Chapter 2 The Liver Flashcards

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1
Q

_____ describes the transverse image taken of the porta hepatis

A

Mickey sign

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2
Q

The ____ carries oxygenated blood to the liver from the abdominal aorta

A

Common hepatic artery

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3
Q

The porta hepatis may also be referred to as

A

Liver Hilum

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4
Q

Scanning after a meal will often demonstrate an increase in

A

Portal vein flow

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5
Q

Normal flow within the portal veins should be:

A

Hepatopetal and monophasic

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6
Q

Enlargement of the portal veins is often indicative of

A

Portal hypertension

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7
Q

The blood within the portal vein is partially oxygenated because it is derived from the:

A

Intestines

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8
Q

The ______ provides the liver with approximately 75% of its total blood supply

A

Portal vein

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9
Q

The main portal vein is created by the union of the

A

SMV & Splenic vein

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10
Q

The main portal vein enters the liver at the _______

A

Porta hepatis (liver hilum)

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11
Q

The ______ has its own separate blood supply and venous drainage, it’s the smallest hepatic lobe

A

Caudate lobe

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12
Q

The ______ is used to separate the liver into eight surgical segments

A

Couinaud system

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13
Q

The liver is covered by _____, a thin fibrous casing

A

Glisson capsule

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14
Q

The left lobe of the liver is located;

A

Within the epigastrium and may transverse the midline and extend into the left hypochondrium

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15
Q

The right lobe of the liver is located

A

RUQ

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16
Q

______ is the largest parenchymal organ in the body

A

Liver

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17
Q

In early embryonic life, the liver is responsible for:

A

Hemopoiesis

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18
Q

E. Granulosus is associated with

A

Hydatid liver cyst

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19
Q

The childhood syndrome beckwith-weidermann is associated with an increased risk for developing:

A

Hepatoblastoma

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20
Q

Clinical findings of hepatocellular carcinoma (3):

A
  1. Elevated AFP
  2. Abnormal liver function test (LFTs)
  3. Cirrhosis
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21
Q

______ is considered the most common benign childhood hepatic mass

A

Infantile Hemangioendothelioma

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22
Q

_____ is often associated with the use of oral contraceptives

A

Hepatic adenoma

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23
Q

_____ is the most common form of liver cancer

A

Metastatic liver disease

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24
Q

Normal flow toward the liver in the portal veins is termed

A

Hepatopetal

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25
Q

Common sequela of cirrhosis includes:

A
  1. Portal hypertension
  2. Varicosities in abdomen
  3. Portal vein thrombosis
  4. Splenomegaly
  5. HCC
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26
Q

What form of hepatic abnormality are immunocompromised patients more prone to develop?

A

Candidiasis

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27
Q

Clinical findings of hepatitis (9):

A
  1. Chills
  2. Dark urine
  3. Elevated LFTs
  4. Fatigue
  5. Fever
  6. Hepatosplenomegaly
  7. Jaundice
  8. Nausea
  9. Vomiting
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28
Q

The most common cause of cirrhosis:

A

Cirrhosis

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29
Q

Sonographically, when the liver is difficult to penetrate and diffusely echogenic, this is indicative of?

A

Fatty liver disease

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30
Q

Shortly after birth, the ductus venosus collapse and becomes the:

A

Ligamentum venosum

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31
Q

Clinical findings of fatty liver disease;

A

Elevated LFTs
(No symptoms)

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32
Q

____ is the leading indication for liver transplantation in the U.S.A

A

Hepatitis C

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33
Q

The inferior extension of the caudate lobe is referred to as:

A

Papillary process

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34
Q

Normal flow within the hepatic veins is said to be:

A

Triphasic

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35
Q

The left umbilical vein after birth becomes the:

A

Ligamentum teres

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36
Q

The left portal vein divides into:

A

Medial and lateral branches

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37
Q

A tongue like extension of the right lobe of the liver is termed:

A

Riedel lobe

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38
Q

Buds-chiari syndrome leads to a reduction in the size of:

A

Hepatic veins

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39
Q

Normal flow within the hepatic artery should demonstrate a:

A

Low-resistance wave form pattern, with a quick upstroke and gradual deceleration with diastole

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40
Q

_______ have brighter walls that the hepatic veins

A

Portal veins

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41
Q

The right lobe of the liver can be divided into:

A

Anterior and posterior segments

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42
Q

The diameter of the portal vein should not exceed:

A

13mm

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43
Q

The right portal vein divides into:

A

Anterior and posterior branches

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44
Q

The TIPS shunt is placed:

A

Between a portal vein and hepatic vein

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45
Q

The right lobe of the liver is divided into segments by the:

A

Right hepatic vein

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46
Q

The right Intersegmental fissure contains the:

A

Right hepatic vein

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47
Q

The main portal vein divides into:

A

Left and right branches

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48
Q

The Ligamentum teres can be used to separate the:

A

Medial and lateral segments of the left lobe

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49
Q

The main lobar tissue contains the:

A

Middle hepatic vein

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50
Q

What are the three structures located within the porta hepatis

A

•main portal vein
•CBD
•hepatic artery

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51
Q

Right sided heart failure often leads to enlargement of the:

A

IVC and hepatic veins

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52
Q

The right lobe can be divided into an anterior and posterior segment by the:

A

Right hepatic vein

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53
Q

Where does the right hepatic vein lie:

A

Within the right intersegmental fissure

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54
Q

The right lobe can be separated from the left lobe by the:

A

Middle hepatic vein

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55
Q

Where does the middle hepatic vein lie:

A

Within the main lobar fissure

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56
Q

The caudate lobe can be separated from the left lobe by the:

A

Ligamentum venosum

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57
Q

As the main portal vein enters the liver it splits into the:

A

Right and left portal veins

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58
Q

The hepatic veins drain into the:

A

IVC

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59
Q

The _____ veins increase in size as they approach the diaphragm

A

Hepatic

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60
Q

______ have a triphasic blood flow pattern

A

Hepatic veins

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61
Q

Occlusion or narrowing of the hepatic veins is seen with:

A

Budd-chiari syndrome

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62
Q

In utero, the umbilical vein supplies the fetus with:

A

Oxygenated blood

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63
Q

The umbilical vein travels to the liver and bifurcates into a:

A

Left and right branche

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64
Q

_____ shunts blood directly into the fetal IVC

A

Ductus venosum (right branch)

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65
Q

The Ligamentum teres ascends along the:

A

Falciforme ligament

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66
Q

The Ligamentum venosum can be seen:

A

Anterior to the caudate lobe

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67
Q

The falciform ligament in transverse can be seen between the:

A

Left and right hepatic lobes

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68
Q

Riedel lobe is most often seen in:

A

Women

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69
Q

Riedel lobe may extend inferiorly as far as the:

A

Iliac crest

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70
Q

The normal liver is:

A

Homogeneous

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71
Q

The liver is slightly less echogenic than the:

A

Spleen

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72
Q

When compared with the pancreas, the liver is slightly

A

Less echogenic

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73
Q

The liver measures approximately

A

13 - 15cm

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74
Q

Fatty liver disease is also known as:

A

Hepatic steatosis

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75
Q

_____ is acquired and reversible

A

Nonalcoholic fatty liver disease

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76
Q

The cause of nonalcoholic fatty liver disease include (6):

A
  1. starvation
  2. obesity
  3. chemotherapy
  4. diabetes mellitus
  5. hyperlipidemia
  6. pregnancy
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77
Q

Metabolic syndrome can lead to:

A

Steatohepatitis

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78
Q

Focal fatty infiltration and focal fatty sparing can occur in:

A

The same place

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79
Q

The signs of sparing and infiltration are seen:

A

near the porta hepatis and the left medial segment

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80
Q

____ is said to resolve within 4 months

A

Acute hepatitis

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81
Q

_____ persists beyond 6 months

A

Chronic hepatitis

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82
Q

The left lobe of the liver can be divided into

A

Medial and lateral segments

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83
Q

The thin fibrous casing of the liver is the

A

Glisson capsule

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84
Q

The hepatic veins are considered intersegmental and interlobar because they are:

A

Located between the segments and the lobes

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85
Q

Shortly after birth, the ductus venosus collapses and becomes the:

A

Ligamentum venosum

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86
Q

The left umbilical vein connects directly to the:

A

Left portal vein

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87
Q

After birth the left umbilical vein becomes a fibrous cord known as the:

A

Ligamentum Teres (round ligament)

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88
Q

Ligamentum Teres is potentially identifiable with sonography within the:

A

Lower margins of the falciform ligament

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89
Q

_____ can be described as a tongue like extension of the right hepatic lobe

A

Riedel lobe

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90
Q

To differentiate Riedel lobe from hepatomegaly, one could exam the:

A

Left lobe for coexisting enlargement

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91
Q

The patient should fast for a period of _____ if the entire RUQ is to be evaluated

A

8 hours

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92
Q

The echogencity of the liver is either equal to or slightly greater than the parenchyma of the:

A

Right kidney

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93
Q

Hepatomegaly is often suspected if the liver measures greater than _____ in the midhepatic line

A

15.5cm

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94
Q

______is a disorder characterized by fatty deposits (triglycerides) within the hepatocytes

A

Fatty liver

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95
Q

______ has been cited as the most common liver disorder in the western world

A

Nonalcoholic fatty liver disease

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96
Q

Fatty liver disease is also the hepatic manifestation of a disorder known as

A

Metabolic syndrome

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97
Q

______ is inflammation of the liver disease leading to FIBROSIS, cirrhosis, and hepatocellular carcinoma

A

Steatohepatitis

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98
Q

_____ will cause the liver to appear diffusely echogenic and it will be more difficult to penetrate

A

Diffuse infiltration

99
Q

Clinical findings of fatty liver disease:

A

Elevated LFTs

100
Q

____ is inflammation of the liver, which can ultimately lead to cirrhosis, portal hypertension and HCC

A

Hepatitis

101
Q

A benign liver mass composed of a combination of hepatocytes and fibrous tissue that typically contains a central scar

A

Focal nodular hyperplasia

102
Q

The left lobe of the liver can be separated from the right lobe by the

A

Middle hepatic vein

103
Q

______ is typically transmitted through contaminated water found in places such as Mexico, Central America, South America, Asia, India, and Africa

A

Amebic liver abscess

104
Q

An abscess that develops from a parasite that grows in the colon and invades the liver via the portal vein

A

Amebic hepatic abscess

105
Q

____ is the largest lobe in the liver

A

Right hepatic lobe

106
Q

The only part of the liver not covered by peritoneum

A

Bare area

107
Q

Where is the liver measurement taken at:

A

Right mid clavicular line

108
Q

The liver measurement is done:

A

Cranial to caudal

109
Q

The left lobe of the liver is best imaged:

A

Midline inferior to the xiphoid

110
Q

Cirrhosis caused by hepatitis will lead to the development of

A

Macronodule (>1cm)

111
Q

Cirrhosis caused by alcoholism will lead to the development of:

A

Larger nodules that measure less than 1cm

112
Q

Sonographic findings of cirrhosis include (4):

A
  1. Echogenic, small right lobe
  2. Enlarged caudate
  3. Nodular surface irregularity
  4. Ascites
113
Q

Cirrhosis can also be caused by

A

•Wilson disease
•primary biliary cirrhosis
•hepatitis
•cholangitis
•hemochromatosis

114
Q

Common sequela of cirrhosis includes (3):

A
  1. Portal hypertension
  2. Portal vein thrombosis
  3. HCC
115
Q

_____ is a liver disorder that is defined as hepatocyte death, fibrosis and necrosis of the liver and the subsequent development of regenerating nodules

A

Cirrhosis

116
Q

In the presence of hepatitis the gallbladder wall may be

A

Thickened

117
Q

Sonographically the periportal cuffing is known as:

A

“Starry sky” sign

118
Q

_____ is an increase in the echogencity of the walls of the portal triads

A

Periportal cuffing

119
Q

As the liver enlarges, it tends to become

A

More hypoechoic

120
Q

Bilirubin exposure in newborns is also known as

A

Kernicterus

121
Q

In newborns, brain damage can occur with severe jaundice as a result of:

A

Bilirubin exposure

122
Q

Jaundice related hepatitis is known as

A

Nonobstructive Jaundice

123
Q

_____ relates to hepatitis is on a cellular level and is not associated with biliary obstruction

A

Jaundice

124
Q

_____ is characterized by disproportionate absorption of dietary iron

A

Hemochromatosis

125
Q

Chronic hepatitis can be caused by (4):

A
  1. Wilson disease
  2. Hemochromatosis
  3. Autoimmune disorder
  4. Drug induced
126
Q

Hepatitis may be triggered by reactions to systemic viruses such as:

A

•HSV
•Epstein-Barr virus

127
Q

_____ is the leading indication for liver transplantation in the United States

A

Hepatitis C

128
Q

Hepatitis C is spread by contact with

A

•blood
•body fluid

129
Q

Hepatitis B is spread by contact with:

A

•contaminated body fluid
•mother to infant
•inadvertent blood contact

130
Q

Hepatitis A is spread by

A

Fecal-oral route in contaminated water or food

131
Q

The two most common forms are hepatitis:

A

•A
•B

132
Q

List all the forms of hepatitis:

A

•A
•B
•C
•D
•E
•G

133
Q

_____ causes the body to accumulate excess copper

A

Wilson disease

134
Q

The posterior surface of the right lobe of the liver are marked by three fossae:

A

•the porta hepatis
•the gallbladder
•IVC

135
Q

The right lobe of the liver occupies the

A

Right hypochondrium

136
Q

With portal hypertension the coronary vein will demonstrate abnormal flow toward the ________ and will measure ________

A

*Esophagus
*Greater than 6mm

137
Q

In some individuals, the normal coronary vein can be seen arising from:

A

Splenic vein and extending superiorly toward the left

138
Q

Coronary vein AKA:

A

Left gastric vein

139
Q

Sonographic evidence of enlargement and reversed flow within the ________ may be seen with portal hypertension

A

Coronary vein

140
Q

With portal hypertension, the umbilical vein becomes open again and shunts blood away from the liver and into:

A

epigastric veins

141
Q

Abdominal varicosities may be noted near the (3):

A
  1. Splenic hilum
  2. Renal hilum
  3. Gastroesophageal junction
142
Q

The umbilical vein is associated with :

A

•left portal vein
•Ligamentum Teres
•falciform ligament

143
Q

The stiffer the liver the more _____

A

Fibrosis present

144
Q

Possible Doppler findings in patients with cirrhosis include (2):

A
  1. Monophasic flow within the hepatic veins
  2. Hepatofungal flow within the portal veins
145
Q

_____ is the elevation of blood pressure within the portal venous system

A

Portal hypertension

146
Q

The most common cause of portal hypertension is:

A

Cirrhosis

147
Q

Normal flow towards the liver within the portal veins is termed ______

A

Hepatopetal

148
Q

With ______ the liver becomes fibrotic or scarred and more difficult to perfuse

A

Cirrhosis

149
Q

With cirrhosis, the blood traveling into the main portal vein meets ______

A

Greater vascular resistance

150
Q

Thrombus can completely _____ the portal vein

A

Occlude

151
Q

Portal vein thrombosis is seen in conditions such as (7):

A
  1. HCC
  2. Portal hypertension
  3. Pancreatitis
  4. Cholecystitis
  5. Pregnancy
  6. Oral contraceptives
  7. Surgery
152
Q

______ is the development of clots within the portal vein

A

Portal vein thrombosis

153
Q

_____ is most commonly caused by tumors from adjacent organs or lymphadenopathy

A

Portal vein compression

154
Q

Portal vein compression, which subsequently leads to ______

A

Portal vein obstruction

155
Q

Surgically placed shunts include

A

• Portocaval shunt
•splenorenal shunts
•mesocaval shunt

156
Q

______ may be placed to reduce the likelihood of complications resulting from portal hypertension

A

Surgical shunts

157
Q

_____ is an ominous sign of ruptured esophageal varices because it markedly increased mortality and morbidity

A

Hematemesis

158
Q

Budd-chiari syndrome will cause _____ of the IVC

A

Narrowing

159
Q

______ may also appear as a cyst within a cyst

A

Hydatid cyst

160
Q

Hydatid cyst debris is referred to as

A

Hydatid sand

161
Q

Hydatid cyst may appear as an

A

Anechoic mass containing some debris

162
Q

______ moves from the bowel through the portal vein to enter the liver

A

Echinococcus grandulosus

163
Q

_____ is a tapeworm that lives in dog feces

A

Echinococcus grandulosus

164
Q

Hydatid liver cysts develop most commonly from a parasite referred to as

A

Echinococcus grandulosus

165
Q

A Hydatid liver cyst is also known as

A

Echinococcal cyst

166
Q

Clinical findings of hepatic cysts (4):

A
  1. Asymptomatic
  2. Possible normal LFTs
  3. ADPKD
  4. Hemorrhagic or large cysts may cause RUQ pain
167
Q

When pain occurs because of hepatic cysts, it may be due to

A

•hemorrhage
•infection
•secondary to mass effect

168
Q

Hepatic cysts are often associated with

A

Autosomal dominant polycystic kidney disease (ADPKD)

169
Q

True hepatic cysts are usually not encountered until

A

Middle age

170
Q

Sonographic findings of Budd-Chianti syndrome (5):

A
  1. Nonvisualization/reduce visualization of the hepatic vein
  2. Thrombus within the hepatic veins
  3. Enlarged caudate lobe
  4. Narrowing of the IVC
  5. Lack of flow in the hepatic veins
171
Q

Sonographic findings of hepatic cysts (3):

A
  1. Anechoic mass(es) with posterior enhancement
  2. May have irregular shape
  3. Clusters of cysts May be noted
172
Q

Sonographic findings of hydatid liver cysts (4):

A
  1. Anechoic mass containing some debris (hydatid sand)
  2. ”Water lily” sign
  3. Mass May contain calcifications
  4. “Mother/daughter” cyst
173
Q

Amebic abscesses are mostly found in the:

A

Right lobes of the liver near the capsule

174
Q

With time, thrombus will become more _______ and_______within the portal vein

A

•echogenic
•noticeable

175
Q

The ______of the portal veins will appear as wormlike or serpiginous vessels within the region of the portal vein

A

Cavernous transformation

176
Q

______ can also be the result of tumor invasion within the portal vein

A

Portal occlusion

177
Q

_____within the portal veins or mesenteric veins that result from ischemic bowel disease is typically fatal

A

Gas

178
Q

Portal venous gas Can be confused with ______

A

Pneumobilia

179
Q

_____ is air located within the biliary ducts

A

Pneumobilia

180
Q

Portosystemic collaterals and varicosities can develop within the abdomen as a result of body’s attempt to repair itself by:

A

channeling blood away from the damaged liver

181
Q

With greater vascular resistance the pressure within the_______increases resulting in portal hypertension

A

Portal veins

182
Q

The flow within the portal vein can eventually become reversed this is termed

A

Hepatofugal

183
Q

Shunting of the blood toward the esophagus increases the risk for ______

A

Esophageal hemorrhage and death

184
Q

Hepatofugal flow is _____ and _____

A

•irregular
•Stagnant

185
Q

Along with hepatofugal flow, the portal vein diameter will exceed ______in the anterior dimension and the SMV will exceed ______

A

•13mm
•10mm

186
Q

Hepatofugal flow increases the patients likelihood of developing:

A

Portal vein thrombosis

187
Q

Clinical features of portal hypertension often mimic_____

A

Cirrhosis

188
Q

Clinical findings of focal nodular hyperplasia

A

Asymptomatic

189
Q

Focal nodular hyperplasia is composed of a combination of:

A

Hepatocytes and fibrous tissue

190
Q

Clinical findings of a cavernous hemangioma (1);

A

Asymptomatic

191
Q

Sonographic findings of a cavernous hemangioma (2):

A
  1. Small, hyperechoic mass
  2. In the right lobe
192
Q

The most common benign liver tumor is the

A

Cavernous hemangioma

193
Q

Cavernous hemangioma measures

A

Less than 3cm but some are larger

194
Q

______can result from the spread of infection from inflammatory conditions

A

Pyogenic hepatic abscess

195
Q

_____ results from the spread of fungus, namely Candida albicans, in the blood to the liver

A

Hepatic candidiasis

196
Q

Clinical findings of hepatic candidiasis (5):

A
  1. Immunocompromised patients
  2. RUQ pain
  3. Fever
  4. Leukocytosis
  5. Infection symptoms
197
Q

Sonographic findings of a hepatocellular adenoma (2):

A
  1. HYPOECHOIC
  2. May be hyperechoic, isoechoic, or be comprised of mixed echogenicities
198
Q

Clinical findings of a hepatocellular adenoma (3):

A
  1. Asymptomatic
  2. Oral contraceptives use
  3. Pain occurs with hemorrhage
199
Q

Sonographic findings of hepatic lipoma

A

Hyperechoic mass

200
Q

Clinical findings of hepatic lipoma (1):

A
  1. Asymptomatic
201
Q

Sonographic findings of hepatic hematoma (liver bruise) 3:

A
  1. Fresh clot may appear hyperechoic
  2. Older hemorrhage can appear anechoic or complex
  3. May be intrahepatic or subcapsular
202
Q

The 8 ligaments of the liver are:

A

• coronary ligament
•right triangular ligament
•left triangular ligament
•falciform ligament
•Ligamentum Teres
•Ligamentum venosum
•gastrohepatic ligament
•hepatoduodebal ligament

203
Q

_____ can appear solid or complex depending on their age

A

Hematomas

204
Q

Clinical findings of hepatic hematoma (4):

A
  1. Trauma
  2. Recent surgery
  3. Pain
  4. Decreased hematocrit
205
Q

The _____ will yield a hypoechoic rim, with the center of the mass often isoechoic to normal liver tissue

A

Target lesion

206
Q

Sonographic findings of hepatocellular carcinoma (3):

A
  1. Solitary, hypoechoic mass
  2. Heterogeneous masses scattered throughout the liver
  3. ”Target” or “bulls-eye” ascites
207
Q

HCC is most often seen in?

A

Men and frequently accompanied by cirrhosis or chronic hepatitis

208
Q

Diffuse metastasis Can produce an appearance of a nodular liver termed

A

Pseudocirrhosis

209
Q

Clinical findings of hepatic metastasis (6):

A
  1. Abnormal LFTs
  2. Weight loss
  3. Jaundice
  4. RUQ pain
  5. Hepatomegaly
  6. Abdominal swelling with ascites
210
Q

Metastatic cancer from the gastrointestinal tract and pancreas tends to be _____

A

Calcified tumors

211
Q

Clinical findings hepatocellular carcinoma (9):

A
  1. Elevated AFP
  2. Abnormal LFTs
  3. Cirrhosis
  4. Chronic hepatitis
  5. weight loss
  6. Hepatomegaly
  7. Fever
  8. Palpable mass
  9. Ascites
212
Q

Sonographic findings of hepatic metastasis (4):

A
  1. Hyperechoic, hypoechoic calcified cystic or heterogeneous masses
  2. Mass demonstrating a hypoechoic rim and central echogenic region
  3. Diffusely heterogeneous liver
  4. Possible ascites
213
Q

_____ is the most common form of liver cancer

A

Metastatic liver disease

214
Q

What is the most common vascular complication of a liver transplantation

A

Hepatic artery thrombosis

215
Q

Sonographic findings of infantile hemangioendothelioma (2):

A
  1. Homogeneous or complex hepatic mass
  2. Calcifications or cystic spaces
216
Q

Sonographic findings of Hepatoblastoma (2):

A
  1. Solid, hyperechoic or heterogeneous mass
  2. Mass may contain some calcifications
217
Q

Clinical findings of Hepatoblastoma (malignant) 8:

A
  1. May be asymptomatic
  2. Palpable abdominal mass
  3. Hepatomegaly
  4. Abdominal pain
  5. Weight loss
  6. Anorexia
  7. Elevated AFP
  8. Jaundice
218
Q

There is a high incidence of Hepatoblastoma in children who have

A

Beckwith-wie-demann syndrome

219
Q

_____are most often discovered before age 5, with half of the cases identified in children less than 2 years old

A

Hepatoblastoma

220
Q

Sonographic findings of a pyogenic hepatic abscess (3):

A
  1. Complex cyst with thick walls
  2. Debris, septations and/or gas
  3. Air may produce dirty shadowing/ring down artifact
221
Q

Clinical findings of a pyogenic hepatic abscess (5):

A
  1. Fever
  2. Hepatomegaly
  3. Leukocytosis
  4. Abnormal LFTs
  5. RUQ pain
222
Q

Clinical findings of hydatid liver cysts (6):

A
  1. Leukocytosis
  2. fever
  3. jaundice
  4. Pain
  5. Infection symptoms
  6. Recently traveled abroad
223
Q

Lab findings of amebic hepatic abscess (3):

A
  1. Leukocytosis
  2. Elevated LFTs
  3. Mild anemia
224
Q

Clinical findings of an amebic hepatic abscess

A
  1. Hepatomegaly
  2. Pain
  3. General malaise
  4. Diarrhea
  5. Fever
  6. Leukocytosis
  7. Elevated LFTs
  8. Traveled abroad
225
Q

Cyst rupture could lead to:

A

Anaphylactic shock

226
Q

_____ comes from the parasite entamoeba histolytica that grows in the colon and invades the liver via the portal vein

A

Amebic hepatic abscess

227
Q

_____ is described as the occlusion of the hepatic veins, with possible coexisting occlusion of the IVC

A

Budd-chiari syndrome

228
Q

_____ involves the placement of a stent between the portal veins and hepatic veins to shunt blood and reduce portal systemic pressure

A

TIPS

229
Q

_____ correlates with cirrhosis complications including variceal hemorrhage, ascites and HCC. All signs of advance cirrhosis and portal hypertension

A

Liver stiffness

230
Q

One of the most common sonographically identifiable collaterals in portal hypertension is the recanalization of the

A

Paraumbilical vein

231
Q

If ascites is not present with cirrhosis, a _______ can be used to analyze the liver surface for surface nodularity or lumps

A

High-frequency linear transducer

232
Q

Focal nodular hyperplasia has been referred to as a?

A

“Stealth lesion” because it may be difficult to identify

233
Q

Focal nodular hyperplasia typically contains a _______ that is not always detected with sonography but is readily identified with CT and MRI

A

Central stellate (star-like) scar

234
Q

Budd-chiari syndrome can be seen secondary to (7):

A
  1. Congenital webbing disorder
  2. Coagulation abnormalities
  3. Tumor invasion from HCC
  4. Thrombosis
  5. Oral contraceptives
  6. Pregnancy
  7. Trauma
235
Q

Clinical symptoms of budd-chiari syndrome when found in females on oral contraceptives include (4):

A
  1. Ascites
  2. RUQ pain
  3. Hepatomegaly
  4. Splenomegaly
236
Q

Clinical findings of budd-chiari syndrome (5):

A
  1. Ascites
  2. Elevated LFTs
  3. Hepatomegaly
  4. Splenomegaly
  5. Upper abdominal pain
237
Q

Patients with portal hypertension will have many of the same sonographic findings as cirrhosis including

A

•ascites
•splenomegaly
•portal vascular and shunting abnormalities
•development of collaterals channels

238
Q

Sonographic findings of focal nodular hyperplasia (2):

A
  1. Isoechoic to liver
  2. Central scar will have hypervascularity
239
Q

Sonographic findings of hepatic candidiasis (3):

A
  1. Multiple masses with hyperechoic central portions and hypoechoic boarders “target”, “halo”, or “bullseye”
  2. Typically 1cm or smaller
  3. Older lesions may calcify
240
Q

Sonographic findings of an amebic hepatic abscess (3):

A
  1. Round, hypoechoic / anechoic mass
  2. May contain debris (with fluid debris layering)
  3. Anechoic enhancement
241
Q

_____ are typically identified in the first few weeks or months of life

A

Infantile hemangioendothelioma

242
Q

Clinical findings of infantile hemangioendothelioma (3):

A
  1. Pediatric patient
  2. May cause hepatomegaly
  3. May be accompanied by hemangiomas
243
Q

_____ is the most common benign liver childhood tumor

A

Infantile hemangioendothelioma