Liver

Question 1

(+) anchovy paste
Necrotic central portion
Containing resdish brown pus like material

Answer 1

Amoebic liver abscess

Question 2

Usual labs of amoebic liver abscess

Answer 2

Mildly elevated ALKALINE PHOSPHATE

Elevated ALT and AST are unusual

Question 3

In liver abscess, what are the indication for aspiration?

Answer 3

Abscess at LEFT LOBE
large abscess
Failure of medical mx
Superinfection

Question 4

Where in the liver you usually see hydatid disease?

Answer 4

Antero-Inferior and

Postero-inferior of right lobe

Question 5

What is the usual complication of hydatid cyst rupture?

Answer 5

Allergic or anaphylactic reaction

Question 6

In CT/MRI: (+) ringlike calcification in right lobe

Answer 6

Hydatid cyst

Question 7

Diagnostic that differentiates pyogenic liver abscess vs amoebic

Answer 7

Fluorescent antibody test

(+) for amoebic liver abscess

Question 8

All clotting factors are synthesized in liver except:

Answer 8

Factor 8 (produced in endothelium)

Question 9

Jaundice happens at serum bilirubin level of:

Answer 9

> 2.5-3 mg/dl

Question 10

Management of spontaneous bacterial peritonitis

Answer 10

Medically

Question 11

Predicts the surgical risk of intra abdominal operations on patients with cirrhosis

Answer 11

Child-Turcotte-Pugh score

Question 12

Components of Child-Turcotte-Pugh scoring:

Answer 12

Nutritional status
Ascites
Encephalopathy
Serum bilirubin
Serum albumin
Prothrombin time

Question 13

Child-Turcotte-Pugh scoring

Answer 13

Class A: 5-6 points (10% mortality)
B: 7-9 ponts (30%)
C: 10-15 points (80%)

Question 14

Pressure required for varices to form

Answer 14

> 12 mmHg

Question 15

Normal portal pressure

Answer 15

5-10 mmHg

Question 16

Most accurate method to determine portal HPN

Answer 16

Hepatic venography

Question 17

Most significant manifestation of portal hypertension

Answer 17

Esophageal varices

Question 18

Pharmacologic treatment for acute variceal bleeding

Answer 18

Octreotide

Question 19

Treatment for childs A

Answer 19

Surgical shunt

Question 20

Treatment for child’s B and C

Answer 20

TIPS

Question 21

Temporary remedy for acute variceal bleeding

Answer 21

Sengstaken blakemore tube

Complication: perforation

Question 22

Liver UTZ: hypoechoic lesions with well defined borders and variable internal echoes

Answer 22

Pyogenic liver abscess

Tx: antibiotic for 8 weeks

Question 23

Infective stage of entamoeba

Answer 23

Cyst

Question 24

Usual site of amoebic liver abscess

Answer 24

Superior anterior of right lobe

Question 25

Treatment for small asymptomatic hydatid cyst

Answer 25

Albendazole

Question 26

Tx for hemangioma

Answer 26

Enucleation

Question 27

MRI: Hypointense in T1 and hyperintense in T2

Answer 27

Hemangioma

Question 28

Clear risk factor of hepatic adenoma

Answer 28

Oral contraceptives

Question 29

Disgnostic test for Focal Nodular Hyperplasia

Answer 29

Nuclear scan
Hot: FNH
Cold: Adenoma

Question 30

Usual site of klatkin’s tumor

Answer 30

At bifurcation of common hepatic duct

Question 31

Common source of metastatic liver CA

Answer 31

Colon carcinoma

Question 32

2 primary live cancer

Answer 32

HCC

Cholangiocarcinoma

Question 33

Difference of HCC and metastasis in CT and MRI

Answer 33

HCC: hyperdense (hepatic artery)
Metastatic: hypodense (portal vein)