Chapter 2: The Liver Flashcards
1
Q
liver injury resulting from alcohol abuse
A
alcoholic liver disease
1
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
2
Q
the surgical connection between two structures
A
anastamosis
3
Q
an abnormal passageway between an artery and a vein
A
arteriovenous fistula
4
Q
disorders in which the body’s immune system attacks and destroys healthy tissues and/or organs
A
autoimmune disorders
5
Q
an inherited disease that results in the development of renal, liver, and pancreatic cysts typically late in life; also referred to as adult polycystic kidney disease
A
autosomal dominant polycystic kidney disease
6
Q
the region of the liver not covered by the peritoneum
A
bare area
7
Q
a growth disorder syndrome synonymous with enlargment of several organs, including the skull, tongue, and liver; children with this disorder are prone to several childhood cancers, including within the liver and kidney
A
Beckwith-Wiedemann syndrome
8
Q
a collection of bile within the abdomen; can be intrahepatic or extrahepatic in location
A
bilomaj
9
Q
a syndrome described as the occlusion of the hepatic veins, with possible coexisting occlusion of the inferior vena cava
A
Budd-Chiari Syndrome
10
Q
recognizable dilation of the superficial veins of the abdomen
A
caput medusae
11
Q
the most common benign liver tumor
A
cavernous hemangioma
12
Q
inflammation of the bile ducts
A
cholangitis
13
Q
condition defined as hepatocyte death, fibrosis, and necrosis of the liver, and the subsequent development of regenerating nodules
A
cirrhosis
14
Q
the water soluble form of bilirubin that is excreted into the intestines in bile and excreted in the stool; also referred to as direct bilirubin
A
conjugated bilirubin
15
Q
sonographic imaging that includes the injection of a contrast agent intravenously to better enhance the borders of liver lesions and to analyze those lesions for possible signs of malignancy
A
contrast enhanced liver ultrasound
16
Q
system used to separate the liver into eight surgical segments; used to describe functional liver anatomy
A
couinaud classification
17
Q
syndrome characterized by cirrhosis, portal hypertension, and dilation of the umbilical and paraumbilical veins
A
Cruveihler-Baumgarten Syndrome
18
Q
genetic disorder linked with the development of scar tissue accumulation within the lungs, liver, pancreas, kidneys, and/or intestines
A
cystic fibrosis
19
Q
a pseudomass of the liver seen on sonography resulting from hypertrophied diaphragmatic muscle bundles
A
diaphragmatic slip
20
Q
infection of the bowel which leads to diarrhea that may contain mucus and/or blood
A
dysentery
21
Q
hydatid liver cyst
A
echinoccal cyst
22
Q
a parasite responsible for the development of hydatid liver cysts
A
Echinococcus granulosus
23
Q
the virus responsible for mononucleosis and other potential complications
A
Epstein-Barr virus
24
dilated or broken vessels located near the surface of the skin on the face that appears as threadlike red lines; commonly referred to as spider veins
Facial telangiesctasia
25
ligament that attaches the liver to the anterior abdominal wall
falciform ligament
26
a reversible disease characterized by deposits of fat within the hepatocytes; also referred to as hepatic steatosis
fatty liver
27
bad breath secondary to end-stage liver disease and the livers inability to filter toxins; often accompanies cirrhosis, portal hypertension, and hepatic encephalopathy
fetor hepaticus
28
manifestation of fatty liver disease in which fat deposits are localized
focal fatty infiltration
29
manifestation of fatty liver disease in which fat deposits are localised
focal fatty infiltration
30
manifestation of fatty liver disease in which an area of the liver is spared from fatty infiltration
focal fatty sparing
31
a benign liver mass composed of a combination of hepatocytes and fibrous tissue that typically contains a central scar
focal nodular hyperplasia
32
the junction between the stomach and the esophagus
gastroesophageal junction
33
the thin fibrous casing of the liver
Glisson capsule
34
enlargement of the male breast
gynecomastia
35
vomiting blood
hematemesis
36
a localized collection of blood
hematoma
37
an inherited disease characterized by disproportionate absorption of dietary iron
hemochromatosis
38
the formation and development of blood cells
hemopoeisis
39
a hepatic mass that results from the spread of fungus in the blood to the liver
hepatic candidiasis
40
a condition in which a patient becomes confused or suffers from intermittent loss of conciousness secondary to the overexposure of the brain to toxic chemicals that the liver would normally remove from the body
hepatic encephalopathy
41
jaundice resulting from the liver's inability to conjugate bilirubin, may be caused by conditions such as viral hepatitis, toxins, drugs, cirrhosis, and liver cancer
hepatic jaundice
42
fatty liver
hepatic steatosis
43
inflammation of the liver
hepatitis
44
a benign liver mass often associated with the use of oral contraceptives
hepatocellular adenoma
45
the primary form of liver cancer
hepatocellular carcinoma
46
blood flow away from the liver
hepatofugal
47
the malignant tumor associated with hepatocellular carcinoma; primary liver cancer
hepatoma
48
enlargement of the liver
hepatomegaly
49
blood flow toward the liver
hepatopetal
50
the development of renal impairment and possible renal failure because of chronic liver disease
hepatorenal syndrome
51
concurrent enlargement of the liver and spleen
hepatosplenomegaly
52
a liver cyst that develops from a tapeworm that lives in dog feces; also referred to as an echinococcal cyst because it originates from the parasite Echinococcus granulosus
hydatid liver cyst
53
elevated levels of serum bilirubin
hyperbilirubinemia
54
abnormally high levels of fat within the blood
hyperlipidemia
55
decreased blood volume
hypovolemia
56
no recognizable cause; from an unknown origin
idiopathic
57
a patient who has a weakened immune system
immunocompromised
58
rare condition characterized by obstruction of the inferior vena cava by membranous or fibrous bands; can cause obstruction of the hepatic veins leading to Budd-Chiari syndrome
inferior vena cava web
59
chronic inflammation of all or parts of the bowel
inflammatory bowel disease
60
condition that results from decreased blood flow to the intestines resulting in damaged bowel tissue owing to inadequate oxygenation; also referred to as intestinal ischemia
ischemic bowel disease
61
broad clinical term referring to the yellowish discoloration of the skin, mucous membranes, and sclerae; found with liver disease and/or biliary obstruction
jaundice
62
brain damage from bilirubin exposure in a newborn with jaundice
kernicterus
63
specialized macrophages within the liver that engulf pathogens and damaged cells
Kupffer cells
64
an elevated white blood count
leukocytosis
65
ligament that forms part of the edge of the falciform ligament of the liver, connecting the liver to the umbilicus; a remnant of the left umbilical vein; also referred to as the round ligament of the liver
ligamentum teres
66
remnant of the fetal ductus venosus; appears as a hyperechoic linear ligament between the caudate lobe and left lobe of the liver
ligamentum venosum
67
a benign fatty tumor
lipoma
68
the development of scar tissue within the liver as a result of the liver repeatedly trying to repair itself
liver fibrosis
69
the area of the liver where the common bile duct exits the liver and portal vein and hepatic artery enter the liver; also referred to as the porta hepatitis
liver hilum
70
a flow pattern that characteristically has antegrade flow throughout the cardiac cycle
low-resistance flow
71
feeling of uneasiness
malaise
72
the deterioration of a benign mass into a malignancy
malignant deterioration
73
the displacement of alteration of normal anatomy that is located adjacent to a tumor
mass effect
74
condition that includes hypertension, hyperglycemia, excessive body fat around the waist, elevated cholesterol, and nonalcoholic fatty liver disease
metabolic syndrome
75
vascular flow yielding a single phase
monophasic
76
death of tissue
necrosis
77
redding of the palms
palmar erythema
78
an increase in the echogenicity of the portal triads as seen in hepatitis and other conditions
periportal cuffing
79
air within the biliary tree
pneumobilia
80
the area of the liver where the portal vein and hepatic artery enter and the hepatic duct exit; also referred to as the liver hilum
porta hepatis
81
the elevation of blood pressure within the portal venous system
portal hypertension
82
an assembly of a small branch of the portal vein, bile duct, and hepatic artery that surround each liver lobule
portal triads
83
the development of clot within the portal vein
portal vein thrombosis
84
elevation in bilirubin caused by an obstruction of bile flow, typically by either a gallstone lodged in the biliary tract or a pancreatic mass
posthepatic jaundice
85
when the liver cannot process the amount of hemolysis of the red blood cells, resulting in a buildup of circulating bilirubin in the bloodstream
prehepatic jaundice
86
nodular appearance of the liver caused by multiple metastatic tumors
pseudocirrhosis
87
false mass
pseudomass
88
blood spots under the skin that may appear purple
purpura
89
a liver abscess that can result from the spread of infection from inflammatory conditions such as appendicitis, diverticulitis, cholecystitis, cholangitis, and endocarditis
pyogenic liver abscess
90
the medial segment of the left lobe
quadrate lobe
91
the reopening of canals or pathways
recanalization
92
a tongue-like extension of the right hepatic lobe
Riedel's lobe
93
an illness resulting from another disease, trauma, or injury
sequela
94
twisted or snake like pattern
serpignous
95
elastography technique that utilizes a standard ultrasound transducer with elastography technology to obtain information about the stiffness of tissue as in the case of liver fibrosis or cirrhosis
shear wave elastography
96
condition in which the organs of the abdomen and chest are on the opposite sides of the body
situs inversus
97
a cluster of vessels noted on the skin that have a web-like pattern;
spider nevi
98
blood flow to the major gastrointestinal organs including the stomach, liver, spleen, pancreas, and small and large intestines; consists of the celiac artery, superior mesenteric artery, and inferior mesenteric artery
splanchnic circulation
99
enlargement of the spleen
splenomegaly
100
the sonographic sign associated with the appearance of periportal cuffing in which there is an increased echogenicity of the walls of the portal triads that may be associated with hepatitis
starry sky sign
101
a type of fatty liver disease that causes inflammation of the liver
steatohepatitis
102
obtained by adding unconjugated and conjugated bilirubin
total bilirubin
103
procedure in which an individual receives vitamin and nutrients though a vein, often the subclavian vein
total parental hyperalimentation
104
imaging technique that utilizes a special transducer to assess the liver and other organs for signs of fibrosis and cirrhosis; used to measure the stiffness of tissue
transient elastography
105
the therapy for portal hypertension that involves the placement of a stent between the portal veins and hepatic veins to reduce portal systemic pressure
transjugular intrahepatic portosystemic shunt (TIPS)
106
vascular flow yielding three phases
triphasic
107
the non-water soluble form of bilirubin that travels to the liver via the bloodstream eventually converted to conjugated bilirubin by the liver; also referred to as indirect bilirubin
unconjugated bilirubin
108
condition in which the body does not have the ability to break down glycogen; also referred to as glycogen storage disease
Von Gierke disease
109
an inherited disease that includes the development of cysts within the liver, pancreas, and other organs
von-Hippel Lindau disease
110
a congenital disorder that causes the body to accumulate excess copper
Wilson disease
111
Vital functions of the liver
carbohydrate metabolism
Fat (lipid) metabolism
amino acid metabolism
removal of waste products
vitamin and mineral storage
drug inactivation
synthesis and secretion of bile
blood reservoir
lymph production
detoxification
112
decrease in albumin
chronic liver disease
cirrhosis
113
increase in ALP
cirrhosis
extrahepatic biliary obstruction
gallstones
hepatitis
metastatic liver disease
pancreatic carcinoma
114
increase in ALT
biliary tract obstruction
hepatitis
hepatocellular disease
obstructive jaundice
115
increase in AST
cirrhosis
fatty liver
hepatitis
metastatic liver disease
116
increase in Gamma-glutamyl transferase
diffuse liver disease
posthepatic obstruction
117
increase in LDH
cirrhosis
obstructive jaundice
118
increase in serum bilirubin
direct bilirubin: acute hepatocellular disease
indirect bilirubin: biliary tract obstruction
total bilirubin: cirrhosis, hepatitis, and other liver cell diseases
119
Prolonged PT
metastasis of the liver and hepatitis
120
Shortened PT
extrahepatic duct obstruction
121
increase in AFP
hepatocellular carcinoma
hepatoblastoma
122
separates the anterior segment of the right lobe from the posterior segment of the right lobe
Right hepatic vein/right intersegmental fissure
123
separates the right lobe from the left lobe (these are located between the anterior segment of the right lobe and the medial segment of the left lobe)
middle hepatic vein/main lobar fissure/ gallbladder fossa
124
separates the left lateral segment of the left lobe form the left medial segment of the left lobe
left hepatic vein/ left intersegmental fissure/ ligamentum teres/ falciform ligament
125
Portal vein waveform
hepatopetal and monophasic
126
Hepatic vein waveform
hepatofugal and triphasic
127
transports blood to the liver from the intestines and other organs
portal veins
128
drain blood from the liver and deposits it into the IVC
hepatic veins
129
Portal veins are ____segmental
intra
130
Hepatic veins are ____segmental
inter
131
Portal veins _____ in size as they approach the diaphragm
decrease
132
Hepatic veins ____ in size as they approach the diaphragm
increase
133
Portal veins have _____ walls
hyperechoic
134
Extension of right lobe beyond the lower pole of the right kidney (without evidence of Reidel's lobe)
Rounding of the inferior tip of the right lobe
extension of the left lobe well into the LUQ
hepatomegaly
135
diffusely echogenic liver
increased attenuation of the sound beam
wall of the hepatic vasculature and diaphragm will not be easily imaged
Diffuse Fatty Liver Disease
136
hyperechoic area adjacent to the gallbladder, near the porta hepatis, or part of a lobe may appear echogenic
focal fatty infiltration
137
hypoechoic area adjacent to the gallbladder, near the porta hepatis, or part of a lobe or an entire lobe
focal fatty sparing
138
Normal or enlarged hypoechoic liver
periportal cuffing with starry sky
gallbladder wall thickening
hepatitis
139
Hepatosplenomegaly
shrunken, echogenic right lobe of the liver
enlarged caudate and left lobes
nodular surface irregularity
coarse echotexture
splenomegaly
ascites
monophasic flow within the hepatic veins
hepatofugal flow within the portal veins
cirrhosis
140
hepatomegaly
shrunken right lobe of the liver
enlarged caudate lobe of the liver
nodular surface irregularity
coarse echotexture
splenomegaly
ascites
monophasic flow within the hepatic veins
hepatofugal flow within the portal veins
enlargement of the portal vein (diameter will exceed 13 mm in the AP dimension)
enlargement of the SMV
Enlargement and reversed flow within the coronary vein
enlarged hepatic arteries
abdominal varicosities at the splenic hilum, renal hilum, and gastroesophageal junction
patent paraumbilical vein (also called a recanalized paraumbilical vein)
Portal hypertension
141
Echogenic thrombus within the portal vein
cavernous transformation of the portal veins will appear as wormlike or serpignous vessels within the region of the portal vein
portal vein thrombosis
142
small, bright reflectors are noted within the circulating blood inside the portal vein
larger air collections may produce ring-down artifact
Portal venous gas
143
nonvisualization or reduced visualization of the hepatic veins
thrombus within the hepatic veins
enlarged caudate lobe
lack of flow within the hepatic veins with color Doppler
Narrowing of the IVC
Budd-Chiari syndrome
144
sonographic findings consistent with cirrhosis
kidneys may appear normal
hepatorenal syndrome
145
anechoic mass or masses with posterior enhancement
may have irregular shapes
clusters of cysts may be noted
located in the liver
hepatic cysts
146
anechoic mass containing some debris (hydatid sand)
water lily sign appears as an endocyst floating within the pericyst
mother cyst containing one or more smaller daughter cysts
mass may contain some elements of dense calcification
Hydatid liver cyst
147
round, hypoechoic or anechoic mass or masses
may contain echoes (with fluid-debris layering)
acoustic enhancement
amebic hepatic abscess
148
bulls eye lesion
anechoic center surrounded by hyperechoic ring
periportal thickening
turtleback sign (chronic appearance)
schistomosomiasis
149
complex cyst with thick walls
mass may contain debris, septations, and/or gas
the air within the abscess may produce dirty shadowing or ring-down artifact
Pyogenic hepatic abscess
150
multiple masses with hyperechoic central portions and hypoechoic borders (may be described as target, halo, or bulls eye lesions)
these masses are typically 1 cm or smaller in size
older lesions may calcify
hepatic candidiasis
151
small, hyperechoic mass
may be found in the right lobe
cavernous hemangioma
152
isoechoic, hyperechoic, or hypoechoic mass
central scar may appear as hyperechoic or hypoechoic linear structure within the mass and will often reveal hypervascularity with color Doppler
Focal Nodular Hyperplasia
153
fresh clot may be hyperechoic
older hemorrhage can appear anechoic or complex
may be intrahepatic or subcapsular
assess for signs of an ateriovenous fistula
hepatic hematoma
154
solitary, hypoechoic mass
heterogenous masses scattered throughout the liver
mass with a hypoechoic halo and central echogenic portion (target or bulls-eye lesion)
possible ascites
hepatocellular carcinomas
155
hyperechoic, hypoechoic, calcified, cystic, or heterogeneous masses
mass or masses demonstrating a hypoechoic rim and central echogenic region
diffusely heterogeneous liver
possible ascites
hepatic metastasis
156
homogeneous or complex hepatic mass
may contain calcification or cystic spaces
infantile hemangioendothelioma
157
solid, hyperechoic, or heterogeneous mass
mass may contain calcifications
hepatoblastoma
158
In early embryonic life, the liver is responsible for:
hematopoeisis
159
largest parenchymal organ
liver
160
located within the epigastrium and may traverse through midline and extend into left hypochondrium
left lobe of liver
161
The liver is ____peritoneal
intra
162
The ____ is the only part of the liver that is retroperitoneal.
bare area
163
thin fibrous casing surrounding the liver
Glisson capsule
164
Liver lobules contain:
hepatocytes
biliary epithelial cells
Kupffer cells
165
Portal triads consist of:
small branches of portal vein
bile duct
hepatic artery
166
system used to separate liver into eight surgical segments and to describe functional liver anatomy
couinaud classification
167
located between the gallbladder fossa and round ligament
quadrate lobe
168
referred to as the medial segment of the left liver lobe
quadrate lobe
169
large lobe of liver
right hepatic lobe
170
can divided into an anterior and posterior segment by right hepatic vein, whicih lies within right intersegmental fissue
right hepatic lobe
171
separated from left lobe by middle hepatic vein which lies within the main lobar fissue
right hepatic lobe
171
located with the epigastrium and may extend into the left hypochondrium
left lobe
172
divided into medial and lateral segments by left hepatic vein, which lies within the left intersegmental fissue
left lobe
173
can be separated by ligamentum teres and falciform ligament
left lobe
174
smallest hepatic lobe, has its own blood supply and venous drainage
caudate lobe
175
located within epigastrium and is bounded anteriorly by ligamentum venosum and posteriorly by IVC
caudate lobe
176
can be separated from left lobe by ligamentum venosum
caudate lobe
177
provides majority of hepatic perfusion
Main portal vein
178
describes blood flow to major gastrointestinal organs
splanchnic circulation
179
Primary vessels of splanchnic circulation
celiac artery (common hepatic artery)
superior mesenteric artery
inferior mesenteric artery
180
The main portal vein enters the liver at _____
porta hepatis
181
The main portal vein is created the union of the ____ and ____
superior mesenteric vein
splenic vein
182
The main portal vein supplies about ___% of blood supply to the liver
75
183
The right portal vein is separated into ____ and ____ divisions
anterior
posterior
184
The left portal vein is separated into _____ and ____ divisions.
medial
lateral
185
The normal diameter of the main portal vein
less than 13 mm
186
enlargement of the portal vein indicates:
portal hypertension
187
Normal portal veins ____ in size as they approach the diaphragm
decrease
188
Portal veins are ____segmental
intra
189
Normal flow of portal veins
hepatopetal and monophasic
190
Hepatic veins are ____segmental and ____lobar.
inter
inter
191
Hepatic veins _____ in size as they approach the diaphram
increase
192
Hepatic veins demonstrate _____ flow
triphasix
193
enlargement of the hepatic veins and IVC indicate:
right sided heart failure
194
occlusion or narrowing of hepatic veins
Budd-Chiari syndrome
195
3 structures located within the porta hepatis
main portal vein
common bile duct
hepatic artery
196
carries oxygenated blood to liver from abdominal aorta
common hepatic artery
197
1st main branch of the abdominal artery as it passes below the diagphragm
celiac artery
198
The common hepatic artery has a __-resistance flow pattern
low
199
describes transverse image taken of porta hepatis
Mickey sign
200
The _____ supplies the fetus with oxygenated blood
umbilical vein
201
right branch of umbilical vein
ductus venosus
202
Shortly after birth the ductus venosus collapses and becomes the _______
ligamentum venosum
203
Recanalization of paraumbilical vein in ligamentum teres can occur in presence of ______
portal hypertension
204
hyperechoic linear structure, anterior to caudate lobe, between caudate and left hepatic lobe
ligamentum venosum
205
hyperechoic; triangular shaped structure between right and left hepatic lobes
falciform ligament
206
houses middle hepatic vein; hyperechoic line which seems to connect neck of GB to right portal vein; used to separate right and left hepatic lobes
main lobar fissure
207
tongue like extension of the right hepatic lobe, more often seen in women, may extend inferiorly as far as iliac crest
Reidel lobe
208
inferior extension of the caudate lobe
papillary process of caudate lobe
209
The liver measures approximately ___-____ cm in adults
15-15
210
____ cm is considered hepatomegaly
15.5
211
yellowish discoloration of the skin, mucous membranes, and sclerae of the eyes because of hyperbilirubinemia
jaundice
212
yellowish compound that results from the breakdown of hemoglobin that is found in red blood cells
bilirubin
213
non-water soluble form of bilirubin that travels to the liver via bloodstream; eventually converted to conjugated bilirubin by the liver
unconjugated bilirubin
214
water soluble form of bilirubin that is excreted into the intestines in bile and passed in the stool
conjugated (direct) bilirubin
215
calculated by adding the direct and indirect bilirubin levels
total bilirubin
216
occurs when liver cannot process the amound of hemolysis in the red blood cells, resulting in a buildup of circulating unconjugated bilirubin in the blood stream
prehepatic jaundice
217
results from liver's inability to conjugate bilurubin and thus my be caused be conditions such as viral hepatitis, toxins, drugs, cirrhosis, and liver cancer
hepatic jaundicw
218
caused by an obstruction of bile flow; elevation in conjugated bilirubin
posthepatic jaundice
219
disorder characterized by fatty deposits (triglycerides) within hepatocytes
fatty liver disease (hepatic steatosis)
220
cause liver to appear diffusely echogenic
diffuse infiltration
221
area of increased echogenicity
focal infiltration
222
involved with fatty infiltration with certain areas spared
focal fatty sparing
223
inflammation of the liver
hepatitis
224
Two most common forms of hepatits
A
B
225
Hepatitis A is passed by:
fecal-oral route, contaminated food or water
226
Hepatitis B is passed by:
contact with contaminated body fluids or mother to infant transmission
227
Hepatitis C is passed by:
contact with blood and body fluids
228
Leading indication for liver transplant in the USA
hepatitis C
229
autosomal recessive disorder, excessive accumulation of copper in the liver, brain, and other tissues
Wilson's disease
230
disproportionate absorption of dietary iron
hemochromatosis
231
Impaired liver function, as a result of hepatitis and other hepatic diseases may lead to:
hepatic encephalopathy
kernicterus
232
condition in which a patient becomes confused or suffers from intermittent loss of consciousness secondary to the overexposure of brain to toxic chemicals that liver would normally remove from body
hepatic encephalopathy
233
brain damage in newborns that can occur with severe jaundice as a result of bilirubin exposure
kernictus
234
increase in echogenicity of walls of portal triads; starry sky sign
periportal cuffing
235
devastating liver disorder that is defined as: hepatocyte death, liver fibrosis, necrosis of liver, subsequent development of regeneration of nodules
cirrhosis
236
Most common cause of cirrhosis
alcoholism
237
Sonographic findings of cirrhosis of the liver
echogenic small right lobe
enlarged caudate and left lobe
nodular surface irregularity
coarse echotexture
ascites
splenomegaly
238
Cirrhosis causes _____ flow in hepatic veins
monophasic
239
Cirrhosis causes ______ flow in portal vein
hepatofugal
240
results in development of scar tissue within the liver as it attempts to repair itself
liver fibrosis
241
If the amount of fibrosis increases, the stiffness ______
increases
242
2 types of elastography
transient elastography
shear-wave elastography
243
elevation of blood pressure within portal venous system
portal hypertension
244
Most common cause of portal hypertension
cirrhosis
245
Most common sonographically identifiable collaterals in portal hypertension
recanalization of paraumbilical vein
246
In portal hypertension, the portal vein diameter exceed __ mm
13
247
ominous sign of ruptured esophageal varices; markedly increases mortality and morbidity
hematemesis
248
involves placement of a stent between the portal veins and hepatic veins to shunt blood and reduce portal systemic pressure
TIPS
249
development of clot within the portal vein
portal vein thrombosis
250
appear as wormlike or serpiginous vessels within region of portal vein
cavernous transformation
251
gas within portal veins or mesenteric veins that results from ischemic bowel disease is typically fatal
portal venous gas
252
air located within the biliary ducts
pneumobilia
253
occlusion of the hepatic veins, with possible co-existing occlusion of IVC
Budd-Chiari syndrome
254
development of renal impairment and possible renal failure as a result of chronic liver disease and liver failure
hepatorenal syndrome
255
may also be referred to as an echinococcal cyst
hydatid liver cyst
256
develop most commonly from a parasite referred to as echinococcus granulosus
hydatid liver cyst
257
comes from parasite Entamoeba histolytica
amebic hepatic abscess
258
grows in colon and invades liver via portal vein
amebic hepatic abscess
259
hepatic infestation of the parasite schistoma, fundamentally a flatworm parasite, may also be referred to as snal fever or biharzia
schistomiasis
260
one of the most common causes of hepatic fibrosis in the world
schistomiasis
261
anechoic center surrounded by hyperechoic rim, associated with schisotmiasis
bulls-eye lesion
262
calcified septa and fibrosis resembling rounded part of a turteshell
turtleback sign
263
can result from the spread of infection from inflammatory conditions such as appendicitis, diverticulitis, cholecystitis, cholangitis, endocarditis
pyogenic hepatic abscess
264
results from spread of fungus, namely candida albicans in the blood to the liver
hepatic candidiasis
265
most common benign liver tumor
cavernous hemangioma
266
second most common benign liver tumor
focal nodular hyperplasia
267
rare benign liver tumor, often associated with use or oral contraceptives
hepatocellular adenoma
268
can be a consequence of surgery or trauma, can be intrahepatic or subcapsular, changes echogenicity over time
hepatic hematoma
269
abnormal passageway between an artery and vein, flow typically from higher pressure to venous system
arteriovenous fistula
270
most common primary form of liver cancer, most often seen in men
hepatocellular carcinoma
271
Malignant mass associated with hepatocellular carcinoma is called:
hepatoma
272
occlusion of the hepatic veins, with possible tumor invasion into the IVC
Budd-Chiari syndrome
273
Most common form of liver cancer
hepatic metastasis
274
Primary cancers that metastasize to the liver:
gallbladder
colon
stomach
pancreas
breast
lung
275
Portal vein normal Doppler waveforms
hepatopetal
continuous
monophasic
low velocity
276
hepatic veins normal Doppler waveforms
triphasic
277
Hepatic artery normal Doppler waveforms
continuous, low-resistance waveform pattern, quick upstroke and gradual deceleration with diastole
278
Normal resistive index or hepatic artery
0.5 and 0.8
279
The TIPS stent is most often created between the _____ and _____ and bridging stent is lieft in place
right portal vein
right hepatic vein
280
Normal flow velocity within TIPS shunt
90-190 cm per second
281
Most common disease that leads to liver transplant
Hepatitis C
282
most common vascular complication of a liver transpland
hepatic artery thrombosis
283
hypoechoic wedge-shaped area scattered throughout periphery of liver
infarction
284
most common benign liver childhood tumor, typically identified in the first few weeks/month
infantile hemangioendothelioma
285
most common malignant tumor of childhood, aggressive, most often discovered before 5 years old
hepatoblastoma
286
utilizes a contrast that is injected into the patient intravenously in order to aid in identification of liver lesions and to assess those lesions for signs of malignancy
contrast enhanced ultrasound
287
3 phases assessed during CEUS of liver
initial arterial
early portal venous phases
contrast washout
288
Which of the following benign liver masses is typically isoechoic and contains a central scar?
a. hepatoblastoma
b. cavernous hemangioma
c. hamartoma
d. focal nodular hyperplasia
d
289
The covering of the liver is referred to as the:
Glisson capsule
290
The left lobe of the liver can be separated from the right lobe by the:
middle hepatic vein
291
The TIPS shunt is placed:
between a portal vein and hepatic vein
292
The right lobe of the liver is divided into segments by the:
right hepatic vein
293
The right intersegmental fissure contains the:
right hepatic vein
294
The main portal vein divides into:
left and right branches
295
The ligamentum teres can be used to separate the:
medial and lateral segments of the left lobe
296
The main lobar fissure contains the:
middle hepatic vein
297
All of the following are located within the porta hepatis except:
a. main portal vein
b. common bile duct
c. hepatic artery
d. middle hepatic vein
d
298
Right-sided heart failure often leads to enlargement of the:
IVC and hepatic veins
299
Which of the following is typically transmitted through contaminated water found in places such as Mexico, Central America, South America, Asia, India, and Africa?
a. amebic liver abscess
b. hydatid liver cyst
c. candidiasis
d. hepatoma
a
300
The right portal vein divides into:
anterior and posterior branches
301
The diameter of the portal vein should not exceed:
13 mm
302
The right lobe of the liver can be divided into:
anterior and posterior segments
303
Which of the following is true about the portal veins?
a. Portal veins carry deoxygenated blood away from the liver
b. Portal veins have brighter walls than the hepatic veins
c. Portal veins should demonstrate hepatofugal flow
d. Portal veins increase in diameter as they approach the diaphragm
b
304
The left lobe of the liver can be divided into:
medial and lateral segments
305
Normal flow within the hepatic artery should demonstrate a:
low-resistance waveform pattern, with a quick upstroke, and gradual deceleration with diastole
306
Budd-Chiari syndrome leads to a reduction in the size of the:
hepatic veins
307
A tongue-like extension of the right lobe of the liver is termed:
Riedel lobe
308
The left portal vein divides into:
medial and lateral branches
309
The left umbilical vein after birth becomes the:
ligamentum teres
310
Normal flow within the hepatic veins is said to be:
triphasic
311
The inferior extension of the caudate lobe is referred to as:
papillary process
312
Which of the following is the most common reason for a liver transplant?
a. hepatocellular carcinoma
b. hepatitis C
c. hepatitis B
d. hepatic metastasis
b
313
Clinical findings of fatty infiltration of the liver include:
elevated liver function labs
314
Shortly after birth, the ductus venosus collapses and becomes the;
ligamentum venosum
315
Sonographically, when the liver is difficult to penetrate and diffusely echogenic, this is indicative of:
fatty liver disease
316
The most common cirrhosis is:
alcoholism
317
Clinical findings of hepatitis include all of the following except:
a. jaundice
b. fever
c. chills
d. pericholecystic fluid
d
318
What form of hepatic abnormality are immunocompromised patients more prone to develop?
candidiasis
319
All of the following are sequela of cirrhosis except:
a. portal vein thrombosis
b. hepatic artery contraction
c. portal hypertension
d. splenomegaly
b
320
Normal flow toward the liver in the portal vein is termed:
hepatopetal
321
Which of the following masses would be most worrisome for malignancy?
a. echogenic mass
b. cystic mass with posterior enhancement
c. isoechoic mass with a central scar
d. hyperechoic mass with a hypoechoic halo
d
322
Which of the following statements is true of hepatic adenoma?
a. hepatic adenomas are more common in males
b. hepatic adenomas are also referred to as a stealth lesion
c. Hepatic adenomas typically contain air owing to bacterial formation
d. hepatic adenomas can undergo malignant degeneration
d
323
Which of the following is the most common cancer found in the liver?
a. hepatocellular carcinoma
b. adenocarcinoma
c. metastatic liver disease
d. hepatoblastoma
c
324
Which hepatic mass is closely associated with oral contraceptive use?
hepatic adenoma
325
Which of the following is considered the most common benign childhood hepatic mass?
a. hepatoblastoma
b. hepatoma
c. hematoma
d. hemangioendothelioma
d
326
All of the following are clinical findings of hepatocellular carcinoma except:
a. reduction in AFP
b. unexplained weight loss
c. fever
d. cirrhosis
a
327
The childhood syndrome Beckwith-Wiedemann is associated with an increased risk for developing:
hepatoblastoma
328
Which of the following is associated with E. granulosus?
a. candidiasis
b. amebic liver abscess
c. hydatid liver cyst
d. hepatocellular carcinoma
c
329
Which of the following laboratory findings would be most likely associated with a decrease in albumin?
a. hepatic stenosis
b. hepatic steatohepatitis
c. cirrhosis
d. hepatitis
c
330
Which of the following are the cells of the liver responsible for engulfing pathogens and damaged cells?
a. Kupffer
b. Morrison
c. Hepatocytes
d. Epstein
a
331
What liver pathology is associated with periportal cuffing?
hepatitis
332
Which of the following is an inherited disease characterized by disproportionate absorption of dietary iron?
a. Wilson disease
b. Hemochromatosis
c. von gierke disease
d. von Hippel-Lindau disease
b
333
What inherited disease is linked with the development of cysts in the liver and other organs?
von Hippel-Lindau syndrome
334
Wilson disease will present sonographically similar to what disorder?
Hepatitis
335
Cavernous transformation of the portal vein is found in the presence of:
portal vein thrombosis
336
Which of the following hepatic lesions may occur following a recent bout of appendicitis, diverticulitis, or cholecystitis?
a. focal nodular hyperplasia
b. pyogenic hepatic abscess
c. echinococcal abscess
d. amebic liver abscess
b
337
