68 Questions
Which of the following is NOT a benign primary liver tumor?
HCC
What is the main difference between fatty sparing and fatty infiltration in the liver parenchyma?
Fatty sparing involves fat deposition relative to the liver, whereas fatty infiltration does not.
Which type of liver tumor is most commonly associated with a history of oral contraceptive use?
Hepatic Adenoma
In the context of liver tumors, what does HCC stand for?
Hepatocellular Carcinoma
Which of the following statements about liver lesions is true?
Focal Fat Sparing indicates fatty deposition in the liver.
What is the recommended imaging modality for workup in cases of Hepatocellular adenoma?
CT scan
What is a risk factor for the development of Hepatocellular adenoma?
Glycogen storage diseases
Which type of patient is at risk for fibrolamellar HCC?
Young patients
What is the typical presentation of hepatocellular carcinoma (HCC)?
Nodule on screening
Which of the following is NOT a common symptom associated with paraneoplastic syndromes in HCC?
Hypotension
What is the main cause of HCC in non-cirrhosis patients?
Hepatitis B
Which of the following is a recommended imaging modality for the diagnosis of Hepatocellular carcinoma?
MRI with gadolinium
What is the most common benign liver lesion?
Hemangioma
What is the doubling time for hepatocellular carcinoma?
$6$ months
Which imaging technique is used to diagnose hemangioma with 97% sensitivity and 83% specificity?
Technetium 99m labelled RBC scan
'Focal Fat Sparing' and 'Focal Fat Infiltration' are associated with which condition?
Focal nodular hyperplasia (FNH)
What presentation is rare in patients with hemangioma?
Kasaback-Merritt syndrome
'Asterixis' can be a sign of what condition during physical examination?
$ ext{Liver Disease}$
Which imaging technique shows arterial enhancement with washout in delayed phase for Focal Nodular Hyperplasia (FNH)?
CT multiphase
What is the main management approach for Focal Nodular Hyperplasia (FNH)?
No need for surveillance, treat if symptomatic
What is the characteristic appearance of hemangioma on ultrasound?
Hyperechoic
Which of the following is NOT associated with Focal Nodular Hyperplasia (FNH)?
Hemangioma
What is the best next step after a suspicious liver mass detected on imaging?
(AFP) Alpha-fetoprotein testing
In which population is Focal Nodular Hyperplasia (FNH) most common?
(F>M) Females more than Males
What characteristic feature is seen on MRI with contrast in patients with Focal Nodular Hyperplasia (FNH)?
High intensity central stellate scar on T2
What is the most common diagnostic tool for Hepatocellular Carcinoma (HCC) work up?
Multiphasic CT scan
In HCC management, what does 'wash out' typically refer to on the portal vein phase of a CT scan?
Reduction in enhancement of the tumor
What does the Child Turcotte Pugh Score assess in HCC patients?
Underlying liver function
In the Child Turcotte Pugh Score, what does an albumin level below 28 g/L indicate?
Grade C liver function
What is the 1-year survival rate for patients with a Child Pugh Score of 10-15?
45%
What are the contraindications to resection in HCC management?
Portal hypertension
'Encephalopathy' in the Child Turcotte Pugh Score refers to a condition affecting which organ?
Brain
'Ascites' in the Child Turcotte Pugh Score refers to an abnormal accumulation of fluid in which part of the body?
Abdomen
'INR' in the Child Turcotte Pugh Score is a measure of what aspect of liver function?
Blood clotting ability
Which liver function score indicates moderate ascites and bilirubin levels between 34-51 µmol/L?
Grade B
What is the main difference between Neoplastic and Non-Neoplastic liver lesions?
Presence of malignant cells
Which type of liver tumor is most likely to be associated with a history of liver cirrhosis?
Hepatocellular Carcinoma (HCC)
What characteristic feature is typically seen in Hepatic Adenoma on imaging studies?
Central stellate scar
Which liver lesion is characterized by localized fatty deposition without fat deposition relative to liver tissue?
Focal Fat Sparing Hemangioma
What is the most common primary malignant liver tumor?
Hepatocellular Carcinoma (HCC)
Which imaging finding is typically observed in Focal Nodular Hyperplasia (FNH)?
'Spoke-wheel' pattern on CT scan
Which liver lesion exhibits a 'cavernous' appearance with vascular structures on ultrasound?
Focal Fat Sparing Hemangioma
'Fatty sparing' in liver parenchyma refers to what condition?
'Fatty' changes without fat deposition relative to liver tissue
Which liver lesion is strongly associated with a history of oral contraceptive use?
'Hepatic Adenoma'
'Focal Fat Infiltration' in the liver parenchyma refers to what condition?
'Fatty' infiltration with localized fatty deposition
Which hormone therapy should be discontinued in patients with Hepatocellular adenoma to potentially induce tumor regression?
Estrogen
What is the most common risk factor for the development of Hepatocellular adenoma?
Glycogen storage diseases
In the management of ruptured Hepatocellular adenoma in a stable patient, what is the first-line intervention?
Angioembolization
What percentage of hemangiomas are fed by hepatic arterial circulation and lined by a single layer of flat endothelial cells?
100%
Which liver disease is NOT associated with an increased risk of developing Hepatocellular carcinoma?
Glycogen storage diseases
Which imaging modality is NOT recommended for the workup of Focal Nodular Hyperplasia (FNH)?
Biopsy before tumor board review
What type of liver lesion is most commonly associated with a history of anabolic steroid use in males?
Hepatic Adenoma
In the management of Focal Nodular Hyperplasia (FNH), what is the indication for treatment?
Symptoms
What is the first-line imaging modality used for the workup of Hepatocellular carcinoma?
CT with multiphase imaging
Which liver tumor is associated with the presence of other vascular malformations such as telangiectases and AVM?
Fibrolamellar Nodular Hyperplasia (FNH)
Which benign liver lesion may require surgery if symptomatic and enlarging beyond 5cm?
Hepatic Adenoma
What is the characteristic appearance of the central scar on MRI with contrast in Focal Nodular Hyperplasia (FNH)?
High intensity on T1
What is the main cause of mortality in patients diagnosed with Hemangioma?
Spontaneous rupture
Which liver function test result is indicative of severe encephalopathy in the Child Turcotte Pugh Score?
INR above 2.3
What is the 2-year survival rate for patients classified as Child Pugh C in the HCC management guidelines?
35%
What is the main reason small liver remnants are considered a contraindication to resection in HCC management?
Concerns related to portal hypertension
In HCC management, what does the Child Pugh Score assess?
Overall liver function
What does a Child Pugh Score of 7-9 indicate in terms of liver function?
Moderate liver dysfunction
Which stage of HCC management is associated with a 1-year survival rate of 100%?
Stage A
Why is 'wash out' on portal vein phase significant in diagnostic imaging for HCC?
Differentiates HCC from benign lesions
'Ascites' is categorized as severe in the Child Pugh Score when it is described as:
'gross'
'Grade 1' survival refers to the survival rates of patients with which Child Pugh Score level at 2 years?
'B'
'Portal hypertension' is listed as a contraindication to resection in HCC management due to its impact on:
'platelet count abnormalities'
Test your knowledge on the imaging of paediatric liver tumours with pathological correlation based on the study by Iyer, Venkateswaran, & Agarwala (2009). Explore insights on liver cancer statistics and the impact of liver disease through the provided references.
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