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Topnotch Surgery Pearls > Liver > Flashcards

Liver Flashcards

1
Q

Ductus venous connects

A

Portal vein and inferior vena cava

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2
Q

Aka hilum of liver

A

Porta hepatis

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3
Q

The hepatoduodenal ligament contains?

A

Portal triad

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4
Q

Occlusion of hepatoduodenal ligament (technique)

A

Pringle maneuver

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5
Q

Only clotting factor not found in the liver

A

Factor VIII

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6
Q

Caudate lobe is drained by te

A

IVC

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7
Q

Assessment of hepatic reserve

A

Child Turcotte Pugh Score

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8
Q

Parameters in child pugh score

A

Nutrional status, ascites, enceph, bilirubin, albumin, PT

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9
Q

Normal portal pressure

A

5-10 mmHg

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10
Q

pressure necessary for varices to form and bleed

A

> 12

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11
Q

Medical prevention of varices

A

Beta blockers

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12
Q

Preferred agent for pharmacologic therapy of varices

A

Octreotide

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13
Q

When is TIPS ised

A

Esophageal varices- child B and C (A- surgical shunt)

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14
Q

Congestive hepatopathy characterized by obstruction to hepatic venous flow

A

Budd chiari syndrome

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15
Q

Aka ecks fistula

A

End to side portacaval anastamosis

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16
Q

Aka warren shunt

A

Distal splenorenal shunt

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17
Q

Dx and TX for budd chiari

A

Hepatic venography; systemic anti coagulation

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18
Q

Most common symptom and indication for resection

A

Hemangioma

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19
Q

Mgmt for hemangioma

A

Enucleation or resection

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20
Q

Clearest risk factors for adenoma

A

Oral contraceptive use

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21
Q

Mgmt for adenoma

A

Resectiont

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22
Q

Mgmt for nodular hyperplasia mgmt

A

Symptomatic:resect; asynp: observe

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23
Q

Most common malignant liver tumor

A

Metastatic

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24
Q

Aka klatskin tumor

A

Extrahepatic proximal(hilar) cholangiocarcinoma

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25
Q

Mgmt for cholangiocarcinoma

A

Resection- gold standard’

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26
Q

Roux en y hepaticojejunostomy is usually for

A

Cholangiocarcinoma

27
Q

Cystic artery is a branch of

A

Right hepatic artery

28
Q

Gallbladder lacks what layers

A

Mucosa and submucosa

29
Q

direct communication between liver and GB

A

Duct of Luschka

30
Q

Stone size that may carry a risk for GB CA

A

> 3cm

31
Q

Brown pigment stones are usually due to

A

Cholangitis

32
Q

Most common choledochal cyst

A

Fusiform

33
Q

Abdominal pain, jaundice, mass

A

Choledochal culust

34
Q

Caroli’s disease

A

Type 5 choledochal cyst

35
Q

Management for sclerosing cholangtis

A

Liver transplant

36
Q

Size of gallbladder polyp with malignant potential

A

> 1cm

37
Q

Most common gallbladder carcinoma

A

Adenocarcinoma

38
Q

Klatskin tumor

A

Perihilar cholangiocarxcinoma

39
Q

Most important factor determining resectability of bile duct carcinoma

A

Proximal extent (klatskin tumor)

40
Q

Main pancreatic duct

A

Witsung

41
Q

Accessory duct

A

Santorini

42
Q

Most common congenital anomaly of the pancreas

A

Pancreas divisum

43
Q

Tx for pancreas divisun

A

Sphincterotomy(enlarge duct of santorini)

44
Q

Tx for annular pancreas

A

Duodenoduoenostomy - bypass(proximal small intestinal obstruction)

45
Q

Most important and largest blood supply of pancreas

A

Splenic artery

46
Q

Most common cause of death of acute pancreatitis

A

Sepsis

47
Q

Cut off sign and reverse 3 or inverted 3 sign

A

Acute pancreatitis

48
Q

Diagnostic gold standard for acute pancreatitis

A

Abdominal Ct scan

49
Q

50% mortality with ranson score of

A

> 7

50
Q

Puestow Gillesby procedure

A

Chronic pancreatitis (roun en y pancreaticojejunostomy)

51
Q

Generally a helpful imaging technique for the pancreas

A

CT scan

52
Q

Resectability of liver

A

Liver end playe

53
Q

Pancreas is inresectable if what is involved

A

SMA

54
Q

Rule of 6

A

Pseudocyst of pancreas: >6cm >6 weeks: drain!

55
Q

Pancreatic tumors etiology

A

Smoking

56
Q

Most common pancreatic tumor

A

Adenocarcinoma

57
Q

Only definitive and potentially curative tx of periampullary carcinoma

A

Whipple’a surgery

58
Q

Whippled triad

A

Symptomatic fastinf hypoglycemia, serum glucose <50, relief of symptoms with glucose administration

59
Q

Mgmt for insulinoma

A

Simple enucleation

60
Q

Tx for VIPoma

A

Debulking as palliative tx

61
Q

Mgmt for glucagonoma

A

Debulking

62
Q

Whipples triad is performed on insulinoma only if

A

It is close to the main pancreatic duct

63
Q

The quadrate and caudate lobes are functionally part of wc side of the liver

A

Left

Topnotch Surgery Pearls (12 decks)

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