Liver & Gallbladder

Question 1

Pringle’s Maneuver compresses the following structures

Answer 1

Portal vein
Hepatic artery
Common bile duct

Question 2

Digitoclasty

Answer 2

Finger fracture of the liver

Question 3

Segments of the liver

Answer 3

1: Caudate
2 & 3: L lateral
4: L medial
5 & 8: R anterior lobe
6 & 7: R posterior lobe

Question 4

Venous drainage of the caudate lobe

Answer 4

Drains directly to the IVC (bypasses the Hepatic vein)

Question 5

The liver synthesizes all clotting factors except:

Answer 5

Factor VIII

Produced in the epithelium

Question 6

Prothrombin time

Answer 6

Extrinsic Pathway

Factors II, V, VII, X, Fibrinogen

Question 7

Partial Prothrombin Time (aPTT)

Answer 7

Intrinsic Pathway

Factors II, V, VIII, IX, X, XI, XII

Question 8

Supplies the Celiac trunk

Answer 8

L Gastric a.
Splenic a.
Hepatic a.

Question 9

Intrahepatic causes of jaundice

Answer 9

Gilbert’s syndrome
Cringer-Najjar syndrome
Dubin-Johnson/Rotors syndrome
Hepatitis

Question 10

Measures the synthetic function of the liver

Answer 10

Albumin
Clotting factors (aPTT & PT)

Question 11

Portal pressure

Answer 11

5-10mmHg

Question 12

Most significant manifestation of Portal HPN

Answer 12

Esophageal varices
(Bleeds at 12mmHg)

Question 13

Congestive hepatopathy due to obstruction to venous outflow

Answer 13

Budd-Chiari Syndrome

Question 14

Anti-cardiolipin bodies

Answer 14

Leptospirosis
Syphilis
Budd-Chiari Syndrome

Question 15

Amebic liver abscess

Answer 15

Entamoeba histolytica
Infective stage: cyst
Pathologic stage: trophozoite

Question 16

Common location of Amebic liver abscess

Answer 16

Superoanterior aslect of the R lobe

Question 17

Diagnostic test for amebic liver abscess

Answer 17

Fluorescent antibody test

Question 18

Hydatid cyst

Answer 18

Echinococcus granulosus

Question 19

US/CT finding of Hydatid cyst

Answer 19

Ring-like calcifications

Question 20

Dual-phase CT scan finding of Hemangioma

Answer 20

Asymmetrical peripheral enhancement with progressive centripetal enhancement

Question 21

Risk factor for Hepatic Adenoma

Answer 21

Prior use of oral contraceptives

Question 22

Most common etiology of liver metastasis

Answer 22

Colonic CA

Rectal CA

Question 23

Risk factors for Hepatocellular CA

Answer 23

Cirrhosis
Hepatitis B or C
Alcoholic
Hemochromatosis
Non-alcoholic steatohepatitis

Question 24

Triangle of Calot

Answer 24

Superior: Inferior portion of the liver
Medial: common hepatic duct
Inferior: cystic duct

Question 25

Promotes gallbladder contraction

Answer 25

Vagus

Cholecystokinin

Question 26

Inhibits gallbladder contraction

Answer 26

VIP

Somatostatin

Question 27

Regulates flow of bile and pancreatic juice into the duodenum

Answer 27

Sphincter of Oddi

Question 28

Black pigment stone

Answer 28

Small, brittle, spiculated
Ca bilirubinate, carbonate, phosphate
CI: hemolytic ds & cirrhosis

Question 29

Brown pigment stones

Answer 29

Soft & mushy

CI: bacterial infections or bile stasis

Question 30

Charcot’s triad

Answer 30

Fever
Jaundice
RUQ pain

Question 31

Most common presentation of Bile Duct CA (Cholangiocarcinoma)

Answer 31

Painless jaundice

Question 32

Most specific tumor marker for the biliary system and pancreas

Answer 32

CA 19-9

Question 33

Most common site of Cholangiocarcinoma

Answer 33

Hepatic duct bifurcation