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ARRT abdomen 3 Flashcards

1
Q

Hepatic steatosis may also be a sign of _____

A

metabolic syndrome

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2
Q

clinical signs of fatty liver infiltration

A

elevated LFTs
no symptoms

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3
Q

Hepatic steatosis sonographic appearance

A

echogenic/dense liver
poor thru transmission (high attenuation)
poor visualization of vasculature

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4
Q

Focal fatty infiltration sonographic appearance

A

focal echogenic area, patty of fatty liver (no mass effect)

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5
Q

Focal fatty sparing sonographic appearance

A

focal hypoechoic area, patch of normal liver

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6
Q

Most common location of focal fatty sparing

A

next to gallbladder/porta hepatitis

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7
Q

liver cell death and fibrosis

A

cirrhosis

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8
Q

What is cirrhosis?

A

liver cell death and fibrosis

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9
Q

What is the most common cause of cirrhosis?

A

alcoholism

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10
Q

Clinical signs of liver cirrhosis

A

poor liver function symptoms (elevated LFTs and jaundice), fatigue, weight loss, diarrhea

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11
Q

What creates jaundice?

A

elevated total or direct bilirubin

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12
Q

Sonographic appearance of cirrhosis

A

heterogeneous/coarse texture
small right lobe
enlarged caudate lobe
nodular surface
ascites

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13
Q

Micronodular liver is caused by

A

alcoholism

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14
Q

Macronodular liver is caused by:

A

hepatitis

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15
Q

Nodules are considered macronodules when measures more than:

A

1 cm

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16
Q

Progression of cirrhosis:

A

portal hypertension and varices, portal vein higronibosis, and hcc

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17
Q

most common cause of portal hypertension is:

A

cirrhosis

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18
Q

increased pressure on portal system, redirecting blood from AWAY from the liver

A

portal hypertension

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19
Q

Blood flow can only flow into:

A

low pressure

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20
Q

What happens when pressure of liver diseases increases too much

A

the liver resists flow coming into it

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21
Q

caput madusa

A

superificial abdominal veins

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22
Q

clinical symptoms of portal hypertension

A

same symptoms as advanced cirrhosis
caput madusa
GI bleeding

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23
Q

Portal hypertension shows _____ portal vein flow.

A

hepatofugal

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24
Q

A dilated MPV measures more than:

A

13mm

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25
Q

dilated venous collaterals near spleen, stomach, and esophagus

A

abdominal varices

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26
Q

Abdominal varices are dilated venous collaterals near _____, _____, and _____

A

spleen
stomach
esophagus

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27
Q

What veins normally drain into portal vein?

A

splenic vein, coronary ((left gastric) vein

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28
Q

sonographic appearance of portal hypertension

A

abdominal varices
abnormal splenic flow
splenomegaly
recanalized paraumbilical vein

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29
Q

What is the treatment for portal hypertension?

A

TIPSS

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30
Q

What does TIPSS stand for?

A

transjugular intrahepatic portosystemic shunt

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31
Q

communication or bridge between PV and HV to decompress the portal vein and normalize flow direction

A

TIPSS

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32
Q

Where is the anastamosis in TIPSS usually done?

A

proximal right portal vein to distal right hepatic vein

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33
Q

If TIPSS is successful, flow will be _____ at proximal anastamosis (RPV), flow will be _____ at distal anastomosis (RHV)

A

hepatopetal
hepatofugal

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34
Q

Most common cause of portal vein compression/thrombosis

A

obstruction of PV by tumors or lymphadenopathy

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35
Q

Thrombosis may be caused by:

A

increased liver resistance
(HCC, mets, portal hypertension)

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36
Q

Clinical symptoms of portal vein compression/thrombosis

A

pain
elevated LFTs
hypovolemia
nausea
vomiting

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37
Q

Sonographic appearance of portal vein thrombosis/compresion

A

thrombosis of PV
cavernous transformation

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38
Q

Cavernous transformation =

A

periportal collaterals

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39
Q

small vessels surrounding the portal vein reroute blood around the clot towards the liver

A

cavernous transformation (periportal collaterals)

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40
Q

Portal hypertension collaterals reroute blood ___ from the liver

A

away

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41
Q

Cavernous transformation collaterals reroute blood ____ from the liver

42
Q

occlusion of hepatic veins and possibly IVC

A

Budd-Chiari syndrome

43
Q

leads to liver congestion and eventual liver necrosis

A

Budd-Chiari syndrome

44
Q

In Budd-Chiari syndrome the ____ lobe enlarges to compensate.

45
Q

The ____ lobe drains directly into the IVC

46
Q

Clinical symptoms of Budd-Chiari syndrome

A

elevated LFTs

47
Q

Sonographic appearance of Budd-Chiari syndrome

A

hepatomegaly
enlarged caudate lobe
absent flow in the hepatic veins

48
Q

Hepatitis is a ____ infection

49
Q

Abscesses are a ____ infection

50
Q

Diffuse labs + fever =

A

whole organ infection “itis”

51
Q

fever + focal finding=

52
Q

Most common hepatitis

53
Q

most likely cause of needing a liver transplant

A

hepatitis C

54
Q

inflammation or infection

55
Q

acute -itis means:

A

ACTIVE infection

56
Q

Most common acute hepatitis

57
Q

Hepatitis A route

A

fecal-oral

58
Q

clinical symptoms of acute hepatitis

A

fever
non-obstructive jaundice (elevated direct bilirubin)
elevated LFTs

59
Q

Sonographic appearance of acute hepatitis

A

initially normal
hepatomegaly
hypoechoic
starry sky sign

60
Q

What is the starry sky sign

A

periportal cuffing (increased echogenicity of portal triads

61
Q

Most common chronic hepatitis

62
Q

Hepatitis C route

A

bodily fluids

63
Q

Clinical symptoms of Hepatitis C

A

no signs of infection
only evidence of decreased liver function (cirrhosis)

64
Q

Sonographic signs of Hepatitis C

A

may have signs of fibrosis or necrosis

65
Q

clinical symptoms of abscesses

A

infection symptoms
fever
pain
leukocytosis

66
Q

Sonographic appearance of abscesses

A

focal, complex cyst

67
Q

The hydatid abscess is caused by what parasite

A

echonicoccal

68
Q

The hydatid abscess shows a ____ sign

A

water-lily

69
Q

Sonographic appearance of water-lily sign

A

daughter cysts, membranes

70
Q

Amebic abscess is caused by:

A

parasite from water

71
Q

The amebic abscess hits the GI tract first causing

72
Q

pyo=

A

pus/bacteria

73
Q

Pyogenic abscess affects patients with a history of:

A

-itis
surgery
biopsy

74
Q

Fungal abscess is caused by:

A

candida albicans

75
Q

Patients who are at higher risk for a fungal abscess include:

A

immunocompromised cancer, transplant, HIV

76
Q

Fungal abscesses show a ___ sign

A

target/halo

77
Q

asymptomatic masses are:

A

benign/ non-endocrine

78
Q

symptomatic masses are:

79
Q

Cysts are commonly associated with:

A

polycystic kidney disease

80
Q

Sonographic appearance of cysts

A

anechoic or complex with posterior enhancement

81
Q

most common benign liver tumor

A

cavernous hemangioma

82
Q

Sonographic appearance of Cavernous hemangioma

A

solid, echogenic mass

83
Q

Hepatocellular adenoma is associated with:

A

oral contraceptives

84
Q

Tumor made of fat and is hyperechoic on sonographic imaging

85
Q

second most common benign liver tumor

A

focal nodular hyperplasia

86
Q

Mass associated with “stealth” lesion

A

focal nodular hyperplasia

87
Q

central scar with vascularity, may be isoechoic to liver tissue

A

focal nodular hyperplasia

88
Q

“bleed” from trauma or surgery

89
Q

Hematoma within the organ, more focal appearing

A

intraparenchymal hematoma

90
Q

hematoma around the liver, just under the Glisson capsule, like “free fluid”

A

subcapsular hematoma

91
Q

Clinical symptoms of hematoma

A

trauma or biopsy history
decreased hematocrit
pain

92
Q

Sonographic appearance of hematoma

A

anechoic to echogenic depending on age

93
Q

Symptoms of cancer in the liver

A

weight loss
fatigue
abnormal labs
jaundice (if obstructive)
hepatomegaly

94
Q

HCC stands for:

A

hepat0cellular carcinoma

95
Q

Hepatocellular carcinoma is also known as:

96
Q

Most common primary liver cancer

A

hepatocellular carcinoma

97
Q

Patients at an increased risk for hepatocellular carcinoma include:

A

chronic liver disease
cirrhosis
hepatitis

98
Q

Tumor marker for hepatocellular carcinoma

A

elevated alpha-fetoprotein

99
Q

Sonographic appearance of hepatocellular carcinoma

A

usually solitary
hypoechoic mass
ascites

100
Q

most common cancer found in the liver

A

metastasis

ARDMS (25 decks)

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