Q21 After liver resection earliest proliferation is of which kinds of liver cells occurs?
a) Parenchymal cells
b) Ductal cells
c) Canalicular cells
d) Non parenchymal cells
Q22. In Hepatocellular carcinoma true is
a) Arterial bruit is seen in 80% cases of hepatocellular carcinoma (HCC)
b) 2/3rd of patients present with signs of liver disease
c) 5% of patients present with haemoperitoneum
d) none
Q23 Most common paraneoplastic syndrome of Hepatocellular carcinoma is
a) Hypoglycemia
b) Hyponatremia
c) Hypercalcemia
Q24 Tumor Marker for Hepatocellular carcinoma is?
a) alpha feto protein
b) carbohydrate antigen
c) alpha fucosidase
d) CA19-9
Q25) In high riskpopulation HCC (Hepatocellular carcinoma ) is best detected by
a) USG
b)CT
c)MRI
ANSWERS
21) b
Partial hepatectomy leads to proliferation of all populations of cells within the liver, including hepatocytes, biliary epithelial cells and endothelial cells. DNA synthesis is initiated in these cells within 10 to 12 hours after surgery and essentially ceases in about 3 days. Cellular proliferation begins in the periportal region (i.e. around the portal triads) and proceeds toward the centers of lobules.
Most of this rapid regeneration is due to mitotic division of preexisting differentiated liver cells, including hepatocytes, bile duct epithelium, and endothelial cells.
Since prolifeartion goes from periphery to centre duct cells are the first to get involved
22)d
Bruit is seen in 30%, haemoperitoneum in 10%, 1-10% with jaundice and 5 % with metastasis. common presenting features are pain abdomen, abdominal mass, weight loss ascites etc
23)a
others are hypercalcemia and hypertrophic osteodystrophy
24) a
Alpha Feto protein is elevated in 55-95% of patients of hepatocellular carcinoma (HCC). High levels are seen in largeand rapidly growing tumors. Also in HBSAg positive.
25) a
Ultrasound is not very sensitive for liver tumors and it is difficult to distinguish in cirrhosis but it is the screening investigation of choice because of low cost.
