How much higher is the incidence of choledochal cyst in Orientals vs. Occidentals?

1.   ?    Two-fold increaes
2.   ?    Four-fold increaes
3.   ?    Seven-fold increaes
4.   ?    Ten-fold increaes

Which type of choledochal cyst constitutes approximately 90 percent of all cases?

1.   ?    Type I
2.   ?    Type II
3.   ?    Type IV
4.   ?    Type V

Which choledochal cyst is a diverticulum?

1.   ?    Type I
2.   ?    Type II
3.   ?    Type IV
4.   ?    Type V

Which type of choledochal cyst is described as a choledochocele?

1.   ?    Type I
2.   ?    Type II
3.   ?    Type III
4.   ?    Type V

Which choledochal cyst is Caroli's disease.

1.   ?    Type I
2.   ?    Type II
3.   ?    Type IV
4.   ?    Type V

Do cysts in Caroli's disease or fibrocystic / polycystic disease communicate wtih the liver?

1.   ?    Caroli's disease
2.   ?    Polycystic disease
3.   ?    Both
4.   ?    Neither

Which choledochal cyst is a fusiform dilation?

1.   ?    Type I
2.   ?    Type II
3.   ?    Type IV
4.   ?    Type V

What is the histology of the cyst wall in choledochal cyst?

1.   ?    Normal mucosa
2.   ?    Absent muscle in the wall
3.   ?    Inflammatory changes
4.   ?    B and C

True or false: In general, most infants with CDC (Choledochal cyst) have patent common bile ducts at diagnosis, while older patients have had complete obstruction at the level of the duodenum when the choledochal cyst is present.

1.   ?    True
2.   ?    False

What do liver biopsies typically show in patients with choledochal cyst?

1.   ?    May be normal
2.   ?    May show bile duct proliferation
3.   ?    Both of the above are true
4.   ?    None of the above are correct

What percentage of patients with retained choledochal cysts may develop carcinoma?

1.   ?    Less than 3%
2.   ?    Less than 10%
3.   ?    10 - 15%
4.   ?    20 - 25%

In patients who have a choledochocele, what is the lining composed of?

1.   ?    Heterotopic pancreatic mucosa
2.   ?    Duodenal mucosa
3.   ?    Heterotopic gastric mucosa

Describe the gender incidence of choledochal cysts.

1.   ?    Maale over Female 4 to 1
2.   ?    Female over Male 4 to 1
3.   ?    Equivalent
4.   ?    Female over male 10 to 1

What do serial ultrasound studies during pregnancy demonstrate about the origin of choledochal cyst?

1.   ?    Origin in 1st trimester
2.   ?    Origin in 2nd trimester
3.   ?    Origin in 3rd trimester

Describe the two clinically distinct groups of patients with choledochal cyst.

1.   ?    Adult form mimics biliary atresia
2.   ?    Infantile form presents with abdominal pain
3.   ?    Infantile group has jaundice in 1st 3 days of life
4.   ?    Infantile group diagnosed at 4 - 6 weeks

What is most common presenting symptom of choledochal cyst?

1.   ?    Jaundice
2.   ?    Mass
3.   ?    Pain
4.   ?    Pancreatitis

What laboratory abnormalities typically do NOT occur in infants with choledochal cysts?

1.   ?    Conjugated hyperbilirubinemia
2.   ?    Mild amylase elevation
3.   ?    Increase in GGT
4.   ?    Increase in Alk phos

What radiographic studies is least useful for neonatal choledochal cysts??

1.   ?    ERCP
2.   ?    CT abd
3.   ?    Abd us
4.   ?    Operative cholangiogram

Why has cyst-duodenostomy and Roux-en -Y cyst jejunostomy been abandoned for Types I, II, and IV, choledochal cysts?

1.   ?    Cirrhosis
2.   ?    Cholangitis
3.   ?    A and B
4.   ?    Increased risk of later obstruction

How are patients with Type 3 choledochal cysts managed?

1.   ?    Lateral duodenotomy and unroofing
2.   ?    Liver transplantation
3.   ?    Roux-en-Y hepaticojejunostomy
4.   ?    ERCP and unroofing

Which is FALSE regarding AlagilleÂ’s syndrome?

1.   ?    1 in 10,000 live births
2.   ?    Often requires liver transplant
3.   ?    Eye, kidney, and heart abnormalities may be associated
4.   ?    Autosomal dominant