Category: Liver

Budd chiari

Budd chiari

Q31) In Budd Chiari Syndrome best management for patients when all three hepatic veins are blocked with deranged LFT

a) Liver transplant

b) Side to side porto caval shunt

c) MEso atrial Shunt

d) TIPS

Answer

Amoebic Liver abscess

Amoebic Liver abscess

Q) Not true about amoebic liver abscess
a) Most common liver enzyme elevated is ALT
b) Metronidazole and luminal amebicide needed in all cases
c) In peritonitis due to amoebiasis perforation of colon are less than perforation of liver
d) 5% to 15% of patients with ALA may be resistant to metronidazole


Answer
The cecum is the most common site of amebic colitis, and the right lobe of the liver is more commonly affected because of drainage
of the right portal branch from the right side of the colon. The condition usually starts as diffuse amebic hepatitis; liver cells
undergo liquefactive necrosis,
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Contraindication of Left lobe liver transplant

Contraindication of Left lobe liver transplant

Q) Absolute contraindication for left lobe LDLT is
A. Trifurcation of the portal vein
B. Bifurcation of portal vein in the right lobe of the liver
C. Aberrant right hepatic artery
D. Right Posterior duct draining into left hepatic duct


ANSWER

Trifurcation of portal vein is not a contraindication of  left lobe liver transplant  as we will get a single portal vein on the left side

9k= Contraindication of Left lobe liver transplant
Portal vein

Bifurcation of portal vein in right lobe does not matter because we are leaving the right lobe behind

Again right aberrant artery does not matter because that segment is left behind

Right post duct draining into left duct gives rise to two ducts on the left or a single duct which is quite high.

C3-4-FF3 Contraindication of Left lobe liver transplant
Right posterior duct to left

 

 

 

 

 

Selective Shunt

Selective Shunt

Q) A type of Selective shunt for portal hypertension is
A. PSRS (Proximal spleno renal shunt) 
B. Warren shunt
C. SSPCS (Side to side portocaval shunt) 
D. Mesocaval
 shunt

Answer  Q 78

Surgical decompression can be achieved with total or partial portal systemic shunts or by selection variceal decompression.

 Total shunts divert all the portal flow to the systemic circulation. Partial shunts maintain some portal flow to the liver. Selective shunts only decompress gastroesophageal varices and maintain portal hypertension and flow to the liver. Read on for answer...

Amoebic liver abscess

Amoebic liver abscess

Q)  Treatment of choice in amoebic liver abscess 4 cm in Right lobe of liver with fever and pain abdomen

a) Metronidazole

b) Aspiration

c) Pig tail insertion

d) Surgery

Answer

Question discusses 

INdications of aspiration 

Indications of Percutaneous drainage

Role of Surgery 

Hepatic blood flow

Hepatic blood flow

Q. All are true regarding hepatic blood flow except
A. Liver has dual blood supply from portal vein and hepatic artery
B. 70% of liver oxygen comes from the hepatic artery
C. 70-80% of blood supply to the liver is from portal vein

d) Liver receives 25% of cardiac output

Answer for premium

The explanation discusses how much blood and oxygen goes through portal vein and hepatic artery to the liver

What is hepatic artery buffer response

 

Liver trauma

Liver trauma

Q) All are true for blunt hepatic trauma except
A. Grade V liver injuries are associated with vascular avulsion
B. Hepatic packing is an expeditious method to control bleeding in blunt hepatic trauma
C. After damage control Surgery and hepatic packing, abdominal compartment syndrome can
happen in immediate postoperative period
D. Post conservative management, in the 3rd week anemia MC occurs due to subcapsular
hematoma rupture

Answer

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