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Liver Flashcards

1
Q

____ is a plane from gallbladder fossa to IVC separating the true left and right lobes of the liver

A

Cantlie’s line

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2
Q

_____ separates the left lateral and left medial segments

A

falciform ligament

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3
Q

the faciform ligaments divide the left lobe to ____

A

left lateral and left medial segments

small left lobe
large left lobe

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4
Q

the right lobe of the liver is divided by the following structures

A
  1. Gallbladder
  2. Fissure of ligamentum teres
  3. IVC
  4. Fissure of ligamentum venosum
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5
Q

The right lobe is composed of what lobes?

A
  1. Quadrate lobe

2. Caudate lobe

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6
Q

[Name the coinaud segemen]

caudate

A

1

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7
Q

[Name the coinaud segemen]

left lateral

A

2 and 3

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8
Q

[Name the coinaud segemen]

left medial

A

4

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9
Q

[Name the coinaud segemen]

right anterior lobe

A

5, 8

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10
Q

[Name the coinaud segemen]

Right posterior lobe

A

6, 7

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11
Q

[hepatic vein drainage]

segment 5-8

A

right hepatic

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12
Q

[hepatic vein drainage]

segment 4,5,8

A

middle hepatic

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13
Q

[hepatic vein drainage]

segment 2,3

A

left hepatic

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14
Q

[hepatic vein drainage]

caudate lobe

A

IVC

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15
Q

the pringle maneuver compress what structures?

A

portal vein, hepatic artery, CBD

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16
Q

[Liver function test]

hepatocellular injury

A

ALT, AST

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17
Q

[Liver function test]

Synthetic function

A

Albumin

Clotting factors EXCEPT factor 8

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18
Q

[Liver function test]

Cholestasis

A

TB
B2 transferrin
ALP
GGTP

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19
Q

[Liver function test]

what is the best measure of liver synthetic function test?

A

PT and INR

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20
Q

[Liver function test]

Most specific for liver diseases: AST or ALT?

A

ALT

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21
Q

[Liver function test]

increased in extrahepatic

A

Direct bilirubun

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22
Q

[Liver function test]

increased in intrahepatic diorders

A

Indirect unconjucated

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23
Q

[Liver function test]

indicative of biliary obstruction

A

alkaline phosphatase

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24
Q

[Liver function test]

early marker and sensitive test for hepatobiliary disease

A

GGTP

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25
Q

[jaundice]

detectable when serum bilirubin is?

A

> 2.5 to 3 mg/dL

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26
Q

[Cirrhosis]

causes if impaired hepatic regeneration

A
  1. Destruction of reticulin framework
  2. Disturbances in blood supply
  3. Necrosis too extensive
  4. Malnutrition
  5. Inhibition of hepatocyte proliferation
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27
Q

[cirrhosis]

Hepatic nodule formation is due to?

A

hepatic proliferation limited by enveloping scars

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28
Q

[cirrhosis]

vein responsible for caput medusae

A

umbilical vein

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29
Q

[cirrhosis]

ascites is clinically detected if the volume is ____

A

> 1.5L

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30
Q

___ syndrome

spigastric vascular murmur

A

Cruveilhier-Baumgarten Syndrome

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31
Q

This syndrome shunts blood from the portal vein to the umbilical vein. It can be present without caput medusae.

A

Cruveilhier-Baumgarten Syndrome

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32
Q

[cirrhosis]

Horizontal white bands and/or proximal white nail plate is due to?

A

Hypoalbuminemia

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33
Q

[cirrhosis]

Dupuytren contracture is due to an increase in what compound?

A

hypoxanthine

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34
Q

[cirrhosis]

Asynchronous flapping motions or dorsiflexed hand

A

asterexis

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35
Q

[spontaneous bacterial peritonitis]

what is the first line drug for SBP?

A

Cefotaxime

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36
Q

[Assessment of hepatic reserve]

This predicts surgical risks of intraabdominal operations prepared by patients with cirrhosis

A

Child-Turcotte-Pugh Score

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37
Q

[Assessment of hepatic reserve]

what are the components of the Child Pugh Score?

A 
Jaundice: bilirubin 2-3
Ascites: minimal, controlled
Prothrombin time: 40-70%
Albumin:  2.8 to 3.5
Nutritional status: Good

Child Pugh B is described above

38
Q

[Assessment of hepatic reserve]

Child-Pugh B is associated with ___ % mortality

39
Q

[Assessment of hepatic reserve]

80% mortality is associated in what Child-Pugh Score?

40
Q

[Portal Hypertension]

What is the normal portal pressure?

41
Q

[Portal Hypertension]

Portal hypertension is diagnosed if the direct portal venous pressure is?

42
Q

[Portal Hypertension]

Portal hypertension is diagnosed if the splenic pressure is?

43
Q

[Portal Hypertension]

varices form if the portal pressure exceeds? ___

44
Q

[Portal Hypertension]

what is the most accurate method of determining the portal pressure?

A

Hepatic Venography

45
Q

[portosystemic collaterals]

Causes Esophageal varices

A

Left Gastric

Azygous Vein

46
Q

[portosystemic collaterals]

Causes caput medusae

A

umbilical vein

47
Q

[portosystemic collaterals]

Causes hemorrhoids

A

middle hemorrhoidal

inferior hemorrhoidal

48
Q

[Portal hypertension]

Due to sinusoidal obstruction

A

Steatohepatitis

Wilson disease

49
Q

[Portal hypertension]

due to high flow states

A

AV fistula

Banti syndrome

50
Q

[diagnosis]

Abdominal pain
ascites
liver enlargement
occlusion of the hepatic vein

A

Budd-Chiari Syndrome

51
Q

[Pre/Sinu/Postsinusoidal]

Alcoholic central hyaline sclerosis

A

postsinusoidal

52
Q

[Pre/Sinu/Postsinusoidal]

Acute alcoholic hepatitis

A

sinusoidal

53
Q

[Pre/Sinu/Postsinusoidal]

vitamin A intoxication

A

Sinusoidal

54
Q

[Pre/Sinu/Postsinusoidal]

Schistosomiasis

A

Presinusoidal

55
Q

[Pre/Sinu/Postsinusoidal]

Chronic active hepatitis

A

Pre-sinusoidal

56
Q

[Pre/Sinu/Postsinusoidal]

vinyl chloride

A

presinusoidal

57
Q

[Pre/Sinu/Postsinusoidal]

cirrhosis

A

sinusoidal

58
Q

[Management of acute variceal bleeding]

Drug of choice

A

Octreotide

But vasopressin can be given

59
Q

[Management of acute variceal bleeding: refractory bleeding]

What is the surgical technique if the patient is classified as Child A?

A

surgical shunt

60
Q

[Management of acute variceal bleeding: refractory bleeding]

What is the surgical management if the patient is classified as Child B and C

61
Q

[Portosystemic Surgical Shunts]

Distal splenorenal

62
Q

[Portosystemic Surgical Shunts]

Left gastric vena caval shunt

63
Q

[Portosystemic Surgical Shunts]

Small diameter portacaval H graft shunt

64
Q

[Portosystemic Surgical: Nonshunts]

ligation of venous branches entering the distal esophagus; for recurrent variceal bleeding

A

Sugiura-Fukugawa

65
Q

[Portosystemic Surgical: Nonshunts]

Splenectomy+ Perihiatal devascularization of the lower esophagus +Ligation of the left gastric vessels + devascularization of the proximal hald of the stomach + separation of stomach from its bed through the abdominal approach

A

Hassab procedure

66
Q

[Portosystemic Surgical: Nonshunts]

the most definitive complication of portal hypertension

A

orthotopic liver transpantation

67
Q

___ tube is used to initially control esophageal bleed

A

Sengstaken-Blakemore Tube

68
Q

Budd-Chiari Syndrome is associated with hyper____

A

homocysteinemia

69
Q

[diagnosis]

hypoechoic lesion with well-defined borders and variable internal echoes

A

Pyogenic Liver Abscess

70
Q

[diagnosis]

hypodense lesions with or without air-fluid levels and peripheral enhancement

A

pyogenic liver abscess

71
Q

[diagnosis]

RUQ pain, fever
elevated WBC, ESR, ALP

A

pyogenic liver abscess

72
Q

[pyogenic liver abscess]

single or multiple large abscesses can be managed surgically by ____

A

percutaneous drainage

73
Q

What is the etiologic agent of hydatid disease?

A

Echinococcus granulosus

74
Q

This is the definitive host of echinococcus granulosus

75
Q

[diagnosis]

anteroinferior or posteroinferior portions of the right lobe, dull RUQ pain or abdominal distention, allergic or anaphylactic reaction with cycst rupture

A

Hydatid disease

Tx: albendazole

76
Q

most frequently encountered liver lesion overall

A

hepatic cysts

77
Q

most common benign solid mass in the liiver

A

hemangioma

78
Q

[diagnose]

Dual-phase CT shows asymmetrical peripheral enhancement with progressive centripetal enhancement

MRI: hypointense in T1, hyperintense in T2

A

hemangioma

79
Q

The greatest risk factor of this benign solid neoplasm of the liver is

80
Q

[diagnose]

On CT: central scar
Nuclear scan shows hot nodules

A

Focal nodular hyperplasia

81
Q

The most common malignant liver tumor

A

metastatic

82
Q

[Management of HCCA]

If non-cirrhotic, child A, single lesion, no metastasis

83
Q

[Management of HCCA]

What are the indications of liver transplant?

A
  1. Nodule < 5cm
  2. 2 or 3 nodules <3cm
  3. No vascular invasion
  4. No extrahepatic spread
  5. Child A, B, C
84
Q

[Cholangiocarcinoma]

Location: when it presents as a hepatic mass

A

Intrahepatic

85
Q

Cholangiocarcinoma]

Location: when it presents at the proximal (hilar) area

A

extrahepatic

86
Q

Cholangiocarcinoma]

Location of a “Klatskin” tumor

A

at the hepatic duct conffuence

87
Q

what is the gold standard in treating cholangiocarcinoma?

88
Q

[Roux-en-Y]

The hepatic ducts are attached to this segment

89
Q

[Roux-en-Y]

The roux limb refers to the

A

Jejunum + remaining hepatic duct

90
Q

[Roux-en-Y]

The Y limb refers to the

A

Duodenum (jejunojejunostomy)

91
Q

[Roux-en-Y]

This part of the small intestine is transected to serve as the Roux and Y limb

A

Duodenum, Jejunom

Pathology (36 decks)

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