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Continuing Medical Education Questions: September 2014 Tannaz Guivatchian, MD, Jacob Kurlander, MD and Kenneth R. DeVault, MD, FACG

If you wish to receive credit for this activity, please refer to the Web site: http://acgjournalcme.gi.org/. Article Title: ACG Clinical Guideline: The Diagnosis and Management of Focal Liver Lesions Am J Gastroenterol 2014; 109:1348; doi:10.1038/ajg.2014.269

QUESTIONS: 1. A 40-year-old woman previously on oral contraceptives is found to have a 4.7-cm hepatic adenoma on imaging. What is the next step in management? A. She should be scheduled for surgical resection, given the risk of hemorrhage. B. Monitoring with imaging every 6 months is recommended for at least 2 years. C. No further treatment or monitoring is needed, as these are benign liver lesions. D. Embolization is a first-line treatment prior to surgical consideration. 2. Which one of the following imaging characteristics seen on computed tomography (CT) or magnetic resonance imaging (MRI) can be used to diagnose hepatocellular carcinoma (HCC)? A. Arterial hyper-enhancement with progressive increase in contrast uptake in the lesion during venous phase B. Peripheral nodular enhancement with progressive centripetal fill-in C. Arterial hyper-enhancement with progressive washout of contrast in the lesion during the venous and delayed phase D. Arterial hypo-enhancement with progressive increase in contrast uptake in delayed phase

3. Which one of the following statements is correct regarding percutaneous interventions in cystic focal liver lesions? A. Fluid aspiration should be performed routinely on suspected biliary cystadenoma for evaluation of tumor markers. B. There is no role for fluid aspiration in the management of large cysts in polycystic liver disease. C. The risk of anaphylaxis with percutaneous treatment of a hydatid cyst is extremely low (

Inflammatory bowel disease.

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