ABSITE ch 31 Liver.txt

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ABSITE ch 31 Liver.txt
2010-01-23 18:38:08
ABSITE liver

ABSITE ch 31 liver
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  1. Most common hepatic artery variant
    Right hepatic off of SMA
  2. Second most common hepatic artery variant
    Left hepatic off left gastric (found in gastrohepatic artery)
  3. Structure separating the medial and lateral segments of the left lobe of liver
  4. Structure that carries the remnant of the umbilical vein
  5. Structure that carries the obliterated umbilical vein to undersurface of liver; extending from falciform
    Ligamentum teres
  6. Line drawn from middle of GB fossa to IVC
    Cantlie's line
  7. Segment I of liver
  8. Segments II-IV of liver
    Left lobe
  9. Segments V-Viii of liver
    Right lobe
  10. Peritoneum that covers the liver
    Glisson's capsule
  11. Area on posterior-superior surface of liver not covered by Glisson's capsule
    Bare area
  12. Structures near segments IV and V
    Portal triad, gallbladder
  13. Liver macrophages
    Kupffer cells
  14. Structure containing the bile duct, portal vein, and hepatic artery
    Hepatoduodenal ligament
  15. Portal triad (structure + location)
    Portal vein (posterior), CBD (lateral), hepatic artery (medial)
  16. SMV + splenic vein
    Portal vein
  17. Segments of liver drained by left portal vein
    II, III, IV
  18. Segments of liver drained by right portal vein
    V, VI, VII, VIII
  19. Number of hepatic veins
    3 (left, middle, right)
  20. structure draining phrenic veins
  21. Enzyme located in canalicular membrane
    Alkaline phosphatase
  22. Usual energy source of liver
  23. Only water-soluble vitamin stored in liver
  24. Hepatocytes most sensitive to ischemia
    Central lobular
  25. Breakdown product of hemoglobin
  26. Enzyme causing breakdown of bilirubin by bacteria in terminal ileum
  27. Enzyme causing dark urine
  28. Amino acids conjugated to bile acids to increase water solubility (2)
    Taurine, glycine
  29. Main biliary phospholipid; solubilizes cholesterol
  30. First location where jaundice is evident
    Under tongue
  31. Causes of unconjugated bilirubinemia
    hemolysis, deficiency of uptake or conjugation
  32. Causes of conjugated bilirubinemia
    Secretion defects, excretion defects (stones, strictures, tumor)
  33. Abnormal bilirubin uptake with mildly high unconjugated bili
    Gilbert's syndrome
  34. Inability to conjugate bilirubin, causing unconjugated bilirubinemia
    Criglar-Najjar disease
  35. Immature glucoronyl transferase causing high unconjugated bilirubinemia
    Physiologic jaundice of the newborn
  36. Deficiency in storage of bilirubin; causes elevated conjugated bilirubin
    Rotor's syndrome
  37. Deficiency of bilirubin secretion; causes high conjugated bilirubin
    Dubin-Johnson syndrome
  38. RNA hepatitis with few serious long-term consequences
    Hep A
  39. DNA hepatitis capable of causing long-term infection; vaccination available
    Hep B
  40. RNA hepatitis with a long incubation period and capability of causing long-term infection; most common hepatitis leading to transplant
    Hep C
  41. RNA hepatitis cofactor for Hep B
    Hep D
  42. RNA hepatitis that can cause fulminant hepatic failure in pregnancy
    Hep E
  43. Anti-HBs antibodies only in:
    s/p Hep B vaccination
  44. Anti-HBs and anti-HBc with NO HBs antigens in:
    Previous Hep B infection; now recovered
  45. Most common cause of liver failure
  46. Best indicator of synthetic function of liver
  47. Cause of hepatic encephalopathy
    Buildup of ammonia, mercatanes, methane thiols
  48. Causes other than liver failure encephalopathy (4)
    GI bleed, infection, electrolyte imbalances, drugs
  49. Cathartic that gets rid of bacteria in gut and acidifies colon
  50. Source of ascites
    Hepatic/splanchnic lymph
  51. Method of shunting ascites into venous system (2)
    Peritoneovenous shunts (Denver, LeVeen)
  52. Cause of postpartum liver failure with ascites
    Hepatic vein thrombosis
  53. Most common organism causing spontaneous bacterial peritonitis
    E coli
  54. Risk factors for SBP (5)
    Prior SBP, variceal hemorrhage, low-protein ascites, nephrotic syndrome, SLE in children
  55. Treatment of SBP
    3rd generation cephalosporins
  56. drugs to treat bleeding esophageal varices (2)
    octreotide, vasopressin
  57. tube used to control esophageal and/or gastric varices
    Sengstaken-Blakemore tube
  58. Initial therapy for bleeding esophageal varices
    Endoscopy and sclerotherapy
  59. Backup therapy for bleeding esophageal varices (after failed endoscopy)
  60. Venous collaterals that develop with portal hypertension (5)
    Paraumbilical vein of Sappey, retroperitoneal veins of Retzius, inferior rectal veins, esophageal varices, splenophrenic veins
  61. Presinusoidal causes of portal hypertension (3)
    Schistosomiasis, congenital hepatic fibrosis, portal vein thrombosis
  62. Sinusoidal causes of portal hypertension (1)
  63. Postsinusoidal causes of portal hypertension (3)
    Budd-Chiari (hepatic vein occlusion), constrictive pericarditis, CHF
  64. Normal portal vein pressure
  65. collaterals between portal vein and systemic venous system of lower esophagus
    coronary veins
  66. risk of TIPS
  67. shunt with lowest risk of encephalopathy
    splenorenal shunt
  68. shunt that can worsen ascites
    splenorenal shunt
  69. shunt used in Child's B and C
  70. Shunt used in Child's A with just bleeding
  71. Categories to determine Child's class (5)
    Albumin, bilirubin, encephalopathy, ascites, nutrition
  72. Most common cause of portal HTN in children
    Extrahepatic thrombosis of portal vein
  73. Occlusion of hepatic veins and IVC
    Budd-Chiari syndrome
  74. Treatment of Budd Chiari
    Portacaval shunt
  75. Cause of isolated gastric varices without elevation of pressure in rest of portal system
    Splenic vein thrombosis
  76. Most common cause of splenic vein thrombosis
  77. Treatment of splenic vein thrombosis
  78. Common lobe of liver for amebic abscess
  79. Anchovy paste
    Amebic abscesses
  80. Treatment of amebic abscess
  81. Most common cause of amebic abscess
    Entamoeba histolytica
  82. Hydatid cyst organism
  83. Most common lobe for echinococcal cyst
  84. Treatment of echinococcal cyst
    Albendazole, surgical removal
  85. Complications of echinococcal cyst aspiration
    Leakage and anaphylactic shock
  86. Liver abscess that can also cause a maculopapular rash and eosinophilia
  87. Organism causing liver abscess and variceal bleeding
  88. Treatment of schistosomiasis
  89. Most common organism in pyogenic liver abscess
    E. coli
  90. Infections that can cause liver abscess as a secondary infection
    Appendicitis, diverticulitis, cholecystitis/cholangitis
  91. Benign liver tumors occurring commonly in women, steroid users, OCP users
    Hepatic adenoma
  92. Benign hepatic tumor with no uptake on sulfur colloid scan (because no Kupffer cells present)
    Hepatic adenoma
  93. Treatment of hepatic adenoma
    Stop OCP's (if asymptomatic), tumor resection or embolization (if symptomatic)
  94. Benign liver condition with central stellate scar
    Focal nodular hyperplasia
  95. Most common benign hepatic tumor
  96. Lesion appearing as hypervascular lesion on CT/MRI
  97. Rare complication of hemangioma
    Consumptive coagulopathy and CHF
  98. Most common malignant liver tumor
  99. Most common liver cancer worldwide
    Hepatocellular carcinoma
  100. Risk factors for HCC (9)
    HBC, HCV, ETOH, hemachromatosis, alpha 1 antitrypsin, PSC, alfatoxin, hdepatic adenoma, steroids
  101. Liver conditions that do not increase risk for HCC
    PBC, Wilson's disease
  102. Serum marker for hepatocellular carcinoma
  103. 5-year survival of HCC after resection
  104. margin required for HCC
  105. risk factor for hepatic sarcoma (3)
    PVC, thorotrast, arsenic
  106. Risk factors for cholangiosarcoma (5)
    Clonorchiasis infection, UC, hemachromatosis, PSC, choledochal cysts
  107. 5-year survival of resected colon ca mets
  108. primary blood supply of liver tumors
    hepatic artery
  109. primary liver tumors: hypovascular or hypervascular?
  110. Metastatic liver tumors: hypovascular or hypervascular?