b) strenuous exercise increases hepatic artery flow
c) Major Oxygen supply to liver by hepatic artery
d) Hepatic artery mainly supplies biliary tree
Q28) False about liver functions
a) makes albumin and fibrinogen
b) endotoxin clearance
c) Thermogenesis
d) stores bile after cholecystectomy
e) Stores vit b12
Q29) Esophageal stricture can present after anastomoses in all except?
a) Anastomotic leak
b) Tumor Recurrence
c) Stapled Esophageal Enteric Anastomoses
d) Hand sewen Anastomose
Q30) In enbloc radical esophagectomy all structures are removed except
a) Esophagus and periesophageal lymphnodes
b) Main trunk Ajygous vein lymphnode
c) coeliac lymh nodes
d) deep coeliac group
Answers
26)d
HCV is more common cause than HBV in Japan in causing Hepatocellular
carcinoma. Harrsion 589
. Recently, Nishiguchi and colleagues reported that interferon therapy
decreased the incidence of hepatocellular carcinoma in a small number of
patients with chronic active hepatitis C with cirrhosis. Mazzella and
coworkers showed that interferon-alpha decreased the risk for hepatocellular
carcinoma in patients with HCV-related cirrhosis. In contrast, Bruno and
associates [30] found that interferon therapy was not an independent risk
factor for hepatocellular carcinoma in anti-HCV-positive patients with
cirrhosis. A European group also did not find a significant benefit of
interferon-alpha in preventing hepatocellular carcinoma in patients with
compensated type C cirrhosis. Thus, the effect of interferon treatment on
the incidence of hepatocellular carcinoma in patients with HCV-related
cirrhosis is controversial. (http://www.annals.org/cgi/content/full/129/2/94).
multicentric is more common in HCV infection (1: J Hepatol. 2005
Feb;42(2):225-9.
Multistep and multicentric development of hepatocellular carcinoma:
histological analysis of 980 resected nodules)
27)b Hepatic blood flow 20% of cardiac output
Hepatic artery 20% of liver bld , 80% of oxygen
30% of hepatic blood flow
exercise decreases splanchnic and hepatic flow
28) c
CBD stores bile after cholecystectomy
29) d
Hand sewn has les stricture rate than stapler. In a randomized trial
performed at the University of Hong Kong Medical Centre that compared
stapled and hand-sewn intrathoracic anastomosis, leak rates were similar for
both groups (4.9% for the stapled method vs 1.6% for the hand-sewn method),
but the stricture rate was substantially higher for the stapled group (40.0%
vs 9.1%). Law S, Fok M, Chu KM, Wong J. Comparison of hand-sewn and stapled
esophagogastric anastomosis after esophageal resection for cancer: a
prospective randomized controlled trial. Ann Surg. 1997;226:169-173
30) b
Two Field esophagectomy is enbloc resection of all lymph nodes from tracheal
bifurcation to coeliac three field isincluding lymphnodes along b/l
recurrent laryngeal nerve as well as modified neck dissection.Arch of
Azygous is removed not the main trunk
