Diffuse Parenchymal Disease

Question 1

Passive Congestion

Answer 1

Due to CHF, blood backs up into liver

Question 2

Signs and Labs for Passive Congestion

Answer 2

Signs: Hepatomegaly, Possible Ascites
Labs: Normal to Slightly elevated

Question 3

Sono of Passive Congestion

Answer 3

Acute- enlarged and hypoechoic
Chronic- Fibrotic and increased echogenicity
Dilated IVC, hepatic veins, portal veins, mesenteric/splenic vein
“Starry Sky” portal veins

Question 4

Doppler for Passive Congestion

Answer 4

Less triphasic hepatic vein

Loss of phasicity

Question 5

Hepatitis - Hep C

Answer 5

Usually due blood exposure, tattoos, piercings and needlesticks
Signs: flu-like illness, no jaundice, 50-60% remain contagious
Labs: elevated AST, ALT
Small increase in bilirubin
Decrease in albumin

Question 6

Sono of Hepatitis C

Answer 6

Acute: decreased echogenicity, bright portal vein, GB wall thickening, hepatosplenomegaly
Chronic: course parenchymal tissue, increased echogenicity,
Small and atrophic

Question 7

Cirrhosis

Answer 7

Replacement of normal tissue w/ fibrotic tissue w/ loss of functional cells.
Progressive w/ failure and portal HTN
Usually due to alcohol abuse

Question 8

Cirrhosis - alcohol, biliary, post necrosis, metabolic

Answer 8

Alcoholic - toxic, fat accumulation, damage by necrosis
Biliary - Primary: lobular ducts become inflamed
Secondary: bile ducts become inflamed
Post Necrosis - tissue replaced w/ fibrous nodular scar tissue
Metabolic - morphological

Question 9

Signs and Labs for Cirrhosis

Answer 9

Signs: Jaundice, ascites, GI bleed, abd pain, anorexia, nausea, palmer erythema, light stools

Labs: Abnormal LFT, Albumin and Coagulation

Question 10

Sono of Cirrhosis

Answer 10

Course echotexture, nodular, portal HTN possibly

Ascites, Splenomegaly, HTN

Question 11

Steatosis

Answer 11

Fatty Infiltration

Question 12

Accumulation of lipids in hepatocytes

Answer 12

Fatty Infiltration

Question 13

Causes of fatty infiltration

Answer 13

Injury

Diseases; diabetes mellitus, ETOH, obesity, malnourishment, steroids

Question 14

Labs for Fatty Infiltration of the liver

Answer 14

Possibly elevated LFT’s

Question 15

Sono of Fatty Infiltration

Answer 15

Increased Echogenecity

Hepatomegaly (>20cm)

Question 16

Focal Fatty Sparing

Answer 16

Can mimic lesions, common in the caudate, near the GB

Question 17

Von Gierke’s

Answer 17

Glycogen Storage Disease

• disorder of carb metabolism, large amounts of glycogen is stored
• 6 types, Type 1 is most common
• Autosomal Recessive

Question 18

Signs and Labs for Von Gierke’s Disease

Answer 18

Growth and development abnormalities

Labs: unstable blood sugars

Question 19

Ascites

Answer 19

Accumulation of fluid in the peritoneum

Usually due to heart failure causing a back up of fluid in the body, portal HTN, Liver damage and hypoalbuminism