Surgery Questions from Exams.

Questions in Liver and Hepatic Surgery

Q1. Which of the following structures is not part of the portal triad in liver

a) Portal Vein

b) Hepatic vein

c) Hepatic Artery

d) Bile Duct

1.b

Hepatic vein does not form part of the portal triad. It forms the central vein around which the hepatocytes are arranged and on the periphery is the portal triad consisting of Portal Vein posteriorly, the bile duct on the right and Hepatic artery on the left.

Portal triad

Q2. Which of the following has the weakest association with Hepatocellular Carcinoma

(HCC)

a) Hepatitis B

b) Hepatitis C

c) oral contraceptives

d) Smoking

2. c

Hepatitis B and Hepatitis C have known association with cirrhosis and Hepatocellular Carcinoma.

Other significant risk factors are

Chronic alcohol abuse

Smoking

Aflatoxins

Nitrates, NItrites

Haemochromatosis, Wilson, Aplpha 1 Antitrypsin deficiemcy

Throrotrast

Associations with hormonal manipulations such as the use of oral contraceptive agents and anabolic steroids have been suggested but are weak

Sabiston 20 th

Q3. Which is not a paraneoplastic syndrome for Hepatocellular Carcinoma

a) Hypercalcemia

b) Hypoglycemia

c) Erythrocytosis

d) Hyperglycemia

3. d

Less than 1% of cases of HCC present as a paraneoplastic syndrome, most commonly hypercalcemia, hypoglycemia, and erythrocytosis

Q4. Which is the most common cause of Hemobilia

a) Blunt Trauma Abdomen

b) Iatrogenic injury

c) Cholelithiasis

d) Hepatic artery aneurysm

4. b

Earlier Blunt Abdominal trauma was the most common cause of Hemobilia.

But recently with the advent of more interventional procedures like PTBD (Percutaneous Transhepatic Biliary Drainage), hemobilia has become more common.

Q5. Which is not true regarding Haemangioendothelioma of liver?

a) It is a rare tumor

b) It is highly vascular

c) It involves both lobes of the liver

d)) In 50% cases it has extrahepatic spread.

5.d

All the above are true except the fourth choice. In one fourth cases extrahepatic spread occurs. Death is usually due to liver failure.

Liver 6-10

Bile Duct

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