Liver Transplantation and Esophageal Disorders Quiz
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Questions and Answers

Which artery provides 50% of the liver's oxygen supply?

  • Hepatic artery (correct)
  • Portal artery
  • Splenic artery
  • Celiac artery

    • Which factor is NOT produced by the liver's sinusoidal and endothelial cells?

  • Factor 8
  • Factor 3 (correct)
  • Factor 2
  • Factor 7

    • What is the most abundant plasma protein?

  • Fibrinogen
  • Albumin (correct)
  • Globulin
  • Hemoglobin

    • What is the main role of the liver in drug metabolism?

    <p>Biotransformation of drugs</p> Signup and view all the answers

    Which of the following is true about the liver's location in the abdomen?

    <p>The liver is located in the right upper quadrant.</p> Signup and view all the answers

    How many lobules are there in the liver?

    <p>50,000 to 100,000 lobules</p> Signup and view all the answers

    Which zone of the liver is the most susceptible to ischemic injury?

    <p>Zone 3</p> Signup and view all the answers

    Which type of hiatal hernia involves the movement of the upper stomach through an enlarged hiatus?

    <p>Type I</p> Signup and view all the answers

    Which medication therapy is commonly used to manage GERD?

    <p>Proton pump inhibitors</p> Signup and view all the answers

    What is the main blood supply to the stomach?

    <p>Celiac artery</p> Signup and view all the answers

    Which procedure aims to relieve outflow resistance in achalasia?

    <p>Endoscopic balloon dilation</p> Signup and view all the answers

    Which of the following is a primary esophageal motility disorder characterized by impaired relaxation of the lower esophageal sphincter (LES)?

    <p>Achalasia</p> Signup and view all the answers

    Which type of hiatal hernia involves the movement of the upper stomach through an enlarged hiatus?

    <p>Type I</p> Signup and view all the answers

    Which condition is characterized by the presence of gallstones in the common bile duct?

    <p>Choledocholithiasis</p> Signup and view all the answers

    What is the recommended treatment for cholecystitis and cholelithiasis?

    <p>Cholecystectomy</p> Signup and view all the answers

    Which of the following is the most common cause of acute liver failure in the US?

    <p>Acetaminophen overdose</p> Signup and view all the answers

    Which of the following is true about chronic hepatitis?

    <p>All of the above</p> Signup and view all the answers

    What are the signs and symptoms of alcohol withdrawal syndrome?

    <p>All of the above</p> Signup and view all the answers

    What is the most common indication for liver transplantation?

    <p>Hepatitis C</p> Signup and view all the answers

    Which sphincters are involved in digestion and absorption?

    <p>Lower esophageal sphincter and pyloric sphincter</p> Signup and view all the answers

    Where are 98% of peptic ulcers located?

    <p>Stomach and duodenum</p> Signup and view all the answers

    What is the most effective treatment for peptic ulcers?

    <p>Eradication of H. Pylori with antibiotics</p> Signup and view all the answers

    Which of the following is true about the liver's blood supply?

    <p>The portal vein provides 75% of the total liver blood flow</p> Signup and view all the answers

    What is the main function of the liver in the digestive system?

    <p>Producing bile</p> Signup and view all the answers

    Where is the liver located in the abdomen?

    <p>Right upper quadrant</p> Signup and view all the answers

    Which of the following is true about the hepatic artery?

    <p>It provides 25% of the liver's blood flow</p> Signup and view all the answers

    What is the main role of the liver in carbohydrate metabolism?

    <p>Production of glucose</p> Signup and view all the answers

    Which of the following factors is NOT produced by the liver's hepatocytes?

    <p>Factor 8</p> Signup and view all the answers

    What is the most common cause of liver cancer in the United States?

    <p>Hepatitis C</p> Signup and view all the answers

    Which is the most common cause of drug-induced hepatitis in the US?

    <p>Alcohol</p> Signup and view all the answers

    What is the most common cause of chronic hepatitis?

    <p>Alcoholism</p> Signup and view all the answers

    Which is the most common indication for liver transplantation?

    <p>Hepatitis C</p> Signup and view all the answers

    What is the main complication of a transjugular intrahepatic portosystemic shunt (TIPS) procedure?

    <p>Hemorrhage</p> Signup and view all the answers

    Which of the following is a common symptom of esophageal motility disorders?

    <p>All of the above</p> Signup and view all the answers

    Which condition is a consequence of chronic gastroesophageal reflux disease (GERD)?

    <p>Barrett esophagus</p> Signup and view all the answers

    Which type of hiatal hernia involves the movement of the upper stomach through an enlarged hiatus?

    <p>Type I</p> Signup and view all the answers

    Which procedure is commonly used to manage achalasia?

    <p>Botox injections</p> Signup and view all the answers

    Which sphincter is responsible for preventing the backflow of stomach acid into the esophagus?

    <p>Lower esophageal sphincter</p> Signup and view all the answers

    What is the main cause of peptic ulcers?

    <p>H. Pylori infection</p> Signup and view all the answers

    What is the most effective treatment for peptic ulcers?

    <p>Antibiotics</p> Signup and view all the answers

    Which of the following is a primary esophageal motility disorder characterized by impaired relaxation of the lower esophageal sphincter (LES)?

    <p>Achalasia</p> Signup and view all the answers

    Which type of hiatal hernia involves the movement of the upper stomach through an enlarged hiatus?

    <p>Type I</p> Signup and view all the answers

    What is the main blood supply to the stomach?

    <p>Celiac artery</p> Signup and view all the answers

    Which medication therapy is commonly used to manage GERD?

    <p>Proton pump inhibitors</p> Signup and view all the answers

    Which type of cancer accounts for the highest incidence of gastric cancers?

    <p>Adenocarcinomas</p> Signup and view all the answers

    What are the common signs and symptoms of gastric cancer?

    <p>Epigastric pain, weight loss, anorexia, fatigue, vomiting</p> Signup and view all the answers

    Which treatment option is recommended for early stages of gastric cancer?

    <p>Endoscopic mucosal resection</p> Signup and view all the answers

    What is the anesthesia consideration for gastric cancer surgery?

    <p>Correction of hypovolemia preoperatively</p> Signup and view all the answers

    What are the post-operative complications of gastric cancer surgery?

    <p>Hemorrhage, hypovolemia, hypothermia, atelectasis, ileus</p> Signup and view all the answers

    What is the recommended approach for gastric decompression and nutrition support after gastric cancer surgery?

    <p>Permanent or temporary opening into the stomach</p> Signup and view all the answers

    What is the recommended anesthesia technique for gastric cancer surgery in patients intolerant to monitored anesthesia care (MAC)?

    <p>General endotracheal anesthesia (GETA)</p> Signup and view all the answers

    What should be done prior to a percutaneous approach for gastric cancer surgery?

    <p>Administration of a bite block</p> Signup and view all the answers

    How long before the procedure should feedings be stopped for gastric cancer surgery?

    <p>8 hours</p> Signup and view all the answers

    What is the main purpose of a laparotomy in gastric cancer surgery?

    <p>Oversewing of the ulcers and application of omental patch</p> Signup and view all the answers

    Which of the following is a common symptom of chronic pancreatitis?

    <p>Severe abdominal pain</p> Signup and view all the answers

    What is the most common cause of chronic pancreatitis?

    <p>Alcohol use</p> Signup and view all the answers

    Which type of pancreatic cancer is the most common?

    <p>Ductal adenocarcinoma</p> Signup and view all the answers

    What is the first symptom of an occult pancreatic cancer?

    <p>New onset diabetes mellitus</p> Signup and view all the answers

    How is pancreatic cancer diagnosed?

    <p>Needle biopsy during CT scan</p> Signup and view all the answers

    What is the most common type of pancreatic tumor?

    <p>Insulinoma</p> Signup and view all the answers

    What is the most common age group affected by pancreatic cancer?

    <p>Old adults aged 60-80 years</p> Signup and view all the answers

    What is the main treatment for gallstones causing pancreatitis?

    <p>Endoscopic sphincterotomy with stone clearance</p> Signup and view all the answers

    What is the main symptom of an insulinoma?

    <p>Symptoms of hypoglycemia</p> Signup and view all the answers

    What is the most common cause of pancreatic abscesses?

    <p>Pancreatitis</p> Signup and view all the answers

    Which of the following is a function of the pancreas?

    <p>Secretion of pancreatic juice</p> Signup and view all the answers

    What stimulates the release of water and bicarbonate from the pancreas?

    <p>Secretin</p> Signup and view all the answers

    What hormone stimulates the elaboration of pancreatic enzymes?

    <p>Cholecystokinin-pancreozymin</p> Signup and view all the answers

    What is the main cause of acute pancreatitis?

    <p>Gallstones</p> Signup and view all the answers

    What is the characteristic pain in acute pancreatitis?

    <p>Mid-epigastric pain</p> Signup and view all the answers

    What is the result of acute pancreatitis?

    <p>Hemorrhage and edema</p> Signup and view all the answers

    What does a C-Reactive protein level >150 mg/L indicate in acute pancreatitis?

    <p>Severe severity</p> Signup and view all the answers

    What is the most correct description of acute pancreatitis?

    <p>Inflammation of the pancreas</p> Signup and view all the answers

    What triggers acute pancreatitis?

    <p>Obstruction of the pancreatic duct</p> Signup and view all the answers

    What is the composition of the pancreatic juice?

    <p>Bicarbonate, sodium, potassium, and chloride</p> Signup and view all the answers

    Which layer of the small intestine is responsible for controlling local blood flow and GI secretions?

    <p>Submucosa</p> Signup and view all the answers

    Which division of the nervous system carries autonomic innervation to the small intestine?

    <p>Parasympathetic nervous system</p> Signup and view all the answers

    What is the length of the small intestine?

    <p>5-7 meters</p> Signup and view all the answers

    What is the role of the Auerbach plexus in the small intestine?

    <p>Controlling gross GI motility</p> Signup and view all the answers

    What is the main blood supply to the small intestine?

    <p>Superior mesenteric artery</p> Signup and view all the answers

    What is the functional unit of the intestines that contains goblet cells, absorptive cells, and endocrine cells?

    <p>Villi</p> Signup and view all the answers

    What is the main role of the mesentery in the small intestine?

    <p>Facilitating intestinal motility</p> Signup and view all the answers

    What is the main function of the small intestine in the digestive system?

    <p>Absorbing nutrients</p> Signup and view all the answers

    What is the main component of the muscularis layer of the small intestine?

    <p>Smooth muscle</p> Signup and view all the answers

    What is the main component of the mucosa layer of the small intestine?

    <p>Epithelial layer</p> Signup and view all the answers

    Which procedure involves the removal of the head of the pancreas, duodenum, gallbladder, distal bile duct, proximal jejunum, and the distal third of the stomach?

    <p>Pancreaticoduodenectomy (Whipple Procedure)</p> Signup and view all the answers

    What is the type of transplant that involves the simultaneous transplantation of the pancreas and kidney?

    <p>Simultaneous pancreas and kidney (SPK)</p> Signup and view all the answers

    What is the type of transplant that involves the transplantation of the pancreas after the kidney?

    <p>Pancreas after kidney (PAK)</p> Signup and view all the answers

    What is the type of transplant that involves the transplantation of the pancreas alone?

    <p>Pancreas alone (PTA)</p> Signup and view all the answers

    What is the recommended anesthesia consideration for pancreatic transplant surgery?

    <p>Type &amp; Crossmatch for blood products</p> Signup and view all the answers

    What is the recommended anesthesia consideration for pancreatectomy surgery?

    <p>Correction of fluid and electrolyte derangements</p> Signup and view all the answers

    What is the recommended anesthesia consideration for partial pancreatectomy surgery?

    <p>Aspiration prophylaxis</p> Signup and view all the answers

    What is the recommended anesthesia consideration for total pancreatectomy surgery?

    <p>Blood glucose monitoring</p> Signup and view all the answers

    What is the recommended anesthesia consideration for distal pancreatectomy surgery?

    <p>Correction of fluid and electrolyte derangements</p> Signup and view all the answers

    What is the recommended anesthesia consideration for child procedure surgery?

    <p>Type &amp; Crossmatch for blood products</p> Signup and view all the answers

    Which of the following is a symptom of ulcerative colitis?

    <p>Abdominal pain and diarrhea</p> Signup and view all the answers

    What deficiency is commonly seen in patients with Crohn's disease?

    <p>Vitamin B12</p> Signup and view all the answers

    Which of the following is a complication of Crohn's disease?

    <p>Rectocutaneous fistulas</p> Signup and view all the answers

    What is the treatment for ulcerative colitis?

    <p>Sulfasalazine agents</p> Signup and view all the answers

    What is the recurrence rate of Crohn's disease at 10 years after colon and ileum resection?

    <p>50%</p> Signup and view all the answers

    Which population is ulcerative colitis more prevalent in?

    <p>Females</p> Signup and view all the answers

    What is the main symptom of ulcerative colitis?

    <p>Bloody diarrhea</p> Signup and view all the answers

    What is the recommended surgical treatment for ulcerative colitis?

    <p>Proctocolectomy with ileostomy</p> Signup and view all the answers

    What are the additional manifestations of Crohn's disease?

    <p>Iritis, erythema nodosum, ankylosing spondylitis</p> Signup and view all the answers

    What is the risk associated with ulcerative colitis?

    <p>Left sided carcinoma of the colon</p> Signup and view all the answers

    Which of the following is a clinical sign of malabsorption syndromes?

    <p>Unexplained weight loss</p> Signup and view all the answers

    Which of the following is a consequence of fat malabsorption in malabsorption syndromes?

    <p>Hypoprothrombinemia</p> Signup and view all the answers

    Which of the following is a cause of maldigestion syndromes?

    <p>Deficiency of pancreatic enzymes</p> Signup and view all the answers

    Which part of the gastrointestinal tract is commonly affected by Crohn's disease?

    <p>Distal ileum</p> Signup and view all the answers

    What is the function of the large colon in the digestive system?

    <p>Storage and expulsion of waste products</p> Signup and view all the answers

    What is the main blood supply to the large intestine?

    <p>Inferior mesenteric artery</p> Signup and view all the answers

    Which division of the nervous system innervates the large intestine?

    <p>Parasympathetic</p> Signup and view all the answers

    What is the hallmark symptom of maldigestion syndromes?

    <p>Steatorrhea</p> Signup and view all the answers

    What is the main role of the small intestine in the digestive system?

    <p>Absorption of nutrients</p> Signup and view all the answers

    Which of the following is a consequence of protein malabsorption in malabsorption syndromes?

    <p>Peripheral edema and ascites</p> Signup and view all the answers

    Which of the following is a contraindication for using bladder pressures in the trans-bladder technique?

    <p>Bladder trauma</p> Signup and view all the answers

    In healthy patients, what is the expected range for bladder pressures?

    <p>Below 5 mmHg</p> Signup and view all the answers

    What is the recommended position for taking bladder pressure measurements in the trans-bladder technique?

    <p>Complete supine position</p> Signup and view all the answers

    What is the purpose of injecting 25cc of sterile saline into the bladder in the trans-bladder technique?

    <p>To measure bladder pressures</p> Signup and view all the answers

    What bladder pressure range can be expected following abdominal surgery and in obese patients?

    <p>10 to 15 mmHg</p> Signup and view all the answers

    What bladder pressure range is highly suspicious of abdominal compartment syndrome in the trans-bladder technique?

    <p>Over 25 mmHg</p> Signup and view all the answers

    What is the recommended approach for recognizing the worsening of intra-abdominal hypertension in the trans-bladder technique?

    <p>Trending pressure measurements</p> Signup and view all the answers

    Which of the following is NOT a contraindication for using bladder pressures in the trans-bladder technique?

    <p>Neurogenic bladder</p> Signup and view all the answers

    What should bladder pressures be correlated with in the trans-bladder technique?

    <p>Clinical correlation</p> Signup and view all the answers

    Which of the following is a primary cause of Abdominal Compartment Syndrome (ACS)?

    <p>Intestinal obstruction</p> Signup and view all the answers

    What is the normal intraabdominal pressure?

    <p>&lt; 10 mmHg</p> Signup and view all the answers

    Which of the following is a symptom of Abdominal Compartment Syndrome (ACS) at an intraabdominal pressure of 15 mmHg?

    <p>Decreased urine output</p> Signup and view all the answers

    What is the most accurate method of confirming the diagnosis of Abdominal Compartment Syndrome (ACS)?

    <p>Measurement of abdominal pressure using pressure transducers</p> Signup and view all the answers

    Which of the following is a secondary cause of Abdominal Compartment Syndrome (ACS)?

    <p>Ascites</p> Signup and view all the answers

    What is the sustained intraabdominal pressure above which intrabdominal hypertension is defined?

    <blockquote> <p>12 mmHg</p> </blockquote> Signup and view all the answers

    What is the consequence of increased intraabdominal pressure in Abdominal Compartment Syndrome (ACS)?

    <p>Decreased lung volumes</p> Signup and view all the answers

    Which of the following is an indirect method of measuring abdominal pressure in Abdominal Compartment Syndrome (ACS)?

    <p>Measurement of intravesicular catheter pressures</p> Signup and view all the answers

    When does organ dysfunction develop in Abdominal Compartment Syndrome (ACS)?

    <p>After 6 hours</p> Signup and view all the answers

    Which of the following is the primary treatment for Abdominal Compartment Syndrome (ACS)?

    <p>Surgical decompression</p> Signup and view all the answers

    What is the average length of the appendix in adults?

    <p>9 cm</p> Signup and view all the answers

    What is the most common general surgical emergency?

    <p>Appendicitis</p> Signup and view all the answers

    What is believed to be the major cause of appendicitis?

    <p>Obstruction of the appendiceal lumen</p> Signup and view all the answers

    Which of the following is NOT an anesthesia consideration for Abdominal Compartment Syndrome (ACS)?

    <p>Administration of opioids</p> Signup and view all the answers

    What is the primary blood supply to the appendix?

    <p>Ileocolic artery</p> Signup and view all the answers

    What is the age group most affected by appendicitis?

    <p>Young adults between 18 and 30</p> Signup and view all the answers

    What is the length range of the appendix in adults?

    <p>5-10 cm</p> Signup and view all the answers

    What is the recommended closure timeframe for the abdominal fascia after surgical decompression?

    <p>5-7 days</p> Signup and view all the answers

    What is the primary purpose of temporary closure devices such as vacs, meshes, and zippers in abdominal compartment syndrome (ACS) treatment?

    <p>To increase abdominal wall compliance</p> Signup and view all the answers

    Which of the following is a common symptom of appendicitis?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is the major complication of untreated appendicitis?

    <p>All of the above</p> Signup and view all the answers

    What is the definitive treatment for appendicitis?

    <p>Appendectomy</p> Signup and view all the answers

    Where is the spleen located in the abdomen?

    <p>Left upper quadrant</p> Signup and view all the answers

    What is the most common complication of splenectomy?

    <p>Infection</p> Signup and view all the answers

    What is the main treatment for splenic trauma?

    <p>Splenectomy</p> Signup and view all the answers

    What is the main cause of lethal hemoperitoneum in splenic trauma?

    <p>Arterial bleeding</p> Signup and view all the answers

    What are the anesthetic considerations for emergency splenectomy?

    <p>All of the above</p> Signup and view all the answers

    What is the most vascular organ in the body?

    <p>Spleen</p> Signup and view all the answers

    What is the recommended anesthesia technique for gastric cancer surgery in patients intolerant to monitored anesthesia care (MAC)?

    <p>General anesthesia</p> Signup and view all the answers

    Which of the following is the most common location for carcinoid tumors?

    <p>Appendix</p> Signup and view all the answers

    What is the main cause of carcinoid syndrome?

    <p>Secretion of vasoactive substances from carcinoid tumors</p> Signup and view all the answers

    Which of the following is a potential life-threatening complication of carcinoid tumors?

    <p>Carcinoid crisis</p> Signup and view all the answers

    What are the clinical manifestations of carcinoid crisis?

    <p>Severe flushing and changes in blood pressure</p> Signup and view all the answers

    What is the recommended treatment for carcinoid tumors?

    <p>Complete surgical excision</p> Signup and view all the answers

    Which of the following is a diagnostic marker for carcinoid tumors?

    <p>Elevated levels of 5-HIAA in urine</p> Signup and view all the answers

    What is the main symptom of carcinoid syndrome?

    <p>Flushing and diarrhea</p> Signup and view all the answers

    What is the potentially life-threatening complication of carcinoid tumors that can be provoked by physical manipulation of the tumor?

    <p>Carcinoid crisis</p> Signup and view all the answers

    What is the recommended treatment for carcinoid crisis?

    <p>Octreotide</p> Signup and view all the answers

    Which hormone do somatostatin analogues suppress the response to?

    <p>Gonadotrophin-releasing hormone (GnRH)</p> Signup and view all the answers

    What is the main effect of serotonin receptor antagonists in patients with diarrhea?

    <p>Relieve diarrhea</p> Signup and view all the answers

    Which receptors do H1 and H2 receptor blockers act on?

    <p>Histamine</p> Signup and view all the answers

    What is the main blood supply to hepatic carcinoid tumors?

    <p>Hepatic artery</p> Signup and view all the answers

    Which method can be used to occlude the hepatic artery?

    <p>All of the above</p> Signup and view all the answers

    Which hormones do somatostatin analogues inhibit the release of?

    <p>Serotonin, gastrin, vasoactive intestinal peptide</p> Signup and view all the answers

    What is the main effect of H1 and H2 receptor blockers in patients with pruritic flush?

    <p>Relieve pruritic flush</p> Signup and view all the answers

    What is the main effect of somatostatin analogues on splanchnic blood flow?

    <p>Decrease splanchnic blood flow</p> Signup and view all the answers

    Which hormones do somatostatin analogues suppress the release of?

    <p>Serotonin, gastrin, vasoactive intestinal peptide, secretin, motilin, pancreatic polypeptide</p> Signup and view all the answers

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