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Surgery > Surgery Block 7 (Liver, Gallbladder, Pancreas) > Flashcards

Surgery Block 7 (Liver, Gallbladder, Pancreas) Flashcards

1
Q

The gallbladder is supplied by the cystic artery, which is a branch of

A

Right hepatic artery

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2
Q

Which of the ff. stones seen in patients with bile stasis?

A

A. Brown stones

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3
Q

A 54 year old male came into your clinic for occasional right upper quadrant pain that occurs after meals. What diagnostic study do you request?

A

A. Abdominal ultrasound

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4
Q

What surgical incision is performed in an open cholecystectomy?

A

A. Kocher incision

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5
Q

A 4-year-old female came in for occasional right upper quadrant pain. Ultrasound and CT scan done showed a saccular outpouching of the common bile duct. What type of choledochal cyst is seen in this patient?

A

A. Type II

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6
Q

What is the ideal management for the above case?

A

Cyst excision + Cholecystectomy + Roux-en-Y Hepaticojejunostomy

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7
Q

A 45 year old patient with an incidental finding of a 0.8 cm gallbladder polyp visualized on ultrasound came in for follow up in your clinic. What would you advise the patient?

A

Observe and repeat ultrasound after 6 months

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8
Q

During open cholecystectomy, the surgeon inadvertently transects the common bile duct. What surgical procedure should be done?

A

A. Primary repair of the common bile duct

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9
Q

Which of the ff. Is a pathognomonic ultrasound finding in cholecystolithiasis?

A

Posterior sonic shadowing

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10
Q

What is the common cost-efficient test for diagnosis of cholelithiasis?

A

A. Ultrasound

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11
Q

Which of the ff. layers of the GIT is absent in the gallbladder wall?

A

A. Submucosa

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12
Q

In 90% of cases, in which vessel does the cystic artery arise?

A

Right hepatic artery

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13
Q

Which part of the duodenum does the common bile duct open into?

A

A. Second portion

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14
Q

The common bile duct is formed by the confluence of these structures

A

A. Common hepatic duct and cystic duct

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15
Q

In patients with liver cirrhosis and portal hypertension, the ff. can manifest:

A

A. Formation of esophageal varices
B. Caput medusae sign
C. Anorectal varices

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16
Q

Treatment for patient with right upper quadrant pain, afebrile with abscess at the right lobe of the liver, 3 cm in size by UTZ, no abdominal tenderness.

A

UTZ guided percutaneous aspiration

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17
Q

Hyperbilirubinemia is detectable as jaundice when blood levels rise above:

A

A. 2.5 mg/dL

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18
Q

Majority of blood supply of the liver is:

A

A. Portal vein

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19
Q

Which of the ff. Variables of Child-Pugh scoring is not included?

A

A. APTT

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20
Q

All of the ff. are true:

A

A. The liver is divided into 8 segments
A. Couinaud segments numbers the liver segments in a clockwise direction
Only segment I is not visible anteriorly

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21
Q

All of the ff. are true about portal hypertension:

A

A. Gastroesophageal varices are most significant manifestation and the leading cause of morbidity and mortality related to portal hypertension
B. Variceal band ligation is recommended for patients with a medium to large varices
C. Hepatic venous pressure gradient (HVPG) is equal to wedge hepatic venous pressure (WHVP) minus free hepatic venous pressure (FHVP)

22
Q

A patient is diagnosed with Amebic Liver Abscess. Which antibiotic will you give?

A

A. Metronidazole

23
Q

Which among the following is the most common solid benign mass of the liver?

A

Hemangioma

24
Q

A 45 year old female with a history of oral contraceptive use sought consultation for an incidental finding of a 6 cm mass of the liver. Biopsy of the mass showed an adenoma. What is the appropriate management?

A

Hepatic resection

25
Q

Which of the ff. is true about Focal Nodular Hyperplasia?

A

A. Pathognomonic finding on CT scan is a central scar
B. There is no risk for malignant transformation
C. No surgical intervention is recommended

26
Q

Which of the ff. is true regarding the portal vein?

A

In the hepatoduodenal ligament, it is usually posterior to the bile duct and hepatic artery

27
Q

The best screening approach for detecting early hepatocellular carcinoma (HCC) in patients with chronic viral hepatitis is:

A

A. Alpha fetoprotein

28
Q

Which of the ff. is true regarding hepatic adenomas?

A

A 5.5 cm lesion should be resected even it is asymptomatic

29
Q

The principal mediators of fibrosis leading to cirrhosis in the liver are:

A

A. Kupffer cells

30
Q

Secretion of what substance is part of the exocrine function of the pancreas

A

A. Cholecystokinin

31
Q

A 38 year old male after a drinking spree was admitted because of severe epigastric pain penetrating to the back, accompanied by jaundice, your impression would be?

A

A. Pancreatitis

32
Q

A 38 year old male after a drinking spree was admitted because of severe epigastric pain penetrating to the back, accompanied by jaundice, your impression would be?

A

A. Pancreatitis

33
Q

You would initially request for

A

A. Ultrasound

34
Q

A 69 year old female admitted because of a history of vague abdominal pain with jaundice and pruritus, ultrasound only showed distended gallbladder, your impression

A

A. Acalculous cholecystitis

35
Q

A patient with a history of pancreatitis 2 weeks ago was admitted because of an abdominal mass with tenderness, your impression is

A

A. Pseudocysts of the pancreas

36
Q

What would be the diagnostic procedure that would aid you in managing the case in the previous number?

A

A. CT scan

37
Q

Diagnostic procedure revealed 4 cm pseudocyst of the pancreas with a cyst wall measuring 0.5 cm and homogenous appearance, your recommendation is

A

A. External drainage

38
Q

A patient with jaundice and no complains of vomiting had a 3 cm adenocarcinoma noted at the head of the pancreas with no lymph nodes, your recommendation is?

A

A. Pancreaticoduodenectomy

39
Q

A 35 year old male with severe epigastric pain was admitted with the ff. laboratories on admission: WBC - 20,000; blood glucose - 400; serum amylase of 1500. Physical examination: he was febrile with distended and tender abdomen and discoloration on the flanks. CT scan results with fluid collection surrounding the pancreas, you recommend?

A

A. Surgery

40
Q

What is the most common pancreatic endocrine tumor?

A

A. Insulinoma

41
Q

A patient with jaundice and no complains of vomiting had a 3 cm adenocarcinoma noted at the head of the pancreas with no lymph nodes, your recommendation is?

A

A. Pancreaticoduodenectomy

42
Q

A 35 year old male with severe epigastric pain was admitted with the ff. laboratories on admission: WBC - 20,000; blood glucose - 400; serum amylase of 1500. Physical examination: he was febrile with distended and tender abdomen and discoloration on the flanks. CT scan results with fluid collection surrounding the pancreas, you recommend?

A

A. Surgery

43
Q

A patient is diagnosed with biliary pancreatitis with an amylase of 3000. You will recommend?

A

Cholecystectomy, IOC, Common bile duct exploration with choledocholithotomy and T-tube insertion

44
Q

68 year old, diabetic was diagnosed to have a pancreatic head carcinoma presented with jaundice without symptoms of gastric outlet obstruction. Upon surgery, you noted a 3 cm tumor with no involvement of other vital structures with the presence of multiple nodules on the liver. You will proceed with?

A

A. Whipple’s procedure

45
Q

Patient with acute pancreatitis was requested with CT scan after three days of abdominal pain. CT findings showed heterogenous with non-liquid density with varying loculations. Definite diagnosis will be?

A

A. MRI

46
Q

What would be the recommended CT scan for acute pancreatitis?

A

Intravenous contrast CT

47
Q

What would be the recommended CT scan for acute pancreatitis?

A

Intravenous contrast CT

48
Q

Patient with acute pancreatitis will have a serum amylase of at least

A

A. 250 U/L

49
Q

Patient diagnosed with a pancreatic pseudocyst, CT scan showed a 2 cm cyst wall, you do?

A

A. Cysto-gastrostomy

50
Q

As nutritional support for patients with acute pancreatitis you recommend?

A

A. Enteral nutrition

51
Q

Pancreatic tumor causing Zolinger-Ellison Syndrome is?

A

A. Gastrinoma

Surgery (9 decks)

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