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year 5 - GIT surgery > intro hepatobiliary and pancreatic system > Flashcards

intro hepatobiliary and pancreatic system Flashcards

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1
Q

blood supply of the liver ?

A

portal vein and hepatic artery

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2
Q

physiological function of bile ?

A

made up of bile salts and bile pigments
bile salts:
fat emulsification
stimullation of peristalsis
antibacterial effect
Absorption of ADEK

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3
Q

liver function test ?

A

albumin
bilirubin
INR

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4
Q

which marker is elevated with hepatocellular carcinoma ?

A

alpha fetoprotein

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5
Q

what are the features associated with fibrolamellar hepatocellular carcinoma ?

A

young patient
normal alpha fetoprotein levels
central hypodense scar

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6
Q

what are hepatic adenomas commonly associated with ?

A

OCP
steriods
and are mainly seen in younger females

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7
Q

what is the most common benign lesion of the liver ?

A

cavernous hemangioma

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8
Q

what is seen on ultrasound imaging of simple cysts of the liver ?

A

posterior acoustic enhancement

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9
Q

what are the different parts of the CBD ?

A

supraduodenal
retroduodenal
intraduodenal

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10
Q

physiological function of the gallbladder :

A

storgae of the bilee
conceentration of the bile
normal choleedochoduodenal mechanism

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11
Q

what is the hormonal regulation of the gallbladder ?

A

secretin
CCK

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12
Q

what is the initial event in acute cholecystitis, and which area is the pain in ?

A

obstruction of gallbladder emptying
affected area is the right upper quadrant

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13
Q

what are the US findings in acute cholecystitis ?

A

oedematous GB wall
stones

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14
Q

what sign is positive for gallstones ?

A

positive murphy sign
ask the patient to take a deep breath and palpate the subcostal area
extreme pain upon palpation

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15
Q

what is the presentation of acute cholecystitis ?

A

extreme right upper quadrant pain
fever
abdominal guarding
fever
positive murphy’s sign

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16
Q

what is porcelain gallbladder ?

A

calcification of the inner wall of the gall bladder

17
Q

what is the problem with porcelain gallbladder ?

A

increases the risk of gallbladder carcinoma

18
Q

what is primary sclerosing cholangitis ?

A

bile ducts inside and outside the liver become inflamed and then fibrosed eventually becoming narrowed and blocked

19
Q

what is the CT appearance of primary sclerosing cholangitis ?

A

beaded appearance due to alternating dilatation and stenosis

20
Q

what is pathognomonic in primary sclerosing cholangitis ?

A

duct diverticula

21
Q

what disease is commonly associated with primary sclerosing cholangitis ?

A

ulcerative colitis

22
Q

what are choledochal cysts ?

A

congenital cystic dilatation of the bile ducts
mostly extra hepatic

23
Q

what is caroli’s disease ?

A

multiple intra-hepatic cysts

24
Q

what is Mirizzi syndrome ?

A

when a stone in the gallbladder or the cystic duct externally compresses the common hepatic duct causing obstructive jaundice

25
Q

what increases the likelihood of mirizzi syndrome ?

A

low insertion of the cystic duct
or a long cystic duct in parallel to the CHD

26
Q

which artery runs along the pancreas ?

A

the splenic artery

27
Q

what structure is related to the head of the pancreas ?

A

c loop of the duodenum

28
Q

what structures are related to the neck of the pancreas?

A

lies in front of the junction of the superior mesenteric and splenic veins

29
Q

the body of the pancreas lies behind the ….

A

stomach

30
Q

what are the endocrine functions of the pancreas ?

A

alpha cells : glucagon
beta cells : Insulin
delta cells : somatostatin

31
Q

what are the causes of pancreatitis ?

A

GET SMASHHED
gallstones
ethanol
trauma
steroids
mumps
autoimmune
scorpion sting
hypercalcemia
hypertriglyceridemia
ERCP
drugs

32
Q

what is the range of pathology that happens with pancreatitis ?

A

mild oedema
hemorrhagic pancreatitis
necrotizing pancreatitis

33
Q

what is the indication for the drainage of pseudocyst ?

A

if above 5 cm

year 5 - GIT surgery (8 decks)

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