Surgery Block 7 (Liver, Gallbladder, Pancreas) Flashcards
The gallbladder is supplied by the cystic artery, which is a branch of
Right hepatic artery
Which of the ff. stones seen in patients with bile stasis?
A. Brown stones
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. Abdominal ultrasound
What surgical incision is performed in an open cholecystectomy?
A. Kocher incision
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. Type II
What is the ideal management for the above case?
Cyst excision + Cholecystectomy + Roux-en-Y Hepaticojejunostomy
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?
Observe and repeat ultrasound after 6 months
During open cholecystectomy, the surgeon inadvertently transects the common bile duct. What surgical procedure should be done?
A. Primary repair of the common bile duct
Which of the ff. Is a pathognomonic ultrasound finding in cholecystolithiasis?
Posterior sonic shadowing
What is the common cost-efficient test for diagnosis of cholelithiasis?
A. Ultrasound
Which of the ff. layers of the GIT is absent in the gallbladder wall?
A. Submucosa
In 90% of cases, in which vessel does the cystic artery arise?
Right hepatic artery
Which part of the duodenum does the common bile duct open into?
A. Second portion
The common bile duct is formed by the confluence of these structures
A. Common hepatic duct and cystic duct
In patients with liver cirrhosis and portal hypertension, the ff. can manifest:
A. Formation of esophageal varices
B. Caput medusae sign
C. Anorectal varices
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.
UTZ guided percutaneous aspiration
Hyperbilirubinemia is detectable as jaundice when blood levels rise above:
A. 2.5 mg/dL
Majority of blood supply of the liver is:
A. Portal vein
Which of the ff. Variables of Child-Pugh scoring is not included?
A. APTT
All of the ff. are true:
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
All of the ff. are true about portal hypertension:
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)
A patient is diagnosed with Amebic Liver Abscess. Which antibiotic will you give?
A. Metronidazole
Which among the following is the most common solid benign mass of the liver?
Hemangioma
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?
Hepatic resection
