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A ORAL BOARDS 2016 > LIVER > Flashcards

Flashcards in LIVER Deck (32)
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1
Q

focal nodular hyperplasia
CT findings
MRI findings

A

“arterial outside
venous inside”
“like cancer outgrowing its blood supply” blah blah blah cannot double top glass characteristics in clinical transformation this is Lynsey

Stellate

MRI:
peripheral nodular enhancement arterial face

Centripetal enhancement Venus phase

2
Q

Test for focal nodular hyperplasia

A

Sulfur colloid

3
Q

Where in the liver metastases found

A

Periphery of the liver

4
Q

What size cystadenoma should be resected

A

Greater than equal to 3 cm

After trial of discontinuation of birth control

5
Q

CT findings of adenoma

A

Heterogeneous

6
Q

CT findings of hemangioma

A

Peripheral AND central enhancement

7
Q

MILAN criteria

A

Eligible for transplantation for hepatocellular carcinoma

Based on an initial size of tumor (not downsizing)

Less than or equal to three tumors
Less than 3 cm

Or one tumor less than 5 cm

8
Q

fibrolamellar hepatocellular carcinoma

A

Young patient
No cirrhosis
Not associated with hepatitis B
Can be AFP negative

9
Q

Most likely cause of alter sound showing intrahepatic structure that is cystic and an elevated White blood cell count

A

Amoebic abscess

Pyogenic

10
Q

Test for a amoebic abscess

A

Hemagglutinin

11
Q

What does calcification suggest in infected liver picture

A

Hydatid cyst

12
Q

Organisms identified in pyogenic abscess

A
E. coli number one
Strep faecalis
Kleb
Proteus
anaerobic colon
B frag
13
Q

What is the usual source of pyogenic abscess

A

GI

also can be from bili

14
Q

Econ a cockle cyst CT findings

A

thick wall
Calcifications in debris
Septations– daughter cysts

15
Q

Diagnoses of echinococal cyst

A

ELISA

Hemagglutinin

16
Q

Medication for pretreating echinococal cyst

A

Albendazole

17
Q

Cystadenoma CT findings

A

Complex cyst

mural nodules

18
Q

What does TIPS stand for

A

Transjugular
intrahepatic
portosystemic
Shunt

19
Q

What kind of shunt is TIPS

A

Nonselective
Good for stopping bleeding
Bad for encephalopathy(Because no longer clearing toxins through deliver)
Pretty good for ascites

NO for right heart failure

20
Q

Mesocaval shunt

A

Best for urgent treatment of bleeding varices

really buggers up transplant options though

21
Q

Distal spinal shunt

A

Time-consuming

Selective shunt

Good for encephalopathy

22
Q

Child’s class

A

Child class a / b / c

Billy Ruben 2/ 2-3 / >3
Albumin >3.5 / 2.8-3.5 / 2.2
Encephalopathy 0 / controlled / uncontrolled
Ascites 0 / controlled / uncontrolled

23
Q

Surgical mortality associated with child score

A

Child a: 5-6 10%
Charles B: 7-9 30%
Child C: 10-15 75 – 80%!

24
Q

What is the MELD score needed to get on the transplant list

A

15

25
Q

TIPS is best with MELD less than

A

24 or greater is contraindication

uptodate

26
Q

MELD for major liver surgery

A

8?

27
Q

Anatomy of portal triad

A

ant right CBD
left HA
portal vein

28
Q

replaced right hapatic artery

A

SMA to
posterior portal vein
posterior to pancrease
posterior to cystic artery

29
Q

test to r/u hemangioma if CT scan and MRI are equivocal

A

Tagged red blood cell scan

30
Q

labs to get for ruling out liver malig

A

AFP

LFTs / bili / coags

hepatitis panel

31
Q

Basic steps to gain access for a Pringle

A

Pars flaccid (gastrohepatic ligament) is opened any fingers passed through the foramen of Winslow

Porta hepatis can then be encircled with umbilical tape

32
Q

Treatment of encephalopathy

A

Decrease aromatic
(can use branch chain amino acids)

Lactulose

neomycin decreased bacteria that makes ammonium