1. The portal vein pressure in an individual with normal physiology is low at 3 to 5 mmHg.

2. Right hepatic vein drains segment V, VI, VII, VIII.

3. Middle hepatic vein drains segment IVa, IVb, V, VIII.
4. Left hepatic vein drains segment II, III.
5. Segment I is drain by short hepatic veins which enters directly to vena cava.
6. Common hepatic artery arises from the celiac trunk, gives off the gastroduodenal and right
gastric artery.
7. Proper hepatic artery gives right to right and left hepatic arteries.
8. A common source of referred pain to the right shoulder and scapula as well as the right side or
back is the right phrenic nerve.
9. Bilirubin is the breakdown product of normal heme catabolism.
10. The continuous process of secretion of bile salts in the bile, their passage through the intestine,
and their subsequent return to the liver is termed the enterohepatic circulation.
11. Phase 1 reactions include oxidation, reduction, and hydrolysis of molecules. These result in
metabolites that are more hydrophilic than the original chemicals.
12. Phase 2 reactions, also known as conjugation reactions, are synthetic reactions that involve
addition of subgroups to the drug molecule.
13. Liver function tests is a term frequently used to refer to measurement of the levels of a group of
serum markers for evaluation of liver dysfunction.
14. The liver is the largest organ in the body, weighing approximately 1500 g.
15. The liver is surrounded by a fibrous sheath known as Glisson’s capsule.
16. The liver is grossly separated into the right and left lobes by the plane from the gallbladder fossa
to the inferior vena cava (IVC), known as Cantlie’s line.
17. The hepatic artery arises from the celiac axis (trunk), which gives off the left gastric, splenic, and
common hepatic arteries.
18. Approximately 10% to 15% of the time there is a replaced or accessory right hepatic artery
arising from the superior mesenteric artery (SMA).
19. The portal vein is formed by the confluence of the splenic vein and the superior mesenteric
vein.
20. ALT is predominately found in the liver and thus is more specific for liver disease.
21. Cholestasis is a condition in which bile flow from the liver to the duodenum is impaired.
22. In general, an elevated indirect bilirubin level suggests intrahepatic cholestasis, and an elevated
direct bilirubin level suggests extrahepatic obstruction.
23. AP is an enzyme with a wide tissue distribution but is found primarily in the liver and bones.
24. GGT is another enzyme found in hepatocytes and released from the bile duct epithelium.
25. Jaundice refers to the yellowish staining of the skin, sclera, and mucous membranes with the
pigment bilirubin.
26. Gilbert’s syndrome is a genetic variant characterized by diminished activity of the enzyme
glucuronyltransferase, which results in decreased conjugation of bilirubin to glucuronide.
27. Another inherited disorder of bilirubin conjugation is Crigler-Najjar syndrome. It is a rare
disease found in neonates and can result in neurotoxic sequelae from bilirubin encephalopathy.
28. CRP is an important acute phase protein that is also involved in the clearance of
microorganisms.
29. LPS is a glycolipid constituent of gram-negative bacteria outer membranes composed of a
hydrophilic polysaccharide portion and a hydrophobic domain called lipid A.
30. LBP is an acute-phase protein synthesized by hepatocytes that binds the lipid A moiety of LPS
and forms a soluble LBP-LPS complex.
31. Nitric oxide (NO) is a diffusible, free radical gas that was first identified in 1980 as endothelium-
derived relaxing factor.
32. The heme oxygenase (HO) is the rate-limiting enzyme in the degradation of heme to yield
biliverdin, carbon monoxide (CO), and free iron.
33. Intraoperative ultrasound is considered the gold standard for detecting liver lesions.
34. Ultrasound elastography, also referred to as transient elastography, can be used to assess the
degree of fibrosis or cirrhosis in the liver.
35. CT produces a digitally processed cross-sectional image of the body from a large series of X-ray
images.
36. MRI is a technique that produces images based on magnetic fields and radio waves.
37. Positron emission tomography (PET) is a nuclear medicine test that produces images of
metabolic activity in tissues.
38. Fluorodeoxyglucose (FDG) is the most common metabolic molecule used in PET imaging.
39. Acute liver failure (ALF) occurs when the rate and extent of hepatocyte death exceeds the
liver’s regenerative capabilities. The most common cause of death is intracranial hypertension
due to cerebral edema.
40. N-acetylcysteine (NAC), the clinically effective antidote for acetaminophen overdose, should be
administered as early as possible to any patient with suspected acetaminophen-associated ALF.
41. Despite advances in medical management, orthotopic liver transplantation (OLT) remains the
only definitive therapy for patients unable to regenerate sufficient hepatocyte mass in a timely
manner.
42. Cirrhosis, the final sequela of chronic hepatic insult, is characterized by the presence of fibrous
septa throughout the liver.
43. Micronodular cirrhosis is characterized by thick regular septa, small uniform regenerative
nodules, and involvement of virtually every hepatic lobule.
44. Macronodular cirrhosis frequently has septa and regenerative nodules of varying sizes.
45. Nonalcoholic fatty liver disease (NAFLD) is now the most common chronic liver disease
worldwide.
46. Chronic hepatitis C infection is the most common cause of chronic liver disease and the most
frequent indication for liver transplantation.
47. Hereditary hemochromatosis is the most common metabolic disorder causing cirrhosis.
48. Cruveilhier-Baumgarten murmur, a venous hum that can be auscultated in the epigastrium
resulting from collaterals between the portal system and the remnant of the umbilical vein.
49. The monoethylglycinexylidide (MEGX) test, which measures MEGX formation after the
administration of lidocaine, has been shown to be approximately 80% sensitive and specific in
diagnosing cirrhosis.
50. The Child-Turcotte-Pugh (CTP) score was originally developed to evaluate the risk of portocaval
shunt procedures performed for portal hypertension and subsequently has been shown to be
useful in predicting surgical risks of other intra-abdominal operations on cirrhotic patients.
51. The Model for End-Stage Liver Disease (MELD) is a linear regression model based on three
objective laboratory values. It was originally developed as a tool to predict mortality after
transjugular intrahepatic portosystemic shunt (TIPS) but has been validated and used as the sole
method of liver transplant allocation
52. The most accurate method of determining portal hypertension is hepatic venography.
53. Budd-Chiari syndrome (BCS) is an uncommon congestive hepatopathy characterized by the
obstruction of hepatic venous outflow.
54. Pyogenic liver abscesses are the most common liver abscesses seen in the United States.
55. The most common infecting agents are gram-negative bacteria. Escherichia coli is found in two
thirds of cases.
56. Amebic Abscesses. Entamoeba histolytica is a parasite that is endemic worldwide. Amebiasis is
most common in subtropical climates, especially in areas with poor sanitation. Metronidazole
750 mg three times a day for 7 to 10 days is the treatment of choice and is successful in 95% of
cases.
57. Hydatid disease is due to infection by the tapeworm Echinococcus granulosus in its larval or
cyst stage. Hydatid disease is most common in sheep-raising areas, where dogs have access to
infected offal.
58. The most common benign lesion found in the liver is the congenital or simple cyst. The
preferred treatment for symptomatic cysts is ultrasound- or CT-guided percutaneous cyst
aspiration followed by sclerotherapy.
59. Biliary cystadenomas are slow-growing, unusual, benign lesions that most commonly present as
large lesions in the right lobe of the liver.
60. Adult polycystic liver disease (PCLD) occurs as an autosomal dominant disease and usually
presents in the third decade of life.
61. Bile duct hamartomas are typically small liver lesions.
62. Primary cancers in the liver that originate from hepatocytes are known as hepatocellular
carcinomas (HCCs or hepatomas), whereas cancers arising in the bile ducts are known as
cholangiocarcinomas.
63. HCC is the fifth most common malignancy worldwide and the third most common cause of
cancer death worldwide.
64. Cholangiocarcinoma, or bile duct cancer, is the second most common primary malignancy of the
liver.
65. Caroli’s disease is a syndrome of congenital ductal plate malformations of the intrahepatic bile
ducts and is characterized by segmental cystic dilatation of the intrahepatic biliary radicals.
66. Hemangiomas (also referred to as hemangiomata) are the most common solid benign masses
that occur in the liver.
67. Hepatic adenomas are benign solid neoplasms of the liver. They are most commonly seen in
premenopausal women older than 30 years of age and are typically solitary.
68. Focal Nodular Hyperplasia. FNH is a solid, benign lesion of the liver believed to be a hyperplastic
response to an anomalous artery.