Hepatic Hydatid Cyst — RACP Adult Medicine MCQ
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Correct answer: B — Use surgical management with peri-procedural albendazole rather than routine PAIR
Explanation lettering: E = shown as A · C = shown as B · B = shown as C · A = shown as D · D = shown as E
C is correct because a multivesicular active cyst with biliary communication is a complex lesion for surgical and infectious-diseases planning; routine PAIR risks leakage, cholangitis and anaphylaxis. D overestimates the suitability of multivesicular morphology for PAIR. E does not make PAIR the default for this complex cyst. A may be used when intervention is not feasible but is not the preferred definitive plan here. B requires truly inactive morphology, which daughter cysts contradict. Albendazole timing and the operative approach are individualised.
Reference: Victorian Department of Health, Hydatid disease: https://www.health.vic.gov.au/infectious-diseases/hydatid-disease-echinococcosis