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Infectious And Inflammatory Diseases Flashcards

1
Q

What are three clinical presentation of infection?

A
  1. Fever
  2. Pain
  3. Leukocytosis
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2
Q

What do we do if fever is of unknown origin? 3

A
  1. History and lab tests important
  2. Look for organomegaly
  3. Look for infection because they can progress to an abscess
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3
Q

Itis means what?

A

Inflammatory process example is hepatitis

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4
Q

What is an abscess?

A

Localized collection of pus

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5
Q

Abscesses are complications of what?

A

Infection

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6
Q

Who are patients that are at risk for abscesses? Patients with abscesses are at risk for what? 3

A
  1. Diabetes, immunosuppressive, cancer patients
  2. Hematomas
  3. Post-op patients
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7
Q

What does abscesses present with? (What does it feel like?)

A

Local tenderness

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8
Q

What does a abscess look like sonographically? 5

A
  1. Fluid filed area
  2. Posterior enhancement
  3. Thick irregular walls
  4. Debris
  5. Possible gas
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9
Q

What is hepatitis?

A

Inflammation of the liver

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10
Q

What causes hepatitis?

A

Viruses or toxins

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11
Q

What are S/S of hepatitis? 2

A
  1. Fever, chills, N and V
  2. Possible jaundice
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12
Q

What are the different typed of viral hepatitis?

A

A, B, C, D

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13
Q

What is the route of entry for hepatitis A?

A

Fecal- oral route

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14
Q

What is the route of entry for hepatitis B? 2

A
  1. Blood and body fluids
  2. Carrier state
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15
Q

How can someone get hepatitis C?

A

Transfusions

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16
Q

How does someone get hepatitis D?

A

Dependent on Hep B/IV drug users

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17
Q

What is the clinical recovery for acute hepatitis (how long it takes for clinical recovery)? How many cases are Hep A?

A
  1. Clinical recovery within 4 months
  2. 99% of cases of Hep A
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18
Q

What is Subfulminant/ fulminant caused by? What causes it? 2

A
  1. Due to Hep B or drug toxicity
  2. Hepatic necrosis ( death occurs if >40% of hepatic parenchyma lost)
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19
Q

What is Chronic hepatitis?

A

Biochemical ABN > 6 months

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20
Q

What is the sonographic appearance of acute hepatitis? 5

A
  1. Hepatomegaly
  2. Decreased liver echogenicity
  3. Prominent portal vein walls
  4. Gallbladder wall thickening
  5. Most often the liver appears normal
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21
Q

What is the sonographic appearance of chronic hepatitis? 3

A
  1. Coarse liver parenchyma
  2. Increased echogenicity
  3. Portal hypertension, cirrhosis
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22
Q

What lab values are affected by hepatitis? 3

A

Increased
1. ALT
2. AST
3. Bilirubin

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23
Q

In terms of bacterial liver infection, progenitor bacteria spreads to the liver from what? 4

A
  1. Biliary tract
  2. Portal Venous system
  3. Hepatic artery
  4. Trauma
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24
Q

What is the clinical signs of bacterial liver infection? 4 (s/s)

A
  1. Fever
  2. RUQ pain
  3. Malaise
  4. Anorexia
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25
What is the sonographic appearance of bacterial infections? 4
1. Simple to complex cysts 2. Shaggy wall 3. Internal septations 4. Echogenic foci with posterior reverberation
26
What is candidiasis?
Yeast infection of the immune compromised
27
What S/S does candidiasis present with
Fever with WBC count returning to normal
28
What is the sonographic appearance of fungal disease?5
1. **Uniformly hypoechoic (most common)** 2. Hyperechoic 3. Bulls eye 4. Wheel in wheel 5. Liver, kidney and spleen involvement
29
What is pneumocystis carinii?
Opportunistic infection which affects immunocompromised patients (AIDS)
30
Which organs are affected by pneumocystis?5
1. Liver 2. Spleen 3. Renal cortex 4. Pancreas 5. Lymph nodes
31
What is the sonographic appearence of pneumocystis carinii?
Diffuse tiny, non shadowing echogenic foci which progress to shadowing calcified deposits
32
What is an example of a parasitic disease?
Amebiasis
33
What is the route of entry for amebiasis?
Fecal-oral route. Travels from colon>PV>liver
34
Which lobe of the liver is most likely affected by amebiasis?
Right lobe is more commonly affected
35
What does amebiasis look like sonographically?2
1. Rounded/oval/ abscess 2. Hypoechoic with fine internal echoes
36
What are symptoms of amebiasis? 2
1. Pain 2. +/- Diarrhea
37
What kind of disease is hydatid diseases? 2
1. Echinococcal disease 2. Parasitic infection - tapeworm
38
What animals transports hydatid disease?
Sheep and cattle countries
39
Which organs do we see hydatid in?5
1. Liver 2. Spleen 3. Ureter 4. Bladder 5. Kidney
40
How does hydatid disease travel?
Travels via portal Venou system to liver
41
Where is hydatid disease most commonly found? (in the body)
Right lobe of the liver
42
What does a hydatid disease embryo look like? What are the three layers?
1. Slow growing cyst 2. Three layers: Ectocyst, Pericyst, endocyst
43
What is the ectocyst? How thick is it?
1. External membrane 2. ~1 mm thick
44
What is a pericyst?
Dense connective tissue capsule around cyst
45
What is endocyst?
Inner germinal layer
46
What is treatment options for hydatid disease?
Surgery
47
What are S/S of hydatid disease?4
1. Pain/ discomfort 2. Jaundice 3. Vascular thrombosis/ infarction 4. Anaphylactic shock (rare - from cyst repari)
48
What kind of infection is schistosomiasis?
Parasitic infection
49
How does schistosomiasis travel?2
1. Worms penetrate the skin 2. Travel to the mesenteric veins
50
What organs are affected by schistosomiasis?4
1. Liver 2. Spleen 3. Bowel 4. Bladder
51
Schistosomiasis ova can migrate where/how?
Up portal vein
52
What is the pathway of schistosomiasis?
PV wall penetrated>granulomtous, periportal fibrosis
53
Over time what does schistosomiasis cause? 2 (conditions)
Over time 1. Portal hypertension 2. Cirrhosis
54
What is the sonographic appearance of schistosomiasis?5 (Initially, chronic)
1. Thickening and increased echogenicity of periportal walls 2. Initially > Liver enlarged 3. Chronic > liver shrinks/ portal hypertension 4. SPlenomegaly 5. Thickened bladder wall
55
What kind of infection is tuberculosis?
Opportunistic
56
Where does tuberculosis start from?
Lungs
57
What organs may tuberculosis affect?3
1. Spleen 2. Adrenal glands 3. UT
58
What is the sonographic appearance of TB spleen?2
1. Tiny echogenic foci 2. +/- Posterior shadow
59
What is the sonographic apeparance of TB adrenal glands?3 (acute/ chronic, what it leads to)
1. Acute - bilateral diffuse enlargement 2. Chronic - atrophied and calcified 3. Adrenal insufficiency
60
What is peritonitis?
Inflammation of peritoneum
61
What are some infectious factors of peritonitis?4 (How can someone get it)
1. Bacterial 2. Viruses 3. Fungi 4. Parasites
62
What are some non infectious s/s of peritonitis?3
1. Pancreatitis complications 2. Reaction to foreign bodies 3. Severe pain
63
Which disease individuals does tuberculous peritonitis affect? And what are two things we see with them?
1. Immunocompromised (AIDS, Alcoholics, Cirrhosis) 2. Exudative fluid 3. Lymphadenopathy
64
What is acute cholecystitis most commonly caused by?
Most often due to impacted stones
65
What happens to blood supply with acute cholecystitis?2
1. Blood supply interfered with > inflammatory 2. Predisposed to infection
66
Which demographic is affected to by predisposed choleystosis ?
Females
67
What ares some s/s of acute cholecystitis?5
1. RUQ 2. Fever 3. Leukocytosis 4. N and V 5. Jaundice
68
What do we look for sonographically with acute cholecystitis?7
1. GB wall >3mm3 2. Hyperaemia 3. Gallstones 4. Impaction at neck 5. GB hydrops 6. Pericholecystitc fluid 7. +/- acute cholecystitis
69
What are some lab values that are affected by acute cholecystitis? 5
1. Serum bilirubin 2. ALP 3. Leukocytosis 4. AST 5. ALT
70
What are some complications of acute cholecystitis? 5
1. Empyema 2. Gangrenous cholecystitis 3. Emphysematous cholecystitis 4. Perforation 5. Abscess
71
What is gangrenous cholecystits?
Necrosis of the gallbladder which appear with no pain
72
What does gangrenous cholecystitis appear like sonographically?
Non- layering bands of echogenic tissue within the lumen
73
Where does perforation occur?
Fundus
74
What does Perforation of GB look like on u/s?4
1. Free fluid in peritoneal cavity 2. Low level collection adjacent to GB 3. Ill - defined, hyperechoic mass surrounding GB 4. May identify perforation in wall
75
How common is emphysematous?
Rare
76
What is emphysematous caused by?
Gas forming bacteria
77
What is the progression of emphysematous in diabetic men vs women?
Rapid progression in diabetic men>women
78
What is the sonographic appearance of a acalculus cholecystitis?
Similar to acute cholecystitis but without stones
79
What is the most common form of symptomatic GB disease?
Chronic cholecystits?
80
What is some symptoms of chronic cholecystitis?4 (s/s)
1. Intolerance to fatty food s 2. Belching/ indigestion 3. Postprandial RUQ 4. N and V
81
What does this image represent?
Abscess
82
What does this image represent?
Acute hepatitis
83
What does this image represent?
Acute hepatitis
84
What does these images represent?
Chronic hepatitis
85
What does this image represent?
Bacterial liver infection
86
What does this image represent?
Bacterial liver infection
87
What does this image represent?
Fungal disease
88
What does this image represent?
Pneumocystis carinii
89
What does this image represent?
Amebiasis
90
What does this image represent?
Hydatid disease
91
What does this image represent?
Schistosomiasis
92
What does this image represent?
TB of spleen and adrenal glands
93
What does this image represent?
Acute cholecystitis
94
What does this image represent?
Acute cholecystitis
95
What does this image represent?
Gangrenous cholecystitis
96
What does this image represent?
Perforation
97
What does this image represent?
GB perforation
98
What does this image represent?
Emphysematous
99
What does this image represent?
Acalculous cholecystitis
100
What does chronic cholecystitis disease look like sonographically?4
1. Thick heterogenous wall 2. Contracted GB 3. Gallstones 4. WES sign
101
What are lab values of chronic cholecystitis?4
1. AST 2. ALT 3. ALP 4. BILI
102
What are complications of chronic cholecystitis?4
1. Bouveret syndrome 2. Gallstone ileus 3. Mirizzi syndrome 4. Associated with the development of GB carcinoma
103
What is bouveret syndrome?
Gastric outlet obstruction
104
What is gallstone ileus?
Distal bowel obstruction
105
How common is miruzzi syndrome?
Rare complication
106
What is mirizzi syndrome? What happens if there is mirizzi syndrome?
1. Impacted stone in the cystic duct, GB neck or Hartmann’s pouch 2. Compression of the CHD by stone or inflammatory reaction > Obstructive jaundice
107
Mirizzi may form what?
Fistulas ( between cystic duct and CHD)
108
What are clinical symptoms of mirizzi syndrome?3
1. Fever 2. Pain 3. Jaundice
109
What is the sonographic appearance of mirizzi syndrome?2
1. Dilated bile ducts above the level of the obstruction 2. CBD normal
110
What does xanthogranulomatou s cholecystitis look like? What does it represent?
1. Hypoechoic nodules/ bands in a thick GB wall 2. Represents fatty granulomatous nodules
111
Xanthogranulomatous cholecystitis is a rare form of what?
Chronic inflammation
112
How common are porcelain gallbladders?
Rare
113
Which demographic of individuals are affected by porcelain gallbladder?
Older females
114
Porcelain gallbladder has a higher incidence of what?
GB carcinoma
115
What is the etiology of porcelain gallbladder?
Unknown
116
What is porcelain gallbladders associated with?2
1. Stones 2. Chronic cholecystitis
117
How common is cholangitis?
Rare
118
What is cholangitis?
Inflammation of bile ducts
119
What are the five types of cholangitis?5
1. Acute (bacterial) 2. Recurrent progenitor 3. AIDS 4. Biliary ascariasis 5. Primary sclerosing
120
What is acute cholangitis caused by? What is related to?
1. Bacterial obstruction 2. Associated with choledocholithiasis/ obstruction
121
What does acute cholangitis look like clinically?3 (s/s)
1. Fever 2. RUQ 3. Jaundice
122
What does cholangitis look like on u/s? 3
1. Dilated biliary tree 2. Stones 3. Liver abscess
123
What are lab values of acute cholangitis?3
1. WBC 2. ALP 3. Bilirubin
124
Which demographic is affected most by recurrent pyogenic? (not gender related)
SE and east Asia
125
What is the etiology of recurrent pyogenic?
Etiology unknown
126
In terms of recurrent pyogenic, chronic obstruction leads to what?
Chronic obstruction>stasis>stone formation
127
Which lobe of the liver is affected most by recurrent pyogenic?
Lateral left lobe
128
What are some complications of recurrent pyogenic?2
1. Biliary cirrhosis 2. Cholangiocarcinoma
129
What does recurrent pyogenic look like on u/s?
Dilated ducts with stones and sludge in one segment
130
What is AIDS due to?
Opportunistic infection
131
What does the bile ducts and GB walls look like with AIDS
Walls thick
132
What does the CBD look like with AIDS?
Dilated
133
What does the focal structures and intra and extrahepatic ducts look like with AIDS?
Dilated
134
What Lab values are affected by AIDS and how?2
1. ALP elevated 2. Bilirubin normal
135
What is biliary ascariasis caused by?
Roundworm infestation
136
What does biliary ascariasis look like u/s?2
1. Echogenic non-shadowing parallel lines/ tubes in ducts an GB 2. Look for worms
137
What is primary sclerosising cholangitis?2
1. Chronic inflammatory disease of unknown cause 2. Bile ducts fibrosed and inflamed
138
What does primary sclerosing cholangitis lead to?3
1. Biliary cirrhosis 2. Portal hypertension 3. Hepatic failure
139
Which demographic is affected by primary sclerosing cholangitis?
Men > women
140
Primary sclerosing cholangitis is asymptomatic or symptomatic?
Mostly asymptomatic
141
What is the percentage of patients that have primary sclerosing cholangitis have ulcerative colitis?
80%
142
What is pancreatitis?
Inflammation of the pancreas
143
What are two types of pancreatitis?2
1. Acute 2. Chronic
144
How does pancreatitis appear?2 (sonographically)
1. Mild, moderate, or severe 2. Focal and diffuse
145
How is acute pancreatitis diagnosed?
Clinical or lab findings
146
What are clinical presentation of acute pancreatitis?3 (S/S)
1. Severe, constant pain 2. N and V 3. Possible fever
147
What is the role of u/s for acute pancreatitis? 3
1. ID stones in GB duct 2. Detect fluid collections 3. Monitoring inflammatory process
148
What is two acute pancreatitis etiology?2 (What causes it)
1. Alcohol abuse 2. Biliary stones
149
What is the diffuse appearance of acute pancreatitis?7
1. Normal appearence 2. Decreased echogenicity 3. Heterogenous s 4. Edematous 5. Smooth contour 6. Increased size 8. Possible fluid collecitions
150
What does focal acute pancreatitis look like?3 Who is generally affected?4
1. Focal hypoechic 2. Pancreatic head most common 3. Mimics neoplasms 4. Alcohol abusers
151
What are complications of acute pancreatitis?7
1. Fluid accumulation 2. Pseudocysts 3. phlegmeon 4. Hemorrhage 5. Necrotizing pancreatitis 6. Peritonitis 7. Abscess formation
152
What is the speed of progression with chronic pancreatitis? Is it reversible? What does it lead to in terms of echotexture?
1.Progressive 2. Irreversible 3. Fibrosis scarring
153
What is the complications of chronic pancreatitis?2
1. Psudocysts 2. Portalsplenic vein thrombosis
154
What are some lab values affected by L acute pancreatitis
Amylase and lipase
155
What are some values are affected by chronic panreatitis?
Amylase normal And Lipase
156
What disease is Inflammatory bowel caused by?
Crohns disease
157
What is Ulcerative colitis?
Inflammatory bowel
158
Inflammatory bowel, barium studies and endoscopy, are tools to do what?
Tools of assessment
159
What does inflammatory bowel look like on u/s
inflammation of wall, nodes and Mesentery
160
What is crohns disease?
Chronic granulomatous inflammation
161
What does Crohn’s disease affect?
All layers of the bowel wall
162
Chrohn’s disease?
Chronic granuomatous inflammation
163
What is typically affected in the body with chrons disease?
Terminal ileum and colon, and affects all layers of the bowel wall
164
The etiology of Crohn’s disease are hat?
Unknown
165
What is the sonographic appearance of crohns?7
1. **Markedly thick hypoechic wall concentration** 2. Narrowed lumen 3. Aperistalsis of affected portion 4. Rigidity to pressure 5. Creeping fat 6. Hyperaemia 7. Mesenteric lymphadenopathy
166
What are some complications of crohns?4
1. Abscess 2. Fistulas 3. Inflamed fat 4. Appendicitis
167
What is the appearance of the different fistulas that affect crohns? What do they affect?
1. Linear bands, variable echogenicity 2. Gut to skin bladder, or other bowel loops
168
What is ulcerative colitis?2
1. Ulceration of colon and rectum 2. Inflamed mucosa and Submucosal of the colon
169
Individuals with ulcerative colitis have an increased risk of what?2
1. Colon carcinoma 2. Rectal bleed/ abscesses
170
What might we see on u/s on ulcerative colitis?
May see thick hypoechoic bowel wall or no change
171
What is pseudomembranous colitis? What is another name for it?
1. Necrotizing inflammation 2. Infection (c. Difficule)
172
What is pseudomembranous colitis caused by? What are three things we see with it?
1. Oral antibiotics 2. Watery diarrhea/ fever/ pain
173
How common is pseudomembranous colits? What is the sonographic markers for it?2
Rare but might see 1. Massive edema/ thickened hypoechoic wall 2. Prominent haustra marking
174
How common is penumatosis intestinalis?
Rare
175
What is pneumatosis intestinalis associated with?
Underlying conditions
176
What does pneumatosis intestinalis look like on u/s?3 (What should we look for?)
1. Thick hypoechoic wall 2. Hypoechic areas in wall with artifact 3. Look for portal venous air
177
Is pneumatosis intestinalis asymptomatic or symptomatic?
Asymptomatic
178
What is the most common cause of acute pain?
Acute appendicitis
179
Acute appendicitis affects which demographic of individuals?2
1. Most prevalent in young adults 2. Women may have atypical presentation
180
What are causes of acute appendicitis?3
1. Obstruction of appendices lumen 2. Venous return compromised 3. Bacterial overgrowth > Inflammation
181
What are s/s of acute appendicitis?6
1. Crappy peri-umbilical pain 2. N and V 3. **RLQ pain and tendernous** 4. **Leukocytosis** 5. **peritoneal irritation** 6. Guarding over McBurney’s point
182
In terms of acute appendicitis, what can be said about guarding over McBurney’s point?2
1. 2/3 from umbilicus 2. 1/3 from iliac crest
183
Who would you send for u/s with acute appendicitis? When would you send someone with acute appendicitis for u/s?4
1. Slim adults 2. Children 3. Symptoms <48 hours 4. Differentiating gyne abnormalities
184
Who would you send for CT for acute appendicitis? When would you use CT for acute appendicitis? What is a reason for CT for acute appendicitis? 4
1. Normal > obese patients 2. Chronic appendicitis 3. Complications 4. Equivocal ultrasound
185
What does appendicitis look like sonographically? 6
1. Blind ended non-peristalsing tube/ non compressible 2. Greater than 6mm AP diameter/ wall >3mm 3. Appendix with fecalith (appendicolith) - also positive 4. Hypervasculiarty 5. Prominent fat around caecum 6. Perforation - Loculated collection
186
What are some complications of appendicitis? 3
1. Rupture 2. Abscess 3. Diffuse peritonitis
187
What does mesenteric adenitis mimics?
Appendicitis
188
What does mesenteric adenitis look like u/s? 2
1. RLQ lymphadenopathy without appendicitis 2. Seen as enlarged lymph nodes with a thick walled ileum
189
What is a mucocele?
Distension of appendix with mucous
190
How common is mucocele?
Rare
191
Which demographic does mucoceles affect?
Females > males
192
Are mucocele benign or malignant?
Both
193
What are benign causes of mucocele? 3
1. Fecaliths 2. Inflammatory scarring 3. Polyps
194
What are malignant causes of mucoceles? 2
1. Primary mucous 2. Cystadenoma/ cyst adenocarcinoma
195
Mucoceles typically are asymptomatic or symptomatic?
Typically asymptomatic
196
What does mucoceles look like u/s? 4
1. Large cystic/ hypoechoic mass in RLQ 2. Posterior acoustic enhancement 3. Solid area with posterior shadow 4. Rupture of malignant form can cause pseudomyxoma peritoneum
197
What is diverticula?
Outpouching of bowel wall
198
What is diverticulosis?
Multiple diverticula
199
What can diverticulitis lead to?
Can lead to inflammation
200
What are clinical presentations of diverticular disease? 3 (s/s)
1. Fever 2. Leukocytosis 3. Pain
201
Which demographic does diverticulitis RLQ affect? 3
1. Women 2. Asian 3. Young adults
202
What structures does diverticulitis RLQ affect? (Structure)
Caecum or ascending colon and involves all layers of the gut wall
203
What does diverticulitis RLQ look like u/s? 5
1. Sac like structure protruding from wall 2. Hyperemia 3. Fecalith 4. Inflamed fat 5. Focal wall thickening
204
What is the most common location of diverticulitis?
LLQ
205
What causes diverticulitis LLQ?
Increased incidence with age/ low bulk diet
206
What is affected by diverticulitis LLQ? 2
1. Typically sigmoid and left colon 2. Multiple saccular outpouchings
207
Diverticulitis LLQ have what causes inflammation?
Fecal material
208
What does diverticulitis LLQ look like sonographically? 4
1. Hypoechoic, concentric thickening of wall 2. Echogenic foci with posterior shadowing/ring down with or outside bowel wall 3. Abscess 4. Mesenteric thickening
209
What is bladder diverticula?
Outpouching of bladder wall
210
Which bladder wall is affect by bladder diverticula? 2
1. Typically lateral wall 2. Congenital and affects all 3 layers, located near ureteral orifice
211
What is affected by bladder diverticula look like? What has a higher occurence with bladder diverticula? 2
1. Inner 2 layers 2. High occurrence with neurogenic bladder
212
What does bladder diverticula look like on u/s? 3
1. Varying sizes and numbers 2. May disappear post void 3. Urinary stasis (stone formation and infection)
213
What is MBO stand for?
Mechanical bowel obstruction?
214
What is MBO? 4 (Late stage, early stage)
1. Physical obstruction (mass, extrinsic compression) 2. Dilated bowel loops proximal to blockage (fluid or gas) 3. Hyperperistalsis - earlier stage 4. No peristalsis - late stage
215
What does this image represent?
Chronic cholecystitis
216
What does this image represent?
Mirizzi syndrome
217
What does this image represent?
Porcelain gallbladder
218
What does this image represent?
Acute Cholangitis
219
What does this image represent?
Biliary ascariasis
220
What does this image represent?
Primary sclerosing cholangitis
221
What does this image represent?
Diffuse Acute pancreatitis
222
What does this image represent?
Focal Acute pancreatitis
223
What does this image represent?
Chronic pancreatitis
224
What does this image represent?
Crohn's disease
225
What does this image represent?
Ulcerative cholangitis
226
What does this image represent?
Appendicitis
227
What does this image represent?
Appendicitis
228
What does this image represent?
Mucocele
229
What does this image represent?
Diverticulitis LLQ
230
What does this image represent?
Bladder diverticula
231
What is S/S of MBO? 2
1. Abdomen pain and distension 2. Vomiting and diarrhea
232
What is Intussusception?
Invagination of the bowel segment into the next distal segment
233
What is s/s of intussusception? 3
1. Pain 2. Vomiting 3. Currant jelly stools
234
What is the most common cause of obstruction in a child?
Intussusception
235
What does intussusception look like on u/s? 2
1. Seen as multiple concentric rings (donut signs) 2. Target appearance/ pseudo kidney sign
236
What is a volvulus?
Obstruction caused by twisting of the bowel
237
UTIs have a higher incidence rate in what demographic? 2
1. Women 2. Diabetics and immunocompromised
238
UTI affects what organs?
Bladders but may work its way up to their kidney
239
What is acute pyelonephritis?
Inflamed renal tubules
240
What is acute pyelonephritis caused by?
E.coli
241
Who is affected by Acute pyelonephritis?
Young women
242
How might Acute pyelonephritis appear?
Focal and diffuse
243
How is acute pyelonephritis diagnosed?
Lab work
244
When is imaging for acute pyelonephritis imaging done?
When symptoms persists
245
How abnormal is a condition of acute pyelonephritis?
Usually normal
246
With acute pyelonephritis, what would we see as signs? 4
1. Loss of CM junction 2. Renal enlargement 3. Compression of sinus 4. Altered echo texture
247
What might we see with acute pyelonephritis on u/s?
Focal masses and gas
248
What is chronic pyelonephritis?
Interstitial nephritis
249
What is chronic pyelonephritis caused by?
Vesicoureteric reflux
250
Chronic pyelonephritis affects which demographic? 2
1. Starts at young age 2. Female
251
What is the sonographic appearance of chronic pyelonephritis? 4
1. Cortical scarring 2. Asymmetrical change 3. Atrophy 4. Dilated, blunted calyces
252
Abscesses are a complication of what?
Pyelonephritis
253
Abscesses may decompress into what?
Collecting system or perinephric space
254
What is the process in terms of getting abscess ultrasound? 2
1. CT initial screen 2. U/S follow resolving abscess
255
What does abscesses look like u/s? 5
1. Solitary 2. Round 3. Thick wall 4. Complex cysts 5. Gas bubbles
256
What is pyonephrosis?
Pus in collecting system
257
How/where does pyonephrosis appear in young adults?
UPJ obstruction/stones
258
How does pyonephrosis appear like with elderly?
Malignant obstruction
259
What does the U/S look like with pyonephrosis? 3
1. Hydroneprhosis 2. Low level echoes 3. Mobile debris
260
What are two forms of rare pyelonephritis? 2
1. Emphysematous 2. Xanthogranulomatous
261
What is emphysematous?
Gas forms in the parenchyma of the kidney
262
What does emphysematous look like on u/s? 2
1. Echogenic lines 2. Dirty shadow
263
Who is affected more often with emphysematous?
Diabetic older women
264
What is the Preferred imaging tool for emphysematous?
CT evaluation
265
What is Xanthogranulomatous?
Chronic pus forming
266
What does Xanthogranulomatous look like on u/s? 3 (what might be seen in it?)
1. Diffuse or focal 2. Usually unilateral 3. **Staghorn calculi**
267
Who is affected by fungal infections?
Diabetics/ immunocompromised
268
What might fungal infections be affected by?
Indwelling catheters
269
What is the most common form of fungal infections?
Candida albicans
270
What might fungal infection appear as?
Fungal balls
271
What does fungal infections look like on u/s?
Hypoechoic parenchymal masses (Abscesses)
272
What are DDXs of fungal balls? 3
1. Blood clot 2. Tumor 3. Polyp
273
What does fungal balls look like?
Echogenic non-shadowing mass which is mobile
274
How do women contract infectious cystitis?
E.coli
275
How does men contract infectious cystitis? 2
1. Prostatitis 2. Bladder outlet obstruction
276
What might we see with infectious cystitis? 3 (S/S)
1. Mucosal edema 2. Decreased bladder capacity 3. Hematuria
277
What is chronic cystitis?
Chronic inflammation
278
Who is most affected by chronic cystitis?
Middle age women
279
What are s/s of chronic cystitis ? 3
1. Frequency 2. Urgency 3. Hematuria
280
What does chronic cystitis look like on u/s? What possible appearance does it have?
1. Thick walled bladder 2. Possible TCC appearance
281
What is interstitial cystitis?
Chronic bladder infection
282
What is the etiology of interstitial cystitis?
Unknown cause
283
What can interstitial cystitis mimic sonographically?
Bladder cancer
284
What is neurogenic bladder?
Loss of voluntary control of voiding
285
What might we see with neurogenic bladder? 4
1. Trebeculated bladder 2. Debris 3. Stones 4. Hydroneprhosis
286
What is the etiology of retroperitoneal fibrosis?
Unknown etiology
287
What might retroperitoneal fibrosis look like? What does it do? 2
Sheets of fibrous tissue in the retroperitoneum, which 1. Drape over great vessels 2. Surround ureters
288
What is the modality of choice in terms of imaging retroperitoneal fibrosis?
CT
289
How does retroperitoneal fibrosis look like on u/s? 2
1. Hypoechoic, homogenous masses 2. Enveloped/ obstructed retroperitoneal structures
290
What does BPH stand for?
Benign prostatic hyperplasia
291
What is BPH?
Enlargement of the prostate
292
What is the common age of occurrence for BPH?
Over 50 years of age
293
What is the upper limits of normal for the prostate?
40g
294
What area of the prostate enlarges with BPH?
Transition zone which also becomes nodular
295
Does s/s always correlate?
Nope
296
What is the s/s of the BPH? 2
1. Nocturia 2. Difficulty voiding
297
What are some features of BPH sonographically? 6
1. Enlargement of the inner gland 2. Hypoechoic inner region 3. Calcifications 4. Degenerative cyst s 5. Nodules 6. Heterogenous
298
What is TURP
Endoscope into penile urethra and the prostrate is respected using electrocautery used to control bleeding *transurethral retrograde prostatectomy*
299
What is the new method of turp?
Laser surgery
300
How is laser TURP done?
Tissue is not cut but heated rapidly
301
Destroyed tissue with laser turn is removed how?
It is absorbed into the body
302
What does TURP do?
Relives symptoms of BPH
303
What is Prostatits? 2
1. Inflammation of prostate and SV 2. Organisms from lower urethra invade ducts in peripheral zone
304
How many different forms of prostatitis are there?
Acute or chronic forms
305
What is the S/S of prostatitis? 3
1. Low back pain 2. Dysuria 3. Perineal pressure
306
What do we see in lab with prostatitis?
Increase PSA
307
What is the role of TRUS with acute prostatitis?
Limited role
308
What do we see with acute prostatitis on u/s? 3
1. Hypoecohic areas 2. Hypervascularity 3. Possible abscess
309
What is a main symptom of acute prostatitis?
PAIN
310
What does chronic prostatitis look like on u/s? 5
1. Focal masses 2. Varying echogenicity 3. Calcifications 4. Periurethral gland irregularity 5. Dilated SV
311
What is a pleural effusion?
Fluid in thoracic cavity between visceral and parietal pleura
312
What does transudative pleural effusion look like? And what conditions is it seen with? 2
1. Anechoic fluid 2. Seen with CHF and Cirrhosis
313
How does exudative pleural effusion look like? 3
1. Echogenic fluid 2. Septations 3. Pleural thickening
314
What is exudative pleural effusions seen with? 2
1. Infection 2. Neoplasms
315
What is the most frequent cause of LUQ mass?
Splenomegaly
316
What are symptoms of Splenomegaly? 3
1. LUQ fullness 2. Pain 3. Palpable spleen
317
What are causes of Splenomegaly? 6
1. Infection 2. Inflammation 3. Hematological disorders 4. Neoplasia (benign and malignant) 5. Congestion (PV thrombosis, portal hypertension) 6. Infiltration
318
What are some infection causes of Splenomegaly? 3
1. Mono 2. TB 3. Malaria
319
What is an example of inflammation causes of Splenomegaly?
Sarcoidosis
320
What is mild to moderate Splenomegaly affected by? (Most likely) 3
1. Portal hypertension 2. Infection 3. AIDS
321
What does Marked Splenomegaly include? 2
1. Leukaemia 2. Lymphoma
322
What are some complications of splenomegaly?
Spontaneous rupture with minimal trauma or even a cough
323
What is AIDS?
Syndrome of opportunistic infections (those that can be eliminated in people with healthy immunity)
324
AIDS is the final stage of what?
HIV
325
What is seen with AIDS 5
1. Moderate Splenomegaly 2. Candida 3. Pneumocystis carinii 4. Kaposi’s sarcoma 5. Lymphoma
326
Is kaposi’s sarcoma seen on U/S?
Rarely
327
What is Kaposi’s sarcoma? 2
1. Hyperechoic nodules in the liver 2. Adrenal gland
328
What is Lymphoma?
Hypoehcoic liver masses
329
Kaposi’s gland usually affects what?
Adrenal gland and GI tract
330
What is acute thyphlitis? 2
1. Inflammation of cecum/ ascending colon 2. Concentric uniform thickening
331
What does this image represent?
Intussusception
332
What does this image represent?
Acute pyelonephritis
333
What does this image represent?
Chronic pyelonephritis
334
What does this image represent?
Abscesses
335
What does this image represent?
Pyonephrosis
336
What does this image represent?
Fungal balls
337
Label
338
What does this image represent?
Cystitis
339
What does this image represent?
Retroperitoneal fibrosis
340
What does this image represent ?
Features of BPH
341
What does this image represent?
TURP
342
What does this image represent?
Pleural effusion
343
What does this image represent?
Splenomegaly

DMST ABD 3 (11 decks)

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