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Surgery PLE > liver and gall bladder > Flashcards

liver and gall bladder Flashcards

1
Q

It is a plane fro the gallbladder fossa to the IVC that separates the livers right and left lobe grossly

A

cantlies line

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2
Q

How is the portal vein formed

A
  1. splenic vein

2. superior mesenteric vein

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3
Q

This measures the liver’s synthetic function

A
  1. PT
  2. Clotting factors (except factor 8)
  3. Serum albumin
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4
Q

This measures the integrity of hepatocellular membranes

A
  1. AST

2. ALT

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5
Q

What is the half life of alkaline phosphatase

A

7 days

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6
Q

It is the diagnostic and therapeutic procedure of choice for stones in the CBD associated with obstructive jaundice, cholangitis, and gallstone pancreatitis

A

ERCP

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7
Q

Parameters of Child Pugh Score

A
  1. Albumin
  2. Bilirubin
  3. clotting factors (INR)
  4. encephalopathy
  5. Ascites
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8
Q

Scoring of Child Pugh Score

A

5 - 6 - 10 %
7 - 9 30%
10 - 15 - 75 - 80%

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9
Q

What is the normal venous pressure

A

5 - 10 mmHg

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10
Q

What is the pressure in diagnosing portal hypertension

A
  1. > 5 mmHg than the IVC pressure
  2. splenic pressure > 15 mmHg
  3. portal venous pressure at surgery is > 20 mmHg
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11
Q

What is the portal pressure needed to form varices

A

> 12 mmHg

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12
Q

Most common cause of portal hyptertension?

A

Liver cirrhosis

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13
Q

Most accurate method in determining portal hypertension

A

hepatic venography

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14
Q

treatment of portal hypertension

A
  1. CTP A - surgical shunt

2. CTP B and C - TIPS

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15
Q

It is a distal splenorenal shunt

A

Warren shunt

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16
Q

An uncommon congestive hepatopathy characterized by the obstruction of hepatic venous outflow due to endoluminal venous thrombosis or compressive lesion external to the veins

A

Budd Chiari Syndrome

17
Q

What is the common site of pyogenic liver abscess

A

right lobe of liver

18
Q

Treatment of pygenic liver abscess

A
  1. correction of underlying cause
  2. percutaneous needle aspiratio
  3. IV antibiotic therapy for 8 weeks
19
Q

Most common location of amebic abscess

A

superior anterior aspect of the right lobe

20
Q

Treatment of amebic abscess

A
  1. metronidazole 750 mg TID for 7 to 10 days
21
Q

What is the most common location of hydatid disease

A

anterior inferior or posterior inferior segment of the right lobe of the liver

22
Q

Treatment of hydatid cyst

A

Surgery and instillation of scolicidal agent

23
Q

Milan critera for liver transplantation

A
  1. single < 5 cm
  2. 2 or 3 nodulers < 3 cm
  3. no vascular invasion or extrahepatic spread
24
Q

Treatment option for liver cancer

A
  1. hepatic resection

2. liver transplantation

25
Q

Most common site of metastasis of liver cancer

A

lungs

26
Q

Types of Cholangiocarcinoma

A
  1. intrahepatic

2. extrahepatic (klatskin tumor)

27
Q

What is the manifestation of klatskin tumor

A

Obstructive and painless jaundice

28
Q

Most important risk factor for gallbladder carcinoma

A

cholelithiasis

29
Q

Most USEFUL radiologic test for diagnosing acute cholecystitis

A

UTZ

  1. thickening of GB
  2. pericholecystic fluid
  3. sonographic murphy’s sign
30
Q

most ACCURATE radiologic test for diagnosis acute cholecystitis

A

HIDA scan

31
Q

Gold standard for diagnosing choledocholithiases

A

endoscopic cholangiography

32
Q

What is charcot’s triad

A
  1. fever
  2. RUQ pain
  3. Jaundice
33
Q

What is reynaud’s pentad

A
  1. fever
  2. RUQ pain
  3. Jaundice
  4. Septic shock
  5. mental status changes
34
Q

Most common type of choledochal cyst

A

Type I - cystic dilatation of the extrahepatic bile duct

35
Q

Types of choledochal cyst

A 
Type I - extrahepatic duct
Type II - common bile duct
Type III - distal duct into the duodenum
Type IV - intrahepatic and extrahepatic duct
Type V - intrahepatic duct
36
Q

Treatment of choledochal cyst

A

complete cyst excision with roux en Y hepaticojejunostomy

Surgery PLE (16 decks)

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