M2-Cx10-L30 --> Surgical Treatment Of Liver Ca

Front 1

LIVER CANCER SURGERY

- Pyogenic Liver Abscesses require what kind of Surgery

- what are the alternatives?

Back 1

- NO Surgical intervention needed

- Interventional Radiology
- IV Antibiotics

Front 2

LIVER CANCER SURGERY

- Infectious Cystic Liver Mass require what kind of Surgery?

- above procedure takes care of what % of Infectious Cystic Liver Masses?

- what are the components involved in this procedure?

Back 2

- Percutaneous drainage with Ab therapy

- 90%

- CT guided catheter
- Broad spectrum Ab
- Drainage

Front 3

LIVER CANCER SURGERY

- HCC is one of most common Primary Liver tumors worldwide due to?

- especially in where?

Back 3

- Hep B

- SE Asia
- Middle East

Front 4

LIVER CANCER SURGERY

- In Louisiana, incidence has almost doubled due to?

Back 4

- Hep C

Front 5

LIVER CANCER SURGERY

- what procedure plays a major role in HCC treatment?

Back 5

- Liver Transplant

Front 6

LIVER CANCER SURGERY

- what are the qualifications for a Liver Transplant in someone with HCC?

Back 6

- Lesion less than 5 cm

or

- 3 lesions (all < 3 cm)

Front 7

LIVER CANCER SURGERY

- in Lab DX of HCC, the most commonly elevated LFT is?

- what else is elevated in 28% to 87% of patients?

Back 7

- Alk. Phoshate

- AFP

Front 8

LIVER CANCER SURGERY

- 10% to 15% of HCC tumors do NOT produce what?

Back 8

- AFP

Front 9

LIVER CANCER SURGERY

- what are the HCC Negative Prognostic Factors? x5

Back 9

(Neg. prognosis if you call AAA PC)

- AFP levels High
- Albumin levels Low
- Advanced age

- Portal Vein Obstruction
- Child's C Classification

Front 10

LIVER CANCER SURGERY

- rather than HCC patients, Liver transplant is better option in patients with what condition?

- why?

Back 10

- Cirrhosis

- improved survival

Front 11

LIVER CANCER SURGERY

- compare the survival rate of Liver Transplant in cirrhosis vs. HCC.

Back 11

- Resection in Cirrhosis is double the survival

Front 12

LIVER CANCER SURGERY

- with Invasive Cirrhosis, the TX is?

Back 12

- Liver Transplant

Front 13

LIVER CANCER SURGERY***

- currently, the incidence of HCC is doing what?

Back 13

- Rising

Front 14

LIVER CANCER SURGERY***

- what are 5 risk factors for HCC?

Back 14

- Cirrhosis
- Hepatitis B,C

- HA

- Aflotoxin repeatedly ingested

- Parasite infection

Front 15

LIVER CANCER SURGERY

- Cirrhosis is present in what % of ppl with HCC?

- what is the likelihood of malignancy in a Hepatic Adenoma?

Back 15

80 to 90%

10% in 10 years

Front 16

LIVER CANCER SURGERY

- Aflotoxin ingestion due to what organism?

- above organisms contaminate diets where?

Back 16

- Aspergillus Flavus

- Africa, Asia

Front 17

LIVER CANCER SURGERY

- common parasite infection that is risk factor for HCC?

Back 17

- Clonorchis sinensis

Front 18

LIVER CANCER SURGERY

- what is the cell of origin for Focal Nodular Hyperplasia (FNH)?

Back 18

- Hepatocellular Epithelium

Front 19

LIVER CANCER SURGERY

- what is the cell of origin for Hemangioma?

Back 19

(h EM angiomas)

- ENDOThelial Mesenchyma

Front 20

LIVER CANCER SURGERY

- what is the cell of origin for Hepatocellular Adenoma?

Back 20

- Hepatocellular Epithelium

Front 21

LIVER CANCER SURGERY

- for most benign liver Dz, all you need is what generally?

- except?

Back 21

- DX

- Hepatic Adenoma

Front 22

LIVER CANCER SURGERY

- why does Hepatic Adenoma require more than just DX?

- what should be done to Hepatic Adenoma?

Back 22

7 to 8% progress to CA
(premalignant & rupture tendency)

Resected

Front 23

LIVER CANCER SURGERY

- Hemangiomas only require intervention if?

Back 23

- Can't R/O CA

- Symptomatic
(too large, painful, obstruction, jaundice)

Front 24

LIVER CANCER SURGERY

- Chick of child bearing age comes to ER in SHOCK! US reveals free fluid in abdomen. What are 3 most common possibilities?

Back 24

- Rupture Ecoptic Pregnancy

- Visceral Aneurysm

- Rupture Hepatic Adenoma

Front 25

LIVER CANCER SURGERY

- what is the MC Benign solid tumor of liver?

- what are its 2 variants?

Back 25

- Hemangioma

- Capillary Hemangioma
- Cavernous Hemangioma

Front 26

LIVER CANCER SURGERY

- which variant of Hemangioma is more clinically significant?

Back 26

- Cavernous Hemangioma
(capillary hemangioma is insignificant)

Front 27

LIVER CANCER SURGERY

- what is the single best diagnostic study for confirming Hemangioma?

Back 27

- DYNAMIC - Contrast MR

Front 28

LIVER CANCER SURGERY

- Hepatic Adenomas are generally?

- Unlike FNH, Hepatic Adenoma tumors have a tendency to?

Back 28

- Solitary (but can be multiple)

- Rupture & get Malignant (10% 10yrs)

Front 29

LIVER CANCER SURGERY

- Hepatic Adenoma has a correlation with what?

- Risk of HA development correlates with what? x2

Back 29

- Oral contraceptives

- Duration of Use
- Age older than 30

Front 30

LIVER CANCER SURGERY

- in the HA pathology, unlike FNH, what 2 things are ABSENT in Hepatic Adenoma?

Back 30

(aBsenT in HA)

- Portal TRIADS

- BILE Ducts

Front 31

LIVER CANCER SURGERY

- what is an accurate procdure for Hepatopancreatic Biliary CA that has replaced every other procedures?

Back 31

- Laparoscopic Ultrasound

(best tool for solid vs. cystic, malignant vs. benign, and STAGING)

Front 32

LIVER CANCER SURGERY

- for Hepatopancreatic Billiary CA, what is useful in STAGING at the level of the Pancreas? GB? and Liver?

Back 32

- all of them Laproscopic US

Front 33

LIVER CANCER SURGERY***

- if standard Pre-Op imaging modalities (URCCC) do not visualize well, what can be used to detect liver lesions at operation?

- above modality allow for DELINEATING what?

- what is the end effect on the procedure?

Back 33

- Intra-Operative US (IOUS)

- IntraHepatic Vascular structures
- IntraHepatic Biliary structures

- more Precise Hepatic Resection

Front 34

LIVER CANCER SURGERY

- what maneuver of Hepatic Resection is associated?

- above maneuver involves what technique?

Back 34

- Pringle Maneuver

- Total Inflow Occlusion

Front 35

LIVER CANCER SURGERY

- what is the Triad for Hemobilia (Biliary Hemorrhage)?

Back 35

(He mo bill's 4 da JUG)

- Jaundice
- Upper Abd Pain
- GI bleed

Front 36

LIVER CANCER SURGERY

- Hemobilia is suspected, so what do you do?

- what about to take care of it?

Back 36

- Angiogram

- Embolization at bleeding site

Front 37

LIVER CANCER SURGERY

- when dealing with Liver abscesses, what MUST you do?

Back 37

- Determine Etiology

(or problem will resurface)

Front 38

LIVER CANCER SURGERY

- in Metastatic Hepatic Malignancy, what is the prognosis?

Back 38

- 50% die in 1 year without Tx

(is 70% of liver tumors)

Front 39

LIVER CANCER SURGERY

- which has a central scar?

Back 39

- FNH

Front 40

LIVER CANCER SURGERY

- which Hemangiomas do you take out?

Back 40

- all Symptomatic

- all where you can't R/O CA

Front 41

LIVER CANCER SURGERY

- while shunting Portal HTN, what vessel preserves Blood Flow to liver the most?

- what medicine helps out most with bleeds?

Back 41

- Splenorenal

- Beta Blockers

Front 42

LIVER CANCER SURGERY

- in terms of mortality after operation in terms of Bleeding Varices, what is the Chief prognostic indicator?

Back 42

(Chief = Child)

- Child's Classification