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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
dilated venous collaterals near spleen, stomach, and esophagus
abdominal varices
26
Abdominal varices are dilated venous collaterals near _____, _____, and _____
spleen stomach esophagus
27
What veins normally drain into portal vein?
splenic vein, coronary ((left gastric) vein
28
sonographic appearance of portal hypertension
abdominal varices abnormal splenic flow splenomegaly recanalized paraumbilical vein
29
What is the treatment for portal hypertension?
TIPSS
30
What does TIPSS stand for?
transjugular intrahepatic portosystemic shunt
31
communication or bridge between PV and HV to decompress the portal vein and normalize flow direction
TIPSS
32
Where is the anastamosis in TIPSS usually done?
proximal right portal vein to distal right hepatic vein
33
If TIPSS is successful, flow will be _____ at proximal anastamosis (RPV), flow will be _____ at distal anastomosis (RHV)
hepatopetal hepatofugal
34
Most common cause of portal vein compression/thrombosis
obstruction of PV by tumors or lymphadenopathy
35
Thrombosis may be caused by:
increased liver resistance (HCC, mets, portal hypertension)
36
Clinical symptoms of portal vein compression/thrombosis
pain elevated LFTs hypovolemia nausea vomiting
37
Sonographic appearance of portal vein thrombosis/compresion
thrombosis of PV cavernous transformation
38
Cavernous transformation =
periportal collaterals
39
small vessels surrounding the portal vein reroute blood around the clot towards the liver
cavernous transformation (periportal collaterals)
40
Portal hypertension collaterals reroute blood ___ from the liver
away
41
Cavernous transformation collaterals reroute blood ____ from the liver
back into
42
occlusion of hepatic veins and possibly IVC
Budd-Chiari syndrome
43
leads to liver congestion and eventual liver necrosis
Budd-Chiari syndrome
44
In Budd-Chiari syndrome the ____ lobe enlarges to compensate.
caudate
45
The ____ lobe drains directly into the IVC
caudate
46
Clinical symptoms of Budd-Chiari syndrome
elevated LFTs
47
Sonographic appearance of Budd-Chiari syndrome
hepatomegaly enlarged caudate lobe absent flow in the hepatic veins
48
Hepatitis is a ____ infection
diffuse
49
Abscesses are a ____ infection
focal
50
Diffuse labs + fever =
whole organ infection "itis"
51
fever + focal finding=
abscess
52
Most common hepatitis
A and B
53
most likely cause of needing a liver transplant
hepatitis C
54
inflammation or infection
-itis
55
acute -itis means:
ACTIVE infection
56
Most common acute hepatitis
A
57
Hepatitis A route
fecal-oral
58
clinical symptoms of acute hepatitis
fever non-obstructive jaundice (elevated direct bilirubin) elevated LFTs
59
Sonographic appearance of acute hepatitis
initially normal hepatomegaly hypoechoic starry sky sign
60
What is the starry sky sign
periportal cuffing (increased echogenicity of portal triads
61
Most common chronic hepatitis
C
62
Hepatitis C route
bodily fluids
63
Clinical symptoms of Hepatitis C
no signs of infection only evidence of decreased liver function (cirrhosis)
64
Sonographic signs of Hepatitis C
may have signs of fibrosis or necrosis
65
clinical symptoms of abscesses
infection symptoms fever pain leukocytosis
66
Sonographic appearance of abscesses
focal, complex cyst
67
The hydatid abscess is caused by what parasite
echonicoccal
68
The hydatid abscess shows a ____ sign
water-lily
69
Sonographic appearance of water-lily sign
daughter cysts, membranes
70
Amebic abscess is caused by:
parasite from water
71
The amebic abscess hits the GI tract first causing
diarrhea
72
pyo=
pus/bacteria
73
Pyogenic abscess affects patients with a history of:
-itis surgery biopsy
74
Fungal abscess is caused by:
candida albicans
75
Patients who are at higher risk for a fungal abscess include:
immunocompromised cancer, transplant, HIV
76
Fungal abscesses show a ___ sign
target/halo
77
asymptomatic masses are:
benign/ non-endocrine
78
symptomatic masses are:
malignant
79
Cysts are commonly associated with:
polycystic kidney disease
80
Sonographic appearance of cysts
anechoic or complex with posterior enhancement
81
most common benign liver tumor
cavernous hemangioma
82
Sonographic appearance of Cavernous hemangioma
solid, echogenic mass
83
Hepatocellular adenoma is associated with:
oral contraceptives
84
Tumor made of fat and is hyperechoic on sonographic imaging
lipoma
85
second most common benign liver tumor
focal nodular hyperplasia
86
Mass associated with "stealth" lesion
focal nodular hyperplasia
87
central scar with vascularity, may be isoechoic to liver tissue
focal nodular hyperplasia
88
"bleed" from trauma or surgery
hematoma
89
Hematoma within the organ, more focal appearing
intraparenchymal hematoma
90
hematoma around the liver, just under the Glisson capsule, like "free fluid"
subcapsular hematoma
91
Clinical symptoms of hematoma
trauma or biopsy history decreased hematocrit pain
92
Sonographic appearance of hematoma
anechoic to echogenic depending on age
93
Symptoms of cancer in the liver
weight loss fatigue abnormal labs jaundice (if obstructive) hepatomegaly
94
HCC stands for:
hepat0cellular carcinoma
95
Hepatocellular carcinoma is also known as:
hepatoma
96
Most common primary liver cancer
hepatocellular carcinoma
97
Patients at an increased risk for hepatocellular carcinoma include:
chronic liver disease cirrhosis hepatitis
98
Tumor marker for hepatocellular carcinoma
elevated alpha-fetoprotein
99
Sonographic appearance of hepatocellular carcinoma
usually solitary hypoechoic mass ascites
100
most common cancer found in the liver
metastasis

ARDMS (55 decks)

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