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HEPATOLOGY > SURGERY: LIVER CANCER > Flashcards

SURGERY: LIVER CANCER Flashcards

1
Q

⚡⚡ MOST COMMON MALIGNANCY in LIVER
⚡⚡ MOST COMMON 1° MALIGNANCY in LIVER
⚡⚡ MOST COMMON 1° MALIGNANCY in LIVER in CHILDREN

A

⚡⚡ MOST COMMON MALIGNANCY in LIVER
🎯 METASTASIS

⚡⚡ MOST COMMON 1° MALIGNANCY in LIVER
🎯 HCC

⚡⚡ MOST COMMON 1° MALIGNANCY in LIVER in CHILDREN
🎯 HEPATOBLASTOMA

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2
Q

⚡⚡ MOST COMMON BENIGN Tumor of LIVER

⚡⚡ 2nd MOST COMMON BENIGN Tumor of LIVER

A

⚡⚡ MOST COMMON BENIGN Tumor of LIVER
🎯 HEMANGIOMA

⚡⚡ 2nd MOST COMMON BENIGN Tumor of LIVER
🎯 FOCAL NODULAR HYPERPLASIA (FNH)

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3
Q

⚡⚡ MOST COMMON age group of HEMANGIOMA

A

♀️ ≥ 45 yrs

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4
Q

🧑🏻‍⚕️ Clinical Features HEMANGIOMA

A
  1. Asymptomatic
  2. Large Hemangiomas ➡️ Kasabach Merritt syndrome ➡️ Bleeding
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5
Q

Types of HEMANGIOMA

A
  1. Capillary HEMANGIOMA
  2. Cavernous HEMANGIOMA
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6
Q

Kasabach Merritt Syndrome

🧠⚡HTC⚡

A
  1. Hemangioma
  2. Thrombocytopenia
  3. Coagulopathy
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7
Q

🩺 IOC for HEMANGIOMA
🩺 IOC for FOCAL NODULAR HYPERPLASIA
🩺 IOC for Hepatic Adenoma
🩺 IOC for Von Mayenburg Disease
🩺 IOC for Peliosis Hepatis

A

CECT

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8
Q

CECT Findings of HEMANGIOMA

A

Arterial phase: Peripheral Nodular Enhancement

Washout phase: Homogenous Enhancement

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9
Q

Giant Live Hemangioma is >

A

5 cm

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10
Q

LIGHT BULB Sign is seen in MRI in

A

Liver HEMANGIOMA
⬇️
Hypointense on T1
Hyperintense on T2

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11
Q

BEST INVESTIGATION to Diagnose HEMANGIOMA if CT & MRI unavailable

A

99m Technitium labelled RBC

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12
Q

Liver HEMANGIOMA

A
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13
Q

Large HEMANGIOMA in children leads to

A

CONGESTIVE HEART FAILURE
⬇️
2° to ARTERIOVENOUS SHUNTING

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14
Q

💊💉 MANAGEMENT of LIVER HEMANGIOMA

A

✨ Observation
✨ Angioembolization ➡️ Large & symptomatic
✨ TOC: Enucleation with INFLOW CONTROL

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15
Q

TOC for HEMANGIOMA

A

Enucleation with INFLOW CONTROL

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16
Q

Etiology of FNH

A
  1. Unknown
  2. 2° to VASCULAR INSULT to Liver
  3. OCP use
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17
Q

Difference BETWEEN Focal Nodular Hyperplasia & Adenoma

A

Focal Nodular Hyperplasia
✨ Bile Duct structure ➕
✨ Hepatocytes ➕
✨ Kupffur cells ➕
✨ Necrosis & Hemorrhage ⛔
✨ Capsule ⛔

HEPATIC ADENOMA
✨ Bile Duct structure ⛔
✨ Hepatocytes ➕
✨ Kupffur cells ⛔
✨ Necrosis & Hemorrhage ➕
✨ Capsule ➕

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18
Q

🧑🏻‍⚕️ Clinical Features of Focal Nodular Hyperplasia

A

Asymptomatic

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19
Q

Central Stellate Scar

🧠⚡SOF CR⚡

A
  1. Serous Cystadenoma of Pancreas
  2. ONCOCYTOMA
  3. Focal NODULAR HYPERPLASIA of Liver
  4. Chromophobe RCC
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20
Q

INVESTIGATION to distinguish BETWEEN Hepatic Adenoma & FNH

A

MRI with GADOBENATE DIMEGLUMINE

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21
Q

⭐ Spoke wheel Pattern on ANGIOGRAPHY

⭐ Spoke wheel Pattern on MRI

A

⭐ Spoke wheel Pattern on ANGIOGRAPHY
🎯 FOCAL NODULAR HYPERPLASIA

⭐ Spoke wheel Pattern on MRI
🎯 MENINGIOMA

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22
Q

💊💉 MANAGEMENT of FOCAL NODULAR HYPERPLASIA

A

Observation
✨ Persistent Symptomatic: RESECTION

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23
Q

F > M

A
  1. Liver Hemangioma
  2. Focal Nodular Hyperplasia
  3. Hepatic Adenoma
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24
Q

Malignant conversion is possible in which Benign Liver Tumour

A

Hepatic Adenoma

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25
Hemorrhage & Necrosis is seen in Hepatic Adenoma DUE TO:
Lack Portal Venous Supply
26
PHACES Syndrome
1. Posterior Fossa malformation 2. Hemangioma 3. Arterial abnormalities 4. Cardiac abnormalities 5. Eye abnormalities 6. Eternal Cleft
27
🧑🏻‍⚕️ Clinical Features of HEPATIC ADENOMA
Asymptomatic Abdominal Pain Non traumatic Hemoperitoneum ➡️ Hypovolemia
28
Liver Specific MRI Contrast Agents
Gadobenate Dimenglumine
29
Which Benign Tumour of Liver has HIGH RISK OF SPONTANEOUS RUPTURE
Hepatic Adenoma
30
CECT Finding of HEPATIC ADENOMA
Peripheral arterialization of tumour
31
Liver Adenoma is more common in which gynecological patient
PCOS
32
💊💉 MANAGEMENT of HEPATIC ADENOMA
✨ Acute Hemorrhage: Hepatic Artery Embolization ✨ Resection
33
Hypervascular well circumscribed tumour supplied bye Peripheral arteries
Hepatic Adenoma
34
Bordeaux Classification is used for
Hepatic Adenoma
35
Bordeaux Classification 🧠⚡BHI⚡
1. Beta catenin mutated ✨ Beta catenin Exon 7/8 mutated ✨ Beta catenin Exon 3 mutated 2. HNF 1 alpha mutated 3. Inflammatory 4. Sonic Hedgehog activated 5. Unclassified
36
MAXIMUM RISK OF MALIGNANT CONVERSION WITH WHICH BORDEAUX TYPE HEPATIC ADENOMA
Beta catenin mutated
37
MAXIMUM RISK OF BLEEDING WITH WHICH TYPE HEPATIC ADENOMA
Inflammatory
38
MAXIMUM RISK OF MULTIPLE ADENOMA WITH WHICH TYPE HEPATIC ADENOMA
HNF 1 ALPHA MUTATED
39
WHICH TYPE HEPATIC ADENOMA develops in MALE on ANABOLIC STEROIDS
Beta catenin mutated
40
HEPATIC ADENOMA HAS HIGH RISK OF MALIGNANT CONVERSION in Male or Female?
MALE
41
💊💉 MANAGEMENT of HEPATIC ADENOMA in ♀️ ✨ Size < 5cm ✨ Size > 5cm
✨ Size < 5cm 🎯 DISCONTINUE OCPs 🎯 MRI Surveillance (atleast 5 yearly) ⚡ Annual in NON-INFLAMMATORY ⚡ Biannual in INFLAMMATORY ✨ Size > 5cm 🎯 RESECTION
42
Von Mayenburg Disease
Multiple Cystic Liver Hamartoma
43
Cause of Von Mayenburg Disease
Failure of Regression of Embryonic Biliary Duct
44
ASSOCIATED DISORDER WITH VON MAYENBURG DISEASE
PCKD CHOLANGIOCARCINOMA
45
Peliosis Hepatis
Multiple Cavernous HEMANGIOMAS of the liver
46
Causes of Peliosis HEPATIC 🧠⚡EA³T ⚡
1. Estrogen 2. Androgens 3. A Vitamin 4. Azathioprine 5. Tamoxifen 6. Immunocompromised 7. AIDS 8. POST TRANSPLANT
47
💊💉 MANAGEMENT of VON MAYENBURG DISEASE & PELIOSIS HEPATIS
Observation ✨ Bleeding ➕: Angioembolization
48
LIRADS 0-5
Liver Imaging Reporting & Data Systems
49
LRM: LIRADS
Definitive MALIGNANCY: Not HCC Specific
50
LR-TIV: LIRADS Meaning?
Definitive Tumour in Vein
51
LIRADS vs BIRADS
BIRADS 0-6
52
⚒️ RISK FACTOR for HEPATOCELLULAR CANCER HCC 🧠⚡H³A³T³A² NO²C²⚡
1. Hepatitis B & Hepatitis C CHRONIC Infection 2. Hemochromatosis 3. Hereditary Hemorrhagic Telengiectasia 4. Alcohol 5. Autoimmune Chronic hepatitis 6. Alpha 1 antitrypsin deficiency 7. Thorotrast Exposure 8. Tyrosinemia 9. Type 1 & 3 Glycogen Storage Disorder 10. Alagille Syndrome 11. Aflatoxin 12. NASH 13. Obesity 14. Orotic aciduria 15. Cirrhosis 16. Cigarette smoking 17. 1° Biliary Cirrhosis 18. Wilson's disease
53
Thorotrast Exposure leads to 🧠⚡RCH⚡
1. Renal Cell Cancer RCC 2. Cholangiocarcinoma 3. HEPATOCELLULAR cancer HCC
54
Vinyl Chloride Exposure leads to
Angiosarcoma
55
Angiosarcoma develops on EXPOSURE with 🧠⚡VAT⚡
1. Vinyl Chloride 2. Arsenic 3. Thorotrast
56
MALE Predominant Liver Condition
HCC
57
⚡⚡ MOST COMMON & EARLIEST SYMPTOM OF HCC
Hepatosplenomegaly Others: Pain Jaundice ( Late Sign )
58
Preneoplastic condition leading to HCC 🧠⚡HDr⚡
1. Hepatic Adenoma 2. Dysplastic Nodule
59
Paraneoplastic Syndrome ASSOCIATED with HCC 🧠⚡Only 1 HYPO, Others HYPER ⚡
1. Hypoglycemia 2. Hypercalcemia 3. Hypercholestrolemia 4. Hypererythrocytosis ( Polycythemia) 5. Hyperfeminization 6. Hypertension
60
⚡⚡ MOST COMMON Paraneoplastic Syndrome ASSOCIATED with HCC
Hypoglycemia
61
⚡⚡ MOST COMMON BIOCHEMICAL Paraneoplastic Syndrome ASSOCIATED with HCC
Hypercholestrolemia
62
Angioinvasive Tumours
1. RCC 2. HCC
63
🩺 IOC of HCC
Triple Phase CT ✨ Hyperdense in Arterial Phase ✨ Early Washout
64
Gold STANDARD INVESTIGATION FOR HCC
Trucut Biopsy
65
🩺 IOC for STAGING FOR HCC
PET-CT
66
Tumour Markers of HCC 🧠⚡ HAG FAD N⚡
1. HepPar-1 2. Alpha Feto Protein AFP 3. Glypican 3 4. alpha L FUCOSIDE 5. Des Gamma Carboxy Prothrombin (OR) PIVKA2 6. Neurotensin B
67
⭐ NORMAL AFP VALUES ⭐ ELEVATED AFP VALUES ⭐ AFP VALUE DIAGNOSTIC FOR HCC
⭐ NORMAL AFP VALUES 🎯 < 20 ng/ml ⭐ ELEVATED AFP VALUES 🎯 20-200 ng/ml ⭐ AFP VALUE DIAGNOSTIC FOR HCC 🎯 > 200 ng/ml
68
Which marker is used to monitor RESPONSE to Therapy in HCC
AFP
69
AFP Elevated in
1. HCC 2. HEPATOBLASTOMA 3. CHOLANGIOCARCINOMA 4. COLORECTAL metastasis 5. NSGCT of Ovary & Tumour ✨ Yolk Sac ✨ Embryonal Carcinoma
70
AFP > 400 ng/ml ➕ Typical Radiological Findings of Cancer
HCC
71
Cause of DEATH IN HCC
60% ➡️ Cancer 40% ➡️ Liver Failure
72
Functional Status of Liver is assessed by
1. Child Pugh Score 2. MELD Score 3. MELD Sodium Score
73
Child Pugh Score 🧠⚡ABCDE ⚡ 🧠⚡Ek BAAP⚡
1. Albumin 2. Bilirubin 3. Coagulation ✨ PT ✨ INR 4. Distension: Ascites Mild to Moderate = Diuretic Responsive Severe = Diuretic Resistance 5. Encephalopathy Mild to Moderate = G1 or G2 Severe = G3 or G4
74
Child Pugh Turcott Score
Calculated by adding All parameters of Child Pugh Score 5-6: Least Severe Liver Disease 7-9: Moderately Severe Liver Disease 10-15: Most Severe Liver Disease
75
MELD SCORE Model for End Stage Liver Disease 🧠 ⚡CBI⚡ 🧠⚡ MELD SODIUM Score : Just add Special CBI⚡
1. Creatinine Serum 2. Bilirubin 3. INR
76
PELD Score used for
Liver TRANSPLANT
77
PELD Score 🧠⚡BANIA⚡
1. Bilirubin 2. Albumin 3. Nutrition 4. INR 5. Age (< 1yr)

HEPATOLOGY (16 decks)

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