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SURGERY BOARDS > Liver > Flashcards

Liver Flashcards

1
Q

best test for vit k def and warfarin therapy

A

PT

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2
Q

Useful in determining liver faulure; shortest half life

A

Factor VIII

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3
Q

AST: ALT ratio

A

> 2:1

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4
Q

more specific for liver disease

A

ALT

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5
Q

Elevations point to extrahepatic causes

obstructive cholestasis

A

direct (conjugated bilirubin)

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6
Q

elevations point to intrahepatic cholestasis; hemolytic d/o

A

indirect (unconjugated bilirubin)

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7
Q

indicative of biliary obstruction

A

ALP

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8
Q

early marker and sensitive test for hepatobiliary disease

A

GGTP

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9
Q

JAUNDICE IS DETECTABLE WHEN SERUM BILIRUBIN IS MORE THAN ___

A

2.5-3 mg/dL

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10
Q

central arteriole with tiny radiating vessels, mainly on trunk and face

A

spider angiomata

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11
Q

cause of spider angiomata

A

elevated estradiol

decreased estradiol degradation in the liver

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12
Q

prominent veins radiating from umbilicus

A

caput medusae

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13
Q

epigastric vascular murmur

A

cruveilhier- Baumgarten syndrome

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14
Q

erythema sparing central portions of the palm

A

palmar erythema

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15
Q

cause of palmar erythema

A

inc estradiol

dec estradiol degradation in the liver

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16
Q

sweet pungent smell n liver failure

A

fetor hepaticus

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17
Q

spontaneous bacterial peritonitis

neutrophil count more than ___

A

250/ml

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18
Q

culture positive community acquired SBP

A

e. coli

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19
Q

culture positive nosocomial SBP

A

strep enterococcus

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20
Q

tx SBP

A

1ST line- cefotaxime

co- amox, quinolones

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21
Q

predicts the surgical risk of intra abdominal operations performed in px wth cirrhosis

A

child-turcotte-pugh score

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22
Q

normal portal pressure

A

5-10 mmhg

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23
Q

direct portal venous pressure >5mmhg of IVC pressure

splenic pressure more than 15

A

portal htn

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24
Q

pressure necessary for varices to form and bleed

A

> 12mmhg

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25
Q

most accurate method of determining portal htn

A

hepatic venography

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26
Q

most significant manifestation of portal htn

A

esophageal varices ( left gastric vein)

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27
Q

mngt of acute esophageal variceal bleeding

A

vasopressin

octreotide- preferred

28
Q

end to side porta caval shunt

A

eck fistula

29
Q

large diameter interposition shunt

A

mesocaval; drapanas

30
Q

proximal splenorenal shunt

A

Linton

31
Q

total diversion of blood from PV to VC

A

NON SELECTIVE

32
Q

partial diversion of blood from PV to VC

A

selective

33
Q

for unsuitable for shunt procedures:
transection of esophagus, splenectomy, truncal vagotomy and pyloroplasty

ligation of venous branches of distal esophagus and the proximal stomach from the level of the inferior pulmonary vein

A

sugiura-fukugawa procedure

34
Q

consists of:
splenectomy
perihiatal devascularization of the lower esophagus
ligation of left gastric vessels
devascularization of the proximal half of the stomach
separation of stomach from its bed

A

Hassab procedure

35
Q

congestive hepatopathy characterized by obstruction to hepatic venous outflow

A

Budd-Chiari syndrome

36
Q

affects YOUNG WOMEN with MYELOFIBROSIS
Factor V Leiden mutation
anti cardiolipin antibodies
hypermomocysteinemia

A

Budd-Chiari syndrome

37
Q

tx Budd-Chiari syndrome

A

systemic anti coagulation

38
Q

DX Budd-Chiari syndrome

A

INITIAL: abd UTZ
Definitive: hepatic venography

39
Q

MC route of hepatic exposure to bacteria

A

Ascending- biliary tree

40
Q

which lobe is more commonly affected in pyogenic liver dse

A

Right lobe

41
Q

mc gram neg organism in pyogenc liver abscess

A

E. Coli

42
Q

causative agent amebic liver abscess

A

Entamoeba histolytica

43
Q

infective stage of E. histolytica

A

cyst

44
Q

pathogenic stage of E. histolytica

A

trophozoite

45
Q

usual location of amebic liver disease

A

superior-anterior aspect of right lobe

46
Q

mildly elevated Alkaline phosphatase

(+)fluorescent antibody test

A

AMEBIC LIVER ABSCESS

47
Q

Caused by echinococcus granulosus

A

hydatid disease

48
Q

MOT: ova containing feces (dog)

A

hydatid disease

ova- intestines
adult cyst- liver

49
Q

dx for hydatid disease

A

ELISA for echinococcal antigens

50
Q

well defined lesion with ring-like calcifications

A

hydatid disease

51
Q

sx tx hydatid disease

A

complete cyst removal with instillation of scolicidal agent

52
Q

med tx hydatid disease

A

Albendazole

53
Q

most frequently encountered liver lesion overall

A

hepatic cyst

54
Q

tx of heaptic cyst

A

asymptomatic- observe

symptomatic: percutaneous aspiration and sclerotherapy

55
Q

most common benign solid masses in the liver

A

hemangioma

56
Q

tx of hemangioma

A

enucleation

57
Q

asymmetrical peripheral enhancement with progressive centripetal enhancement

A

hemangioma

58
Q

benign solid liver mass

assoc with women using OCP

A

Adenoma

59
Q

benign liver mass with spontaneous rupture and hemorrhage and malignant degeneration

A

adenoma

60
Q

benign liver mass usually DO NOT spontaneously rupture and hemorrhage and malignant degeneration

A

focal nodular hyperplasia

61
Q

nuclear scan- cold

A

adenoma

62
Q

nuclear scan- hot

A

focal nodular hyperplasia

63
Q

metastatic liver tumors usally are from__

A

colon

64
Q

mc malignant liver tumor

A

metastatic

65
Q

criteria for liver transplant

A

MILAN

66
Q

Tumor in the bifurcation of right hepatic duct

A

Klatskin tumor

SURGERY BOARDS (7 decks)

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