HEPATOCELLULAR CARCINOMA

Question 1

Hepatocellular carcinoma is more common in which sex

Answer 1

More common in men than women

Question 2

Complications of hepatocellular carcinoma

Answer 2

Liver failure
Variceal bleeding
Tumor rupture with bleeding into peritoneum

Question 3

Symptoms of hepatocellular carcinoma include

Answer 3

Jaundice
Itching
Anorexia
Early satiety
Feeling of a mass in the upper abdomen
Right upper abdominal pain
Weight loss
Hematemesis
Abdominal distension
Bone pain
Dyspnea

Question 4

Signs of hepatocellular carcinoma

Answer 4

Jaundice
Cachexia
Hepatomegaly
Ascites
Hepatic bruit

Question 5

Investigations in hepatocellular carcinoma

Answer 5

FBC
LFTS
INR
Serum Alpha-Fetoprotein
Hepatitis B-Surface Antigen (HBsAg)
Hepatitis C Antibody (HCVab)
Chest X-Ray
Abdominal ultrasound scan
CT/MRI scan (if ultrasound inconclusive)

Question 6

Treatment objectives in hepatocellular carcinoma

Answer 6

Curative
To assess for potential resectability

Palliative
To relieve pain
To relieve discomfort from gross ascites
To prevent or treat hepatic encephalopathy

Question 7

Non-pharmacological treatment of hepatocellular carcinoma

Answer 7

Surgical resection of non-metastatic localised lesions
Paracentesis for tense ascites
Supportive care (multi-vitamin supplements)

Question 8

Paain control in hepatocellular carcinoma

Answer 8

Tramadol, oral, 50 mg 12 hourly (titrate further as tolerated to desired effect: maximum 300 mg daily)

Or

Morphine sulphate, oral, 5-10 mg 8-12 hourly