Flashcards Davies Abdomen 2

Question 1

large (pericyst) cyst, containing one or more smaller daughter cysts (endocysts). Fine, internal echoces (hydatid sand) are also found within these cysts. Undergoes a sequence of changes, ending as a collapsed calcified mass

Answer 1

echinococcal cyst

Question 2

______ is one of the most common parasitic infections worldwide (Africa and South America).

Answer 2

Schistosomiasis

Question 3

What is the most significant vascular event associated with schistosomiasis?

Answer 3

portal vein occlusion by the larvae

Question 4

Portal vein occlusion by the larvae in schistomiasis leads to:

Answer 4

portal hypertension
splenomegaly
varices
ascites

Question 5

What is the sonographic appearance of schistosomiasis?

Answer 5

distended, echogenic debris-filled intrahepatic portal veins

Question 6

What is the most common organism causing infections in AIDS and other immunocompromised patients?

Answer 6

Pneumocystis carinii

Question 7

How does pneumocystis carinii look sonographically?

Answer 7

nonshadowing echogenic foci

Question 8

Describe the sonographic appearance of focal fatty infiltration

Answer 8

regions of increased echogenicity present within a background of normal liver parenchyma.

Question 9

Where is fatty infiltration in the liver most commonly seen?

Answer 9

porta hepatis

Question 10

Describe the sonographic appearance of focal fatty sparing

Answer 10

islands of normal liver parenchyma, which appear as hypoechoic masses within a dense fatty infiltrated liver.

Question 11

Where is focal fatty sparing most commonly seen?

Answer 11

adjacent to the gallbladder

Question 12

results in large quantities or glycogen being deposited in the hepatocytes of the liver and convulated tubules of the kidney

Answer 12

glycogen storage disease

Question 13

Glycogen storage disease results in large quantities of glycogen being deposited in the _____ of the liver and ______

Answer 13

hepatocytes
convulated tubules of the kidney

Question 14

What liver mass is associated with glycogen storage disease?

Answer 14

Hepatic adenomas

Question 15

_____ are associated with glycogen storage disease

Answer 15

hepatic adenomas

Question 16

Hepatic adenomas are associated with

Answer 16

glycogen storage disease

Question 17

_____ are linked to the usage of oral contraceptive agents.

Answer 17

hepatic adenomas

Question 18

Hepatic adenomas are linked to the usage of ______

Answer 18

oral contraceptive agents

Question 19

Due to the increased incidence of tumor hemorrhage and risk of malignant transformation, surgical resection is recommended for:

Answer 19

hepatic adenomas

Question 20

Due to the increased incidence of _____ and risk of ______, surgical resection is recommended for hepatic adenomas.

Answer 20

tumor hemorrhage
malignant transformation

Question 21

What is the sonographic appearance of a hepatic adenoma?

Answer 21

nonspecific. Often difficult to distinguish from focal nodular hyperplasia.

Question 22

Hepatic adenomas are often difficult to distinguish from ______

Answer 22

focal nodular hyperplasia

Question 23

What are three major pathologic mechanisms of cirrhosis?

Answer 23

Hepatocellular death
fibrosis
regeneration

Question 24

What is the classic clinical presentation of a patient with cirrhosis?

Answer 24

hepatomegaly
jaundice
ascites

Question 25

What are the clinical signs of portal hypertension>

Answer 25

ascites splenomegaly varices

Question 26

______ has been associated with hepatocellular carcinoma, metastatic liver disease, pancreatic carcinoma, and pancreatitis to name a few.

Answer 26

Portal vein thrombosis

Question 27

Portal vein thrombosis has been associated with ____, _____, _____, and _____ to name a few.

Answer 27

hepatocellular carcinoma metastatic liver disease pancreatic carcinoma pancreatitis

Question 28

What are the sonographic signs of portal vein thrombosis?

Answer 28

intraluminal thrombus increased vein diameter cavernous transformations

Question 29

______ is characterized by occlusion of the hepatic veins.

Answer 29

Budd-Chiari syndrome

Question 30

characterized by occlusion of the hepatic veins

Answer 30

Budd-Chiari syndrome

Question 31

Budd-Chiari is characterized by occlusion of the _____

Answer 31

hepatic veins

Question 32

What are the sonographic findings associated with Budd-Chiari syndrome?

Answer 32

hepatic vein thrombosis ascites hepatomegaly- acute phase caudate lobe enlargement- chronic phase portal hypertension

Question 33

most common benign tumors of the liver

Answer 33

cavernouse hemangiomas

Question 34

_____ may enlarge during pregnancy or with estrogen replacement therapy.

Answer 34

cavernous hemangiomas

Question 35

Cavernous hemangiomas may enlarge during ____ or with ______

Answer 35

pregnancy estrogen replacement therapy

Question 36

What is the typical sonographic appearance of a cavernous hemangioma?

Answer 36

small, well-defined hyperechoic mass with possible posterior acoustic enhancement

Question 37

What is the sonographic appearance of a focal nodular hyperplasia?

Answer 37

solitary mass, usually less than 5 cm in diameter, that may have a central fibrous scar.

Question 38

Stealth lesion

Answer 38

focal nodular hyperplasia

Question 39

solitary mass, usually less than 5 cm in diameter, that may have a central fibrous scar

Answer 39

focal nodular hyperplasia

Question 40

Name four well-defined hyperechoic liver masses

Answer 40

hemangiomas hepatic lipomas echogenic metastasis focal fatty infiltration

Question 41

Name the most common primary malignant tumor of the liver

Answer 41

hepatocellular carcinoma

Question 42

Etiologic factors for hepatocellular carcinoma

Answer 42

alcoholic cirrhosis chronic hepatitis B and C infections

Question 43

With hepatocellular carcinoma there is a propensity toward

Answer 43

portal vein invasion

Question 44

Sonographic appearance of hepatocellular carcinoma

Answer 44

variable; typically seen as a hypoechoic mass

Question 45

In patients with ____, surgically placed portosystemic shunts decompress the portal system.

Answer 45

portal hypertension

Question 46

In patients with portal hypertension, surgically placed _______ decompress the portal system.

Answer 46

portosystemic shunts

Question 47

Name five portosystemic shunts

Answer 47

portocaval shunt proximal splenorenal shunt Distal splenorenal (Warren shunt) mesocaval shunt transjugular intrahepatic portosystemic shunt

Question 48

The distal splenorenal shunt is also known as the

Answer 48

Warren Shunt

Question 49

Shunt patency is confirmed sonographically by:

Answer 49

demonstrating the flow within the shunt itself the presence of hepatofugal portal vein flow

Question 50

The ____ shunt and the _____ shunt will have hepatopedal portal vein flow.

Answer 50

Warren or distal splenorenal transjugular intrahepatic portosystemic shunt

Question 51

The Warren shunt and transjugular intrahepatic portosystemic shunt will have ______ flow.

Answer 51

hepatopedal

Question 52

The _____, _____, and ______ shunt will have hepatofugal flow.

Answer 52

portocaval shunt proximal splenorenal shunt mesocaval shunt

Question 53

The portocaval shunt, proximal splenorenal shunt, and the mesocaval shunt will have ____ portal vein flow.

Answer 53

hepatofugal

Question 54

With a properly functioning transjugular intraphepatic portosystemic shunt, what is the flow direction of the right and left portal branches?

Answer 54

hepatofugal

Question 55

What are the two types of gallbladder folding?

Answer 55

junctional fold phrygian cap

Question 56

folding of the gallbladder neck

Answer 56

junctional fold

Question 57

What is a junctional fold in the gallbladder?

Answer 57

folding of the gallbladder neck

Question 58

folding of the gallbladder fundus

Answer 58

phrygian cap

Question 59

What is a phrygian cap?

Answer 59

folding of the gallbladder fundus

Question 60

What are the two terms that describe a stone filled contracted gallbladder

Answer 60

wall-echo-shadow (WES sign) double arc shadow sign

Question 61

What is the purpose of administering a fatty meal to a patient?

Answer 61

helpful in assessing biliary obstruction.

Question 62

An obstructed bile duct should ______ in size following administration of a fatty meal

Answer 62

increase

Question 63

A non obstructed bile duct should _____ in size after administration of a fatty meal.

Answer 63

decrease

Question 64

What does a significant elevation of conjugated bilirubin levels indicate?

Answer 64

obstructive jaundice intrahepatic cholestasis biliary tree obstruction

Question 65

Gallbladder wall thickening is diagnosed when the wall is greater than ___

Answer 65

3 mm

Question 66

What are the causes for a gallbladder wall thickening?

Answer 66

cholecystitis (inflammation) ascites hypoalbuminemia hepatitis congestive heart failure renal disease AIDS sepsis

Question 67

Name the sonographic criteria for gallstones

Answer 67

mobile, echogenic structure with posterior acoustic shadowing

Question 68

Describe the composition of gallstones

Answer 68

cholesterol calcium bilirubinate calcium carbonate

Question 69

Gallstones are composed of ______, ______, _______

Answer 69

cholesteral calcium bilirubinate calcium carbonate

Question 70

______ are composed of cholesterol, calcium bilirubinate, calcium carbonate

Answer 70

Gallstones

Question 71

Describe acute cholecystitis

Answer 71

usually precipitated by a stone obstructing the cystic duct. This situation results in an obstruction of venous drainage, and inflammation of the gallbladder wall with variable degrees of necrosis and infection

Question 72

Acute cholecystitis is usually precipitated by a stone obstructing the _____

Answer 72

cystic duct

Question 73

Acute cholecystitis results in an obstruction of ______, and _______ with variable degrees of necrosis and infection

Answer 73

venous drainage inflammation of the gallbladder wall

Question 74

What symptoms accompany acute cholecystitis?

Answer 74

right upper quadrant tenderness, guarding, fever, chills, and leukocytosis

Question 75

Name the five sonographic criteria that define acute cholecystitis

Answer 75

gallstones sonographic murphys sign diffuse wall thickening gallbladder dilatation sludge

Question 76

What is emphysematous cholecystitis?

Answer 76

an infection associated with gas-forming bacteria within the wall of the gallbladder

Question 77

an infection associated with gas-forming bacteria within the wall of the gallbladder

Answer 77

emphysematous cholecystitis

Question 78

Describe the sonographic appearance of emphysematous cholecystitis

Answer 78

gas shadowing from the wall of the gallbladder

Question 79

Hydrops of the gallbladder

Answer 79

distended, non inflamed gallbladder due to total obstruction of the cystic duct

Question 80

distended, non inflamed gallbladder due to total obstruction of the cystic duct

Answer 80

hydrops of the gallbladder

Question 81

Hydrops of the gallbladder is defined as a distended, non inflamed gallbladder due to total obstruction of the _____

Answer 81

cystic duct

Question 82

The traped bile is resorbed and the gallbladder is filled with a clear mucinous secretion derived from the mucosa

Answer 82

hydrops of the gallbladder

Question 83

What are Rokitansky- Aschoff sinuses (RAS)?

Answer 83

diverticula within the wall of the gallbladder

Question 84

diverticula within the wall of the gallbladder

Answer 84

Rokitansky-Aschoff sinuses (RAS)

Question 85

What is the pathology associated with Rokitansky- Aschoff sinuses?

Answer 85

adenomyomatosis

Question 86

Adenomyomatosis is pathology associated with:

Answer 86

Rokitansky- Aschoff sinuses

Question 87

Sludge and stones accumulate within the sinuses, and present as focal wall thickening. Echogenic foci are visible within the thickened wall. This accumulation causes a characteristic comet tail reverberation artifact

Answer 87

Rokitanksy- Aschoff sinuses

Question 88

What is the sonographic presentation of gallbladder carcinoma

Answer 88

intraluminal mass, asymmetric wall thickening, or a mass-filled gallbladder

Question 89

What three other findings should be investigated to confirm the diagnosis of gallbladder carcinoma?

Answer 89

liver metastases lymphadenopathy bile duct dilatation

Question 90

What are the two most common causes of biliary tract obstruction?

Answer 90

gallstones (choledocholithiasis) carcinoma of the pancreas

Question 91

What lab values are most likely to be elevated due to biliary tract obstruction?

Answer 91

alkaline phosphatase conjugated (direct) bilirubin gamma glutymi transpeptidase

Question 92

What are the two signs that indicate intrahepatic bile duct dilatation?

Answer 92

shotgun sign parallel channel sign

Question 93

What are the shotgun sign and the parallel channel sign associated with?

Answer 93

intrahepatic bile duct dilatation

Question 94

What is Mirizzi's syndrome?

Answer 94

extrahepatic bile duct obstruction due to a stone within the cystic duct

Question 95

Extrahepatic bile duct obstruction due to a stone within the cystic duct

Answer 95

Mirizzi's syndrome

Question 96

Mirrizi's syndrome is an extrahepatic bile duct obstruction due to a stone within the _____

Answer 96

cystic duct

Question 97

In Mirizzi's syndrome, the stone causes extrinsic mechanical compression of the ______

Answer 97

common hepatic duct

Question 98

Describe sonographic findings associated with Mirizzi's syndrome

Answer 98

intrahepatic bile duct dilatation normal sized CBD large stone in the cystic duct of the gallbladder

Question 99

Name three extrahepatic biliary ducts

Answer 99

common hepatic duct cystic duct common bile duct

Question 100

What pathology causes intrahepatic biliary dilatation without extrahepatic biliary dilatation?

Answer 100

Klatskin tumor