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Gastroenterology > Liver & Biliary Neoplasms > Flashcards

Liver & Biliary Neoplasms Flashcards

1
Q

what is the most common benign liver neoplasm? what is it associated with?

A

cavernous hemangioma
oral contraceptive pills

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2
Q

what symptoms will a patient with a benign liver neoplasm present with? (2)

A

RUQ pain
+/- palpable RUQ mass

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3
Q

what imaging is preferred for a benign liver neoplasm?

A

multiphase CT/MRI

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4
Q

in which patients is surgical resection of a benign neoplasm done? (3)

A

symptomatic lesion
tumor > 5cm
rapidly enlarging tumor

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5
Q

when can benign liver adenomas regress?

A

when OCPs are stopped

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6
Q

malignant neoplasms that form from the liver’s normal hepatocytes

A

hepatocellular carcinoma

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7
Q

what is the most common risk factor for hepatocellular carcinoma?

A

cirrhosis

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8
Q

a patient presents with cachexia, bitemporal wasting, fatigue, ascites +/- blood, palpable liver enlargement and auscultation of bruit over tumor within the liver. Dx?

A

hepatocellular carcinoma

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9
Q

what labs will be found in a patient with hepatocellular carcinoma? (4)

A

leukocytosis
anemia
elevated liver enzymes
elevated alpha-fetoprotein

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10
Q

what is the marker for hepatocellular carcinoma?

A

alpha-fetoprotein

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11
Q

what will be present if a patient has hepatocellular carcinoma with viral load or antibodies?

A

concurrent hepatitis

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12
Q

what imaging is used to determine location and vascularity of hepatocellular carcinoma?

A

CT / MRI

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13
Q

what imaging is used to diagnose hepatocellular carcinoma?

A

multiphasic CT or MRI with contrast

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14
Q

what gives a definitive diagnosis of hepatocellular carcinoma?

A

liver biopsy

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15
Q

what is the protocol of imaging if a hepatocellular lesion is <1cm? (2)

A

US q 3 months
biopsy if lesion enlarges

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16
Q

what is the treatment for hepatocellular carcinoma that offers the best prognosis for patients with early HCC?

A

hepatic resection + liver transplant

17
Q

what are 2 palliative treatments for HCC in patients who are non-surgical candidates? (2)

A

radiofrequency ablation
sorafenib

18
Q

in which patients should we screen for HCC? (2)

A

chronic HBV
cirrhosis due to HBV, HBV, or alcohol

19
Q

what is the surveillance method for HCC?

A

U/S + alpha-fetoprotein q 6 months

20
Q

what is the most common neoplasm of the pancreas? and which part of the pancreas?

A

pancreatic adenocarcinoma
head

21
Q

a pancreatic adenocarcinoma is most symptomatic if it’s located where in the pancreas?

A

head

22
Q

in which patients should we suspect pancreatic cancer?

A

middle-age or older patients with weight loss and/or painless jaundice

23
Q

what indicates advanced disease beyond the pancreatic cancer?

A

pain

24
Q

a patient presents with diarrhea, migratory thrombophlebitis, weight loss, satiety, and silver stools (thomas sign). Dx?

A

pancreatic cancer

25
Q

what are 2 clinical signs that would indicate pancreatic cancer?

A

Courvoisier sign (palpable nontender gallbladder)

sister mary joseph nodule (hard periumbilical nodule d/t mets to abdominal wall)

26
Q

what labs will be present in a patient with pancreatic cancer? (5)

A

mild anemia
CA19-9
+ FOB test
+/- DM/hyperglycemia
+/- elevated amylase/lipase

27
Q

what will indicate biliary obstruction in a patient with pancreatic cancer?

A

elevated LFTs

28
Q

what is elevated with neuroendocrine tumors in a patient with pancreatic cancer?

A

plasma chromogranin A

29
Q

what is the 1st line diagnostic for pancreatic cancer?

A

multiphase, thin cut CT with contrast

30
Q

what diagnostic will provide a definitive diagnosis for pancreatic cancer?

A

percutaneous FNA

31
Q

what is the treatment of choice for carcinoma of the head of the pancreas without evidence of extension or mets?

A

surgical resection (whipple)

AKA pancreaticoduodenal resection

32
Q

what treatment can be used for non-surgical candidates to relieve jaundice?

A

endoscopic stenting

Gastroenterology (26 decks)

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