nodular Hyperplasia?

- Arterial phase, portal venous phase, delayed phase

A
  • arterial: intense enhancement, central fibrous scar with radiating septa
  • venous phase: partial filling
  • delayed: enhancement of central scar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

First step of a right hepatectomy

A
  • cholecystectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

most common sign of recurrence for gall bladder cancer?

A
  • ascites

- jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the underlying physiology behind hepatorenal syndrome?

A
  • liver failure leads to severe vasodilation and arterial hypovolemia -> kidneys see decreased BP and therefore retain sodium/water
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pharmacological therapy for HRS?

A
  • Albumin + vasoconstrictive agent (most common is terlipressin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Patient is post op from a VARD, has small volume hematemesis…next step?

A
  • CTA of the abdomen and possible angio-embolization

- this is potentially a herald bleed from a pseudoaneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are primary bile salts conjugated with in hepatocytes?

A
  • taurine and glycine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

where is the bulk of conjugated bile acids absorbed in the GI tract?

A
  • 80% of all secreted conjugated bile salts are absorbed in the terminal ileum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what vitamins do bile acids help absorb?

A
  • fat soluble ones

- A D E K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

indication to resect a hepatic adenoma

A
  • male gender
  • size > 5cm
  • symptomatic
  • suspicion of malignancy on imaging
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

jaundice, right upper quadrant pain, hematemesis…what do you call this triad (not an eponym)

A

hemobilia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Male who recently traveled to the tropics has a fever and right upper quadrant pain. CT scan shows a large cystic mass with a thick hyperenhancing wall…what does he have?

A

Entamoeba histolytica infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Male who recently traveled to the tropics has a fever and right upper quadrant pain. CT scan shows a large cystic mass with a thick hyperenhancing wall…how do you treat it?

A

10 days of metronidazole

E. Histolytica infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

when do you consider a TIPS procedure for ascites?

A

when 2-3 large volume paracentesis are required per month despite salt restriction and maximized diuretic use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

In children, what is the most common cause of portal vein thrombosis

A

previously infected umbilical vein

  • be on the look out for ICU babies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

mass in liver that is hypointense on T1 but hyperintense on T2 MRI imaging?

A

likely a hepatic hemangioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Liver mass that is hyper intense T1 and hypo intense T2?

A

could be either HCC or hepatic adenoma

23
Q

how deep is a T1a gallbladder carcinoma tumor?

A

invades only the lamina propria

24
Q

how deep is a T1b gall bladder carcinoma?

A

extends to the muscular propria

  • partial hepatectomy with portal lymphadenectomy
25
Q

how high of an amylase indicates a pancreatic fistula?

A

3 times above serum is indicative of a pancreatic fistula

26
Q 
Give the following for Pseudocyst:
Location: 
Communication with ducts:
Mucin Stain:
Amylase:
CEA:
A
  • anywhere
  • yes
  • negative
  • high
  • low
27
Q 
Serous Cystic Neoplasm:
Location:
Communication with ducts:
Mucin Stain:
Amylase:
CEA:
A
  • anywhere
  • no
  • negative
  • low
  • low
28
Q 
Mucinous Cystic Neoplasm:
Location:
Communication with ducts:
Mucin Stain:
Amylase:
CEA:
A
  • body tail > head
  • very rarely
  • positive
  • low
  • high
29
Q 
Give the following for Intraductal papillary mucinous Neoplasm:
Location:
Communication with ducts:
Mucin Stain:
Amylase:
CEA:
A
  • head > tail
  • yes
  • positive
  • high
  • high
30
Q

Reasons to resect a hepatic adenoma?

A
  • > 5cm in size regardless of OCP use
  • symptomatic
  • cannot diagnose based on imaging
  • rupture
31
Q

gallstone dissolving medication

A

Urodeoxycholic acid

  • can only be used with small cholesterol stones where surgery is contraindicated/unwanted
32
Q

Most common etiology of Budd Chiari Syndrome

A

Myloproliferative disorders

33
Q

Future liver remnant that can be left after resection and is considered sufficient for patient without parenchymal disease?

A

20-30%

34
Q

future liver remnant needed after resection for patient with parenchymal disease?

A

40%

35
Q

you calculate that the future liver remnant is insufficient…what can you do to try and tip the odds in the patient’s favor?

A

Portal vein embolisation can cause hypertrophy in the projected FLR

36
Q

buzz word to perform right hepatecotmy with lymphadenectomy for gall bladder cancer found on final path of cholecystectomy?

A

invades the muscle layer

37
Q

peripheral nodular enhancement on early phase liver CT followed by centripetal filling in during the late phase

A

hepatic hemangioma

38
Q

nonrim hyperenhancing lesion on early phase CT of the liver with washout there after

A

hepatocellular carcinoma

39
Q

vinyl chloride exposure increases risk for what?

A

hepatic angiosarcoma

40
Q

anatomical marker between left and right hepatic lobes?

A

Cantlie’s line

  • imaginary line between gall bladder fossa and IVC…in 70% of patients this is where the middle hepatic vein is
41
Q

in which patient should you be worried about gall bladder cancer

A

older patients (age > 60), with cholelithiasis and single polyp > 10 mm

42
Q

preferred treatment for symptomatic hepatic hemangioma

A

enucleation

43
Q

exposure to vinyl chloride increases your risk for what?

A

hepatic angiosarcoma

44
Q

peripheral enhancement, smooth, with centripetal pattern of enhancement on liver CT scan

A

hepatic adenoma

45
Q

peripheral rim enhancement during both early and late phase of liver CT scan

A

intrahepatic cholangiocarcinoma

46
Q

most common polyps found within gall bladders?

A

cholesterolosis

  • represents more than 50% of all gall bladder polyps
47
Q

Screening for patients with primary sclerosing cholangitis

A
  • Right upper quadrant US every 6-12 months
  • MRI/MRCP every 6-12 months
  • colonoscopy every 1-2 years
48
Q

how do you treat a type III choledochal cyst?

A

ERCP and sphincterotomy, no need to resect because of limited malignant potential

49
Q

location of splenic artery in relation to pancreas?

A

runs superiorly to pancreas

50
Q

location of splenic vein in relation to pancreas?

A

runs posteriorly

51
Q

Management of Cholecystostomy tube for acalculous cholecystitis

A
  • US to assess for stones or sludge

- if present then cholecystectomy, if absent can remove drain once output is minimal

52
Q

How do you localize a gastrinoma

A

Somatostatin Scintigraphy

53
Q

female with epigastric pain, found to have pancreatic mass, EGD with biopsy gets a bloody aspirate

A

solid pseudo papillary neoplasm of the pancreas

54
Q

most common cause of liver pyogenic abscess

A
  • E. choli

- Klebsiella

True Learn Studying 2021 (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions