MCQ Gastrointestinal Liver abscess

  1. MC site of abdominal visceral abscessQ?
    Liver
  2. Most common cause of pyogenic liver abscess in children?
    • Staphylococcus
    • PLA chronic granulomatous diseaseQ, disorder of granulocyte function and hematologic malignancies
  3. Causative organism of pyogenic liver abscess?
    • MC in western countriesQ - E. coli
    • MC in Asian countriesQ - Klebsiella pneumoniae
  4. Multiple liver abscesses, most common site of origin?
    Biliary originQ
  5. Most common routes of Infection in PLA?
    • Biliary tract (MC):Q
    • −−CBD stones leading to cholangitis (in Asia)Q
    • −−Hilar cholangiocarcinoma in western countriesQ
    • Portal vein (2nd MC) Q
  6. MC presenting symptom is PLA and ALA?
    • PLA - FeverQ.
    • ALA - Abdominal painQ
  7. MC LFT abnormality in PLA and ALA?
    • PLA – ALPQ
    • ALA – Raised PT, Jaundice is rareQ
  8. Etiology of endogenous Endophthalmitis in PLA?
    KlebsiellaQ hepatic abscesses, more common in diabetic patientsQ.
  9. Treatment of PLA and ALA?
    • PLA - Percutaneous catheter drainage + IV antibiotics. After 2 weeks of parenteral antibiotics, oral agents should be used for further 4 weeks.
    • ALA - Metronidazole (750 mg orally TDS X 10-14 days), luminal agents like
    • diloxanide furoateQ.
  10. Indications of Aspiration in ALA?
    • 1. Diagnostic uncertainty Q
    • 2. Failure to respond to therapy in 3-5 daysQ
    • 3. Pyogenic superinfectionQ
    • 4. High risk of rupture (size >5 cm, left lobe abscess)Q
    • 5. PregnancyQ
  11. Confirmation of diagnosi in ALA and PLA?
    • PLA - confirmed by aspiration and cultureQ
    • ALA - serological testsQ (ELISA)
  12. Most frequent complications of PLA?
    Rupture into the peritoneum (MC)Q, pleural cavity, or pericardium.
  13. The average time to radiologic resolution in ALA?
    3 to 9 months
  14. The average time to radiologic resolution in ALA?
    3 to 9 months
  15. Species for Hydatid cyst?
    • Echinococcus granulosusQ.
    • E. multilocularis,
    • E. vogelli,
    • E. oligarthusQ
  16. Life cycle of Echinococcus?
    • • Dogs are the definitive hostQ
    • • Sheep: Usual intermediate hostQ
    • • Human: Accidental dead end intermediate hostQ without human to human transmission
  17. Layers of hydatid cyst?
    • Two layers:
    • −−Ectocyst: outer gelatinous membraneQ
    • −−Endocyst: inner germinal membraneQ
    • Pericyst: Fibrous capsule derived from host tissues, develops around the hydatid cyst
  18. Most common signs and symptoms of Hydatid cyst?
    • • MC symptoms: Abdominal pain, dyspepsia and vomiting.
    • • MC sign: HepatomegalyQ•
  19. MC complication of hydatid liver cystsQ?
    Intrabiliary rupture
  20. Common scolicidal Agents?
    • • Hypertonic (20%) salineQ: 100% scolicidal with contact time of 6 minutes
    • • 0.5% cetrimide with 0.05% chlorhexidineQ
    • • Absolute alcoholQ
    • • 10% povidone iodineQContraindications
  21. Contraindications of PAIR?
    • • Superficially located cystsQ
    • • Inaccessible or hazardous locationQ of cyst
    • • Cysts with multiple internal septalQ divisions (honeycombing pattern)
    • • Dead or inactive cystsQ
    • • Cysts communicating with biliary treeQ
    • • Lung or brain cystsQ
Author
surgerymaster
ID
333886
Card Set
MCQ Gastrointestinal Liver abscess
Description
Liver abscess
Updated