Podcast
Questions and Answers
Which of the following is NOT classified as a benign liver lesion?
Which of the following is NOT classified as a benign liver lesion?
- Cholangiocarcinoma (correct)
- Hemangioma
- Hepatic Cysts
- Biliary Cystadenoma
What is the primary clinical presentation of acute liver failure?
What is the primary clinical presentation of acute liver failure?
- Jaundice (correct)
- Bloating
- Nausea
- Fatigue
Which organism is associated with hydatid disease affecting the liver?
Which organism is associated with hydatid disease affecting the liver?
- Echinococcus granulosus (correct)
- Ascaris lumbricoides
- Entamoeba histolytica
- Schistosoma mansoni
In the case of acetaminophen overdose leading to acute liver failure, which of the following is an appropriate initial management step?
In the case of acetaminophen overdose leading to acute liver failure, which of the following is an appropriate initial management step?
Which of the following is a known risk factor for developing hepatocellular carcinoma?
Which of the following is a known risk factor for developing hepatocellular carcinoma?
Which sign is typically NOT indicative of portal hypertension?
Which sign is typically NOT indicative of portal hypertension?
Which type of liver abscess is commonly caused by amoebas?
Which type of liver abscess is commonly caused by amoebas?
What is the most appropriate method for monitoring a patient with acute liver failure?
What is the most appropriate method for monitoring a patient with acute liver failure?
Which of the following is a common clinical presentation of ascariasis involving the liver?
Which of the following is a common clinical presentation of ascariasis involving the liver?
What is a key diagnostic test for schistosomiasis that highlights elevated alkaline phosphatase levels?
What is a key diagnostic test for schistosomiasis that highlights elevated alkaline phosphatase levels?
Which medication is considered the treatment of choice for hepatic schistosomiasis?
Which medication is considered the treatment of choice for hepatic schistosomiasis?
Which condition is associated with acute pancreatitis in the context of liver infections?
Which condition is associated with acute pancreatitis in the context of liver infections?
Which laboratory finding is expected in patients with hepatic schistosomiasis?
Which laboratory finding is expected in patients with hepatic schistosomiasis?
What is the likely consequence of retrograde locomotion of Ascaris ova in the gastrointestinal tract?
What is the likely consequence of retrograde locomotion of Ascaris ova in the gastrointestinal tract?
In which stage of hepatic schistosomiasis would a patient experience itching after entry of cercariae?
In which stage of hepatic schistosomiasis would a patient experience itching after entry of cercariae?
Which of the following is NOT a management strategy for ascaris-induced liver infections?
Which of the following is NOT a management strategy for ascaris-induced liver infections?
Which type of benign liver lesion is characterized by a vascular mass in the liver?
Which type of benign liver lesion is characterized by a vascular mass in the liver?
What condition is most commonly associated with portal hypertension?
What condition is most commonly associated with portal hypertension?
Which malignant liver lesion is primarily associated with chronic viral hepatitis infection?
Which malignant liver lesion is primarily associated with chronic viral hepatitis infection?
Which infection is caused by a parasitic organism that can lead to liver abscess?
Which infection is caused by a parasitic organism that can lead to liver abscess?
Which of the following is NOT a characteristic symptom of advanced hepatocellular carcinoma?
Which of the following is NOT a characteristic symptom of advanced hepatocellular carcinoma?
Which benign liver lesion is typically asymptomatic and requires no treatment?
Which benign liver lesion is typically asymptomatic and requires no treatment?
Which malignant liver lesion is a secondary tumor that results from spread from another cancer site?
Which malignant liver lesion is a secondary tumor that results from spread from another cancer site?
What is a common consequence of acute liver failure?
What is a common consequence of acute liver failure?
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Study Notes
Infections of the Liver
Ascariasis
- Caused by Ascaris lumbricoides.
- Ova can migrate from the gastrointestinal tract to bile ducts, leading to retrograde locomotion.
- Clinical symptoms include:
- CBD obstruction and intrahepatic stones
- Biliary colic
- Acute cholecystitis
- Acute pancreatitis
- Hepatic abscess
- Diagnosis via ultrasound and ERCP, which may reveal linear filling defects in bile ducts.
- Management options:
- Endoscopic extraction of worms
- Anti-parasitics such as Piperazine citrate, Mebendazole, or Albendazole.
- Surgical extraction if ERCP fails.
Schistosomiasis
- Hepatic schistosomiasis occurs via mesenteric venous system emboli.
- Clinical symptoms develop in three stages:
- Itching post cercariae entry
- Fever, urticaria, and eosinophilia
- Advanced symptoms (not specified).
- Diagnostic methods include fecalysis, serologic tests, and blood tests showing elevated alkaline phosphatase and decreased serum albumin.
- Treatment of choice is Praziquantel at 40 to 75 mg/kg in a single dose.
Evaluation of Incidental Liver Mass
- Benign Liver Lesions:
- Hepatic Cysts
- Biliary Cystadenoma
- Hemangioma
- Adenoma
- Focal Nodular Hyperplasia
- Malignant Liver Lesions:
- Hepatocellular Carcinoma
- Cholangiocarcinoma
- Metastatic Colorectal Cancer
Acute Liver Failure
- Etiologies include:
- Viral hepatitis (types B, A, E)
- Drug-induced liver damage, particularly from Acetaminophen.
- Clinical presentation features:
- Jaundice
- Encephalopathy
- Hepatic coma
- Elevated creatinine (>2 mg/dL)
- Abnormal arterial pH.
- Management involves:
- ICU admission and monitoring
- Liver biopsy if indicated
- Specific actions for acetaminophen overdose:
- Discontinue acetaminophen
- Administer activated charcoal
- Use N-acetylcysteine as an antidote.
Malignant Neoplasms of the Liver - Hepatocellular Carcinoma (HCC)
- Typically asymptomatic in early stages, often diagnosed at advanced stages.
- Symptoms may include jaundice, weight loss, malaise, and upper abdominal pain.
- Recommended screening populations:
- Individuals with liver cirrhosis
- Patients with Hepatitis B and C infections.
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