Liver

Amoebic liver abscess

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Q)  Treatment of choice in amoebic liver abscess 4 cm in Right lobe of liver with fever and pain abdomen

a) Metronidazole

b) Aspiration

c) Pig tail insertion

d) Surgery

Answer

Question discusses 

INdications of aspiration 

Indications of Percutaneous drainage

Role of Surgery 

Hepatic blood flow

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Q. All are true regarding hepatic blood flow except
A. Liver has dual blood supply from portal vein and hepatic artery
B. 70% of liver oxygen comes from the hepatic artery
C. 70-80% of blood supply to the liver is from portal vein

d) Liver receives 25% of cardiac output

Answer for premium

The explanation discusses how much blood and oxygen goes through portal vein and hepatic artery to the liver

What is hepatic artery buffer response??

 

Liver trauma

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Q) All are true for blunt hepatic trauma except
A. Grade V liver injuries are associated with vascular avulsion
B. Hepatic packing is an expeditious method to control bleeding in blunt hepatic trauma
C. After damage control Surgery and hepatic packing, abdominal compartment syndrome can happen in immediate postoperative period
D. Post conservative management, in the 3rd week anemia MC occurs due to subcapsular
hematoma rupture

Answer

Fibrolamellar carcinoma of the liver

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Fibrolamellar Carcinoma Liver MCQ |

Fibrolamellar Carcinoma Liver MCQ – Young Female Liver Tumor

📘 Theme: Liver Tumors – Hepatobiliary Surgery (NEET SS / INI-CET High Yield)

Fibrolamellar Carcinoma MCQ

Which of the following statements regarding fibrolamellar carcinoma of the liver is correct?

A. Occurs in the setting of cirrhosis
B. Has worse survival than hepatocellular carcinoma
C. Can be followed up for long time
D. Seen in young females

Answer: D. Seen in young females

Explanation

Fibrolamellar carcinoma (FLC) is a rare variant of hepatocellular carcinoma that typically affects adolescents and young adults, often females, without underlying cirrhosis or chronic liver disease. Unlike conventional HCC, AFP is usually normal or only mildly elevated.

Histologically, it is characterized by large eosinophilic tumor cells separated by dense lamellar fibrosis.

Why other options are incorrect

  • Occurs in the setting of cirrhosis: False. FLC usually arises in non-cirrhotic livers.
  • Has worse survival than hepatocellular carcinoma: False. Fibrolamellar carcinoma generally has better survival than conventional HCC because patients are younger and liver function is preserved.
  • Can be followed up for long time: False. Surgical resection is the treatment of choice because the tumor has malignant potential.

High-yield teaching points

  • Young patient + liver mass + no cirrhosis = think fibrolamellar carcinoma.
  • AFP is often normal in fibrolamellar carcinoma.
  • Central scar may mimic focal nodular hyperplasia on imaging.
  • Best treatment is aggressive surgical resection.

Practice More Surgery MCQs

Significance of MELD Scoring in Liver Transplant

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Q) The significance of MELD Scoring in Liver transplant is :

a) Less ill patients are given more priority in liver transplant

b) Set threshold for patients who are too ill to undergo transplant.

c) To access  mortality in the waiting list.

d) To list patients in cadaveric deceased donor program

d

MELD score takes into account  three factors. Bilirubin, INR and creatinine. Recently MELD Na is also included. Model for end stage Liver Disease (MELD) was initially developed to evaluate three months prognosis in patients undergoing TIPS. 
It ranges from 6 (3 months survival = 90%) to 40 (3 months survival =7%).

In countries where DDLT is more common MELD Score is used to allot grafts to people in the cadaveric list. More severe is the MELD, earlier is the allotment of cadaveric graft.

Sicker patients are given priority