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Most common benign liver lesion?
Hemangioma
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Liver lesion with hypervascularity on CT, no sulfur colloid scan uptake, and no Kupfer cells
Hepatic Adenoma
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FNH on CT looks like this:
CENTRAL STELLATE SCAR, may look like cancer: fibromalleolar cancer
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What consumptive coagulopathy can occur as a result of a hepatic angioma?
Kasbach Merritt
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What do hepatic angiomas look like on CT scan?
Hypervascular lesions with peripheral to central enhancement on CT
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Management of an asymptomatic hepatic adenoma?
Stop OCP's, if regression: nada. If not: resect
If NOT on steroids/OCP: resect
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Management of Schistosomiasis lesion of the liver?
Praziquantel and control of any resultant variceal bleeding
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Management of pyogenic liver abscess?
CT guided percutaneous drainage and antibiotics, surgical drainage if unstable or septic or multiple abscesses
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Management of an Echinococcal liver cyst?
Tx with albendazole, do NOT resect: can spill into the abdomen and cause anaphylaxis
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Positive Casoni skin test =
Echinococcal cyst
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Management of an amebic abscess:
Usually just flagyl, typically dont need to drain
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Management of a lesion with:
-Central stellate scar
-Positive sulfur colloid uptake on liver scan
FNH: just need to manage conservatively
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What is the #1 cause of HCC worldwide?
Hep B virus
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How can you distinguish metastatic vs primary liver tumors on CT
- Primary = hypervascular
- Metastatic = hypovascular
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What is the only liver lesion that has positive sulfur colloid uptake on liver scan?
Focal Nodular Hyperplasia
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What are the odds of rupture of a hepatic adenoma?
10%
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What are Kupffer cells?
Liver macrophages
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What is a replaced R hepatic?
How common is it (%)?
- R hepatic REPLACED by branch of SMA
- 17%
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What is a accessory L hepatic?
How common is it?
- L hepatics is present, but so is a branch of the L gastric
- 10%
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Normal GB ejection fraction?
35%
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What is a common heart problem that arises in children with a hemangioma?
CHF
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