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DMST ABD 3 > Infectious And Inflammatory Diseases > Flashcards

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
Q

What is the sonographic appearance of bacterial infections? 4

A
  1. Simple to complex cysts
  2. Shaggy wall
  3. Internal septations
  4. Echogenic foci with posterior reverberation
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26
Q

What is candidiasis?

A

Yeast infection of the immune compromised

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27
Q

What S/S does candidiasis present with

A

Fever with WBC count returning to normal

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28
Q

What is the sonographic appearance of fungal disease?5

A
  1. Uniformly hypoechoic (most common)
  2. Hyperechoic
  3. Bulls eye
  4. Wheel in wheel
  5. Liver, kidney and spleen involvement
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29
Q

What is pneumocystis carinii?

A

Opportunistic infection which affects immunocompromised patients (AIDS)

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30
Q

Which organs are affected by pneumocystis?5

A
  1. Liver
  2. Spleen
  3. Renal cortex
  4. Pancreas
  5. Lymph nodes
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31
Q

What is the sonographic appearence of pneumocystis carinii?

A

Diffuse tiny, non shadowing echogenic foci which progress to shadowing calcified deposits

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32
Q

What is an example of a parasitic disease?

A

Amebiasis

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33
Q

What is the route of entry for amebiasis?

A

Fecal-oral route. Travels from colon>PV>liver

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34
Q

Which lobe of the liver is most likely affected by amebiasis?

A

Right lobe is more commonly affected

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35
Q

What does amebiasis look like sonographically?2

A
  1. Rounded/oval/ abscess
  2. Hypoechoic with fine internal echoes
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36
Q

What are symptoms of amebiasis? 2

A
  1. Pain
  2. +/- Diarrhea
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37
Q

What kind of disease is hydatid diseases? 2

A
  1. Echinococcal disease
  2. Parasitic infection - tapeworm
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38
Q

What animals transports hydatid disease?

A

Sheep and cattle countries

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39
Q

Which organs do we see hydatid in?5

A
  1. Liver
  2. Spleen
  3. Ureter
  4. Bladder
  5. Kidney
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40
Q

How does hydatid disease travel?

A

Travels via portal Venou system to liver

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41
Q

Where is hydatid disease most commonly found? (in the body)

A

Right lobe of the liver

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42
Q

What does a hydatid disease embryo look like? What are the three layers?

A
  1. Slow growing cyst
  2. Three layers: Ectocyst, Pericyst, endocyst
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43
Q

What is the ectocyst? How thick is it?

A
  1. External membrane
  2. ~1 mm thick
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44
Q

What is a pericyst?

A

Dense connective tissue capsule around cyst

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45
Q

What is endocyst?

A

Inner germinal layer

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46
Q

What is treatment options for hydatid disease?

A

Surgery

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47
Q

What are S/S of hydatid disease?4

A
  1. Pain/ discomfort
  2. Jaundice
  3. Vascular thrombosis/ infarction
  4. Anaphylactic shock (rare - from cyst repari)
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48
Q

What kind of infection is schistosomiasis?

A

Parasitic infection

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49
Q

How does schistosomiasis travel?2

A
  1. Worms penetrate the skin
  2. Travel to the mesenteric veins
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50
Q

What organs are affected by schistosomiasis?4

A
  1. Liver
  2. Spleen
  3. Bowel
  4. Bladder
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51
Q

Schistosomiasis ova can migrate where/how?

A

Up portal vein

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52
Q

What is the pathway of schistosomiasis?

A

PV wall penetrated>granulomtous, periportal fibrosis

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53
Q

Over time what does schistosomiasis cause? 2 (conditions)

A

Over time
1. Portal hypertension
2. Cirrhosis

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54
Q

What is the sonographic appearance of schistosomiasis?5 (Initially, chronic)

A
  1. Thickening and increased echogenicity of periportal walls
  2. Initially > Liver enlarged
  3. Chronic > liver shrinks/ portal hypertension
  4. SPlenomegaly
  5. Thickened bladder wall
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55
Q

What kind of infection is tuberculosis?

A

Opportunistic

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56
Q

Where does tuberculosis start from?

A

Lungs

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57
Q

What organs may tuberculosis affect?3

A
  1. Spleen
  2. Adrenal glands
  3. UT
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58
Q

What is the sonographic appearance of TB spleen?2

A
  1. Tiny echogenic foci
  2. +/- Posterior shadow
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59
Q

What is the sonographic apeparance of TB adrenal glands?3 (acute/ chronic, what it leads to)

A
  1. Acute - bilateral diffuse enlargement
  2. Chronic - atrophied and calcified
  3. Adrenal insufficiency
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60
Q

What is peritonitis?

A

Inflammation of peritoneum

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61
Q

What are some infectious factors of peritonitis?4 (How can someone get it)

A
  1. Bacterial
  2. Viruses
  3. Fungi
  4. Parasites
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62
Q

What are some non infectious s/s of peritonitis?3

A
  1. Pancreatitis complications
  2. Reaction to foreign bodies
  3. Severe pain
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63
Q

Which disease individuals does tuberculous peritonitis affect? And what are two things we see with them?

A
  1. Immunocompromised (AIDS, Alcoholics, Cirrhosis)
  2. Exudative fluid
  3. Lymphadenopathy
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64
Q

What is acute cholecystitis most commonly caused by?

A

Most often due to impacted stones

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65
Q

What happens to blood supply with acute cholecystitis?2

A
  1. Blood supply interfered with > inflammatory
  2. Predisposed to infection
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66
Q

Which demographic is affected to by predisposed choleystosis ?

A

Females

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67
Q

What ares some s/s of acute cholecystitis?5

A
  1. RUQ
  2. Fever
  3. Leukocytosis
  4. N and V
  5. Jaundice
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68
Q

What do we look for sonographically with acute cholecystitis?7

A
  1. GB wall >3mm3
  2. Hyperaemia
  3. Gallstones
  4. Impaction at neck
  5. GB hydrops
  6. Pericholecystitc fluid
  7. +/- acute cholecystitis
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69
Q

What are some lab values that are affected by acute cholecystitis? 5

A
  1. Serum bilirubin
  2. ALP
  3. Leukocytosis
  4. AST
  5. ALT
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70
Q

What are some complications of acute cholecystitis? 5

A
  1. Empyema
  2. Gangrenous cholecystitis
  3. Emphysematous cholecystitis
  4. Perforation
  5. Abscess
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71
Q

What is gangrenous cholecystits?

A

Necrosis of the gallbladder which appear with no pain

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72
Q

What does gangrenous cholecystitis appear like sonographically?

A

Non- layering bands of echogenic tissue within the lumen

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73
Q

Where does perforation occur?

A

Fundus

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74
Q

What does Perforation of GB look like on u/s?4

A
  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
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75
Q

How common is emphysematous?

A

Rare

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76
Q

What is emphysematous caused by?

A

Gas forming bacteria

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77
Q

What is the progression of emphysematous in diabetic men vs women?

A

Rapid progression in diabetic men>women

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78
Q

What is the sonographic appearance of a acalculus cholecystitis?

A

Similar to acute cholecystitis but without stones

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79
Q

What is the most common form of symptomatic GB disease?

A

Chronic cholecystits?

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80
Q

What is some symptoms of chronic cholecystitis?4 (s/s)

A
  1. Intolerance to fatty food s
  2. Belching/ indigestion
  3. Postprandial RUQ
  4. N and V
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81
Q

What does this image represent?

A

Abscess

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82
Q

What does this image represent?

A

Acute hepatitis

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83
Q

What does this image represent?

A

Acute hepatitis

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84
Q

What does these images represent?

A

Chronic hepatitis

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85
Q

What does this image represent?

A

Bacterial liver infection

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86
Q

What does this image represent?

A

Bacterial liver infection

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87
Q

What does this image represent?

A

Fungal disease

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88
Q

What does this image represent?

A

Pneumocystis carinii

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89
Q

What does this image represent?

A

Amebiasis

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90
Q

What does this image represent?

A

Hydatid disease

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91
Q

What does this image represent?

A

Schistosomiasis

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92
Q

What does this image represent?

A

TB of spleen and adrenal glands

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93
Q

What does this image represent?

A

Acute cholecystitis

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94
Q

What does this image represent?

A

Acute cholecystitis

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95
Q

What does this image represent?

A

Gangrenous cholecystitis

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96
Q

What does this image represent?

A

Perforation

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97
Q

What does this image represent?

A

GB perforation

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98
Q

What does this image represent?

A

Emphysematous

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99
Q

What does this image represent?

A

Acalculous cholecystitis

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100
Q

What does chronic cholecystitis disease look like sonographically?4

A
  1. Thick heterogenous wall
  2. Contracted GB
  3. Gallstones
  4. WES sign
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101
Q

What are lab values of chronic cholecystitis?4

A
  1. AST
  2. ALT
  3. ALP
  4. BILI
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102
Q

What are complications of chronic cholecystitis?4

A
  1. Bouveret syndrome
  2. Gallstone ileus
  3. Mirizzi syndrome
  4. Associated with the development of GB carcinoma
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103
Q

What is bouveret syndrome?

A

Gastric outlet obstruction

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104
Q

What is gallstone ileus?

A

Distal bowel obstruction

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105
Q

How common is miruzzi syndrome?

A

Rare complication

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106
Q

What is mirizzi syndrome? What happens if there is mirizzi syndrome?

A
  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
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107
Q

Mirizzi may form what?

A

Fistulas ( between cystic duct and CHD)

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108
Q

What are clinical symptoms of mirizzi syndrome?3

A
  1. Fever
  2. Pain
  3. Jaundice
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109
Q

What is the sonographic appearance of mirizzi syndrome?2

A
  1. Dilated bile ducts above the level of the obstruction
  2. CBD normal
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110
Q

What does xanthogranulomatou s cholecystitis look like? What does it represent?

A
  1. Hypoechoic nodules/ bands in a thick GB wall
  2. Represents fatty granulomatous nodules
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111
Q

Xanthogranulomatous cholecystitis is a rare form of what?

A

Chronic inflammation

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112
Q

How common are porcelain gallbladders?

A

Rare

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113
Q

Which demographic of individuals are affected by porcelain gallbladder?

A

Older females

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114
Q

Porcelain gallbladder has a higher incidence of what?

A

GB carcinoma

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115
Q

What is the etiology of porcelain gallbladder?

A

Unknown

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116
Q

What is porcelain gallbladders associated with?2

A
  1. Stones
  2. Chronic cholecystitis
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117
Q

How common is cholangitis?

A

Rare

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118
Q

What is cholangitis?

A

Inflammation of bile ducts

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119
Q

What are the five types of cholangitis?5

A
  1. Acute (bacterial)
  2. Recurrent progenitor
  3. AIDS
  4. Biliary ascariasis
  5. Primary sclerosing
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120
Q

What is acute cholangitis caused by? What is related to?

A
  1. Bacterial obstruction
  2. Associated with choledocholithiasis/ obstruction
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121
Q

What does acute cholangitis look like clinically?3 (s/s)

A
  1. Fever
  2. RUQ
  3. Jaundice
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122
Q

What does cholangitis look like on u/s? 3

A
  1. Dilated biliary tree
  2. Stones
  3. Liver abscess
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123
Q

What are lab values of acute cholangitis?3

A
  1. WBC
  2. ALP
  3. Bilirubin
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124
Q

Which demographic is affected most by recurrent pyogenic? (not gender related)

A

SE and east Asia

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125
Q

What is the etiology of recurrent pyogenic?

A

Etiology unknown

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126
Q

In terms of recurrent pyogenic, chronic obstruction leads to what?

A

Chronic obstruction>stasis>stone formation

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127
Q

Which lobe of the liver is affected most by recurrent pyogenic?

A

Lateral left lobe

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128
Q

What are some complications of recurrent pyogenic?2

A
  1. Biliary cirrhosis
  2. Cholangiocarcinoma
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129
Q

What does recurrent pyogenic look like on u/s?

A

Dilated ducts with stones and sludge in one segment

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130
Q

What is AIDS due to?

A

Opportunistic infection

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131
Q

What does the bile ducts and GB walls look like with AIDS

A

Walls thick

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132
Q

What does the CBD look like with AIDS?

A

Dilated

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133
Q

What does the focal structures and intra and extrahepatic ducts look like with AIDS?

A

Dilated

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134
Q

What Lab values are affected by AIDS and how?2

A
  1. ALP elevated
  2. Bilirubin normal
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135
Q

What is biliary ascariasis caused by?

A

Roundworm infestation

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136
Q

What does biliary ascariasis look like u/s?2

A
  1. Echogenic non-shadowing parallel lines/ tubes in ducts an GB
  2. Look for worms
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137
Q

What is primary sclerosising cholangitis?2

A
  1. Chronic inflammatory disease of unknown cause
  2. Bile ducts fibrosed and inflamed
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138
Q

What does primary sclerosing cholangitis lead to?3

A
  1. Biliary cirrhosis
  2. Portal hypertension
  3. Hepatic failure
139
Q

Which demographic is affected by primary sclerosing cholangitis?

A

Men > women

140
Q

Primary sclerosing cholangitis is asymptomatic or symptomatic?

A

Mostly asymptomatic

141
Q

What is the percentage of patients that have primary sclerosing cholangitis have ulcerative colitis?

142
Q

What is pancreatitis?

A

Inflammation of the pancreas

143
Q

What are two types of pancreatitis?2

A
  1. Acute
  2. Chronic
144
Q

How does pancreatitis appear?2 (sonographically)

A
  1. Mild, moderate, or severe
  2. Focal and diffuse
145
Q

How is acute pancreatitis diagnosed?

A

Clinical or lab findings

146
Q

What are clinical presentation of acute pancreatitis?3 (S/S)

A
  1. Severe, constant pain
  2. N and V
  3. Possible fever
147
Q

What is the role of u/s for acute pancreatitis? 3

A
  1. ID stones in GB duct
  2. Detect fluid collections
  3. Monitoring inflammatory process
148
Q

What is two acute pancreatitis etiology?2 (What causes it)

A
  1. Alcohol abuse
  2. Biliary stones
149
Q

What is the diffuse appearance of acute pancreatitis?7

A
  1. Normal appearence
  2. Decreased echogenicity
  3. Heterogenous s
  4. Edematous
  5. Smooth contour
  6. Increased size
  7. Possible fluid collecitions
150
Q

What does focal acute pancreatitis look like?3 Who is generally affected?4

A
  1. Focal hypoechic
  2. Pancreatic head most common
  3. Mimics neoplasms
  4. Alcohol abusers
151
Q

What are complications of acute pancreatitis?7

A
  1. Fluid accumulation
  2. Pseudocysts
  3. phlegmeon
  4. Hemorrhage
  5. Necrotizing pancreatitis
  6. Peritonitis
  7. Abscess formation
152
Q

What is the speed of progression with chronic pancreatitis? Is it reversible? What does it lead to in terms of echotexture?

A

1.Progressive
2. Irreversible
3. Fibrosis scarring

153
Q

What is the complications of chronic pancreatitis?2

A
  1. Psudocysts
  2. Portalsplenic vein thrombosis
154
Q

What are some lab values affected by L acute pancreatitis

A

Amylase and lipase

155
Q

What are some values are affected by chronic panreatitis?

A

Amylase normal
And
Lipase

156
Q

What disease is Inflammatory bowel caused by?

A

Crohns disease

157
Q

What is Ulcerative colitis?

A

Inflammatory bowel

158
Q

Inflammatory bowel, barium studies and endoscopy, are tools to do what?

A

Tools of assessment

159
Q

What does inflammatory bowel look like on u/s

A

inflammation of wall, nodes and Mesentery

160
Q

What is crohns disease?

A

Chronic granulomatous inflammation

161
Q

What does Crohn’s disease affect?

A

All layers of the bowel wall

162
Q

Chrohn’s disease?

A

Chronic granuomatous inflammation

163
Q

What is typically affected in the body with chrons disease?

A

Terminal ileum and colon, and affects all layers of the bowel wall

164
Q

The etiology of Crohn’s disease are hat?

165
Q

What is the sonographic appearance of crohns?7

A
  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
Q

What are some complications of crohns?4

A
  1. Abscess
  2. Fistulas
  3. Inflamed fat
  4. Appendicitis
167
Q

What is the appearance of the different fistulas that affect crohns? What do they affect?

A
  1. Linear bands, variable echogenicity
  2. Gut to skin bladder, or other bowel loops
168
Q

What is ulcerative colitis?2

A
  1. Ulceration of colon and rectum
  2. Inflamed mucosa and Submucosal of the colon
169
Q

Individuals with ulcerative colitis have an increased risk of what?2

A
  1. Colon carcinoma
  2. Rectal bleed/ abscesses
170
Q

What might we see on u/s on ulcerative colitis?

A

May see thick hypoechoic bowel wall or no change

171
Q

What is pseudomembranous colitis? What is another name for it?

A
  1. Necrotizing inflammation
  2. Infection (c. Difficule)
172
Q

What is pseudomembranous colitis caused by? What are three things we see with it?

A
  1. Oral antibiotics
  2. Watery diarrhea/ fever/ pain
173
Q

How common is pseudomembranous colits? What is the sonographic markers for it?2

A

Rare but might see
1. Massive edema/ thickened hypoechoic wall
2. Prominent haustra marking

174
Q

How common is penumatosis intestinalis?

175
Q

What is pneumatosis intestinalis associated with?

A

Underlying conditions

176
Q

What does pneumatosis intestinalis look like on u/s?3 (What should we look for?)

A
  1. Thick hypoechoic wall
  2. Hypoechic areas in wall with artifact
  3. Look for portal venous air
177
Q

Is pneumatosis intestinalis asymptomatic or symptomatic?

A

Asymptomatic

178
Q

What is the most common cause of acute pain?

A

Acute appendicitis

179
Q

Acute appendicitis affects which demographic of individuals?2

A
  1. Most prevalent in young adults
  2. Women may have atypical presentation
180
Q

What are causes of acute appendicitis?3

A
  1. Obstruction of appendices lumen
  2. Venous return compromised
  3. Bacterial overgrowth > Inflammation
181
Q

What are s/s of acute appendicitis?6

A
  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
Q

In terms of acute appendicitis, what can be said about guarding over McBurney’s point?2

A
  1. 2/3 from umbilicus
  2. 1/3 from iliac crest
183
Q

Who would you send for u/s with acute appendicitis? When would you send someone with acute appendicitis for u/s?4

A
  1. Slim adults
  2. Children
  3. Symptoms <48 hours
  4. Differentiating gyne abnormalities
184
Q

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

A
  1. Normal > obese patients
  2. Chronic appendicitis
  3. Complications
  4. Equivocal ultrasound
185
Q

What does appendicitis look like sonographically? 6

A
  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
Q

What are some complications of appendicitis? 3

A
  1. Rupture
  2. Abscess
  3. Diffuse peritonitis
187
Q

What does mesenteric adenitis mimics?

A

Appendicitis

188
Q

What does mesenteric adenitis look like u/s? 2

A
  1. RLQ lymphadenopathy without appendicitis
  2. Seen as enlarged lymph nodes with a thick walled ileum
189
Q

What is a mucocele?

A

Distension of appendix with mucous

190
Q

How common is mucocele?

191
Q

Which demographic does mucoceles affect?

A

Females > males

192
Q

Are mucocele benign or malignant?

193
Q

What are benign causes of mucocele? 3

A
  1. Fecaliths
  2. Inflammatory scarring
  3. Polyps
194
Q

What are malignant causes of mucoceles? 2

A
  1. Primary mucous
  2. Cystadenoma/ cyst adenocarcinoma
195
Q

Mucoceles typically are asymptomatic or symptomatic?

A

Typically asymptomatic

196
Q

What does mucoceles look like u/s? 4

A
  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
Q

What is diverticula?

A

Outpouching of bowel wall

198
Q

What is diverticulosis?

A

Multiple diverticula

199
Q

What can diverticulitis lead to?

A

Can lead to inflammation

200
Q

What are clinical presentations of diverticular disease? 3 (s/s)

A
  1. Fever
  2. Leukocytosis
  3. Pain
201
Q

Which demographic does diverticulitis RLQ affect? 3

A
  1. Women
  2. Asian
  3. Young adults
202
Q

What structures does diverticulitis RLQ affect? (Structure)

A

Caecum or ascending colon and involves all layers of the gut wall

203
Q

What does diverticulitis RLQ look like u/s? 5

A
  1. Sac like structure protruding from wall
  2. Hyperemia
  3. Fecalith
  4. Inflamed fat
  5. Focal wall thickening
204
Q

What is the most common location of diverticulitis?

205
Q

What causes diverticulitis LLQ?

A

Increased incidence with age/ low bulk diet

206
Q

What is affected by diverticulitis LLQ? 2

A
  1. Typically sigmoid and left colon
  2. Multiple saccular outpouchings
207
Q

Diverticulitis LLQ have what causes inflammation?

A

Fecal material

208
Q

What does diverticulitis LLQ look like sonographically? 4

A
  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
Q

What is bladder diverticula?

A

Outpouching of bladder wall

210
Q

Which bladder wall is affect by bladder diverticula? 2

A
  1. Typically lateral wall
  2. Congenital and affects all 3 layers, located near ureteral orifice
211
Q

What is affected by bladder diverticula look like? What has a higher occurence with bladder diverticula? 2

A
  1. Inner 2 layers
  2. High occurrence with neurogenic bladder
212
Q

What does bladder diverticula look like on u/s? 3

A
  1. Varying sizes and numbers
  2. May disappear post void
  3. Urinary stasis (stone formation and infection)
213
Q

What is MBO stand for?

A

Mechanical bowel obstruction?

214
Q

What is MBO? 4 (Late stage, early stage)

A
  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
Q

What does this image represent?

A

Chronic cholecystitis

216
Q

What does this image represent?

A

Mirizzi syndrome

217
Q

What does this image represent?

A

Porcelain gallbladder

218
Q

What does this image represent?

A

Acute Cholangitis

219
Q

What does this image represent?

A

Biliary ascariasis

220
Q

What does this image represent?

A

Primary sclerosing cholangitis

221
Q

What does this image represent?

A

Diffuse Acute pancreatitis

222
Q

What does this image represent?

A

Focal Acute pancreatitis

223
Q

What does this image represent?

A

Chronic pancreatitis

224
Q

What does this image represent?

A

Crohn’s disease

225
Q

What does this image represent?

A

Ulcerative cholangitis

226
Q

What does this image represent?

A

Appendicitis

227
Q

What does this image represent?

A

Appendicitis

228
Q

What does this image represent?

229
Q

What does this image represent?

A

Diverticulitis LLQ

230
Q

What does this image represent?

A

Bladder diverticula

231
Q

What is S/S of MBO? 2

A
  1. Abdomen pain and distension
  2. Vomiting and diarrhea
232
Q

What is Intussusception?

A

Invagination of the bowel segment into the next distal segment

233
Q

What is s/s of intussusception? 3

A
  1. Pain
  2. Vomiting
  3. Currant jelly stools
234
Q

What is the most common cause of obstruction in a child?

A

Intussusception

235
Q

What does intussusception look like on u/s? 2

A
  1. Seen as multiple concentric rings (donut signs)
  2. Target appearance/ pseudo kidney sign
236
Q

What is a volvulus?

A

Obstruction caused by twisting of the bowel

237
Q

UTIs have a higher incidence rate in what demographic? 2

A
  1. Women
  2. Diabetics and immunocompromised
238
Q

UTI affects what organs?

A

Bladders but may work its way up to their kidney

239
Q

What is acute pyelonephritis?

A

Inflamed renal tubules

240
Q

What is acute pyelonephritis caused by?

241
Q

Who is affected by Acute pyelonephritis?

A

Young women

242
Q

How might Acute pyelonephritis appear?

A

Focal and diffuse

243
Q

How is acute pyelonephritis diagnosed?

244
Q

When is imaging for acute pyelonephritis imaging done?

A

When symptoms persists

245
Q

How abnormal is a condition of acute pyelonephritis?

A

Usually normal

246
Q

With acute pyelonephritis, what would we see as signs? 4

A
  1. Loss of CM junction
  2. Renal enlargement
  3. Compression of sinus
  4. Altered echo texture
247
Q

What might we see with acute pyelonephritis on u/s?

A

Focal masses and gas

248
Q

What is chronic pyelonephritis?

A

Interstitial nephritis

249
Q

What is chronic pyelonephritis caused by?

A

Vesicoureteric reflux

250
Q

Chronic pyelonephritis affects which demographic? 2

A
  1. Starts at young age
  2. Female
251
Q

What is the sonographic appearance of chronic pyelonephritis? 4

A
  1. Cortical scarring
  2. Asymmetrical change
  3. Atrophy
  4. Dilated, blunted calyces
252
Q

Abscesses are a complication of what?

A

Pyelonephritis

253
Q

Abscesses may decompress into what?

A

Collecting system or perinephric space

254
Q

What is the process in terms of getting abscess ultrasound? 2

A
  1. CT initial screen
  2. U/S follow resolving abscess
255
Q

What does abscesses look like u/s? 5

A
  1. Solitary
  2. Round
  3. Thick wall
  4. Complex cysts
  5. Gas bubbles
256
Q

What is pyonephrosis?

A

Pus in collecting system

257
Q

How/where does pyonephrosis appear in young adults?

A

UPJ obstruction/stones

258
Q

How does pyonephrosis appear like with elderly?

A

Malignant obstruction

259
Q

What does the U/S look like with pyonephrosis? 3

A
  1. Hydroneprhosis
  2. Low level echoes
  3. Mobile debris
260
Q

What are two forms of rare pyelonephritis? 2

A
  1. Emphysematous
  2. Xanthogranulomatous
261
Q

What is emphysematous?

A

Gas forms in the parenchyma of the kidney

262
Q

What does emphysematous look like on u/s? 2

A
  1. Echogenic lines
  2. Dirty shadow
263
Q

Who is affected more often with emphysematous?

A

Diabetic older women

264
Q

What is the Preferred imaging tool for emphysematous?

A

CT evaluation

265
Q

What is Xanthogranulomatous?

A

Chronic pus forming

266
Q

What does Xanthogranulomatous look like on u/s? 3 (what might be seen in it?)

A
  1. Diffuse or focal
  2. Usually unilateral
  3. Staghorn calculi
267
Q

Who is affected by fungal infections?

A

Diabetics/ immunocompromised

268
Q

What might fungal infections be affected by?

A

Indwelling catheters

269
Q

What is the most common form of fungal infections?

A

Candida albicans

270
Q

What might fungal infection appear as?

A

Fungal balls

271
Q

What does fungal infections look like on u/s?

A

Hypoechoic parenchymal masses (Abscesses)

272
Q

What are DDXs of fungal balls? 3

A
  1. Blood clot
  2. Tumor
  3. Polyp
273
Q

What does fungal balls look like?

A

Echogenic non-shadowing mass which is mobile

274
Q

How do women contract infectious cystitis?

275
Q

How does men contract infectious cystitis? 2

A
  1. Prostatitis
  2. Bladder outlet obstruction
276
Q

What might we see with infectious cystitis? 3 (S/S)

A
  1. Mucosal edema
  2. Decreased bladder capacity
  3. Hematuria
277
Q

What is chronic cystitis?

A

Chronic inflammation

278
Q

Who is most affected by chronic cystitis?

A

Middle age women

279
Q

What are s/s of chronic cystitis ? 3

A
  1. Frequency
  2. Urgency
  3. Hematuria
280
Q

What does chronic cystitis look like on u/s? What possible appearance does it have?

A
  1. Thick walled bladder
  2. Possible TCC appearance
281
Q

What is interstitial cystitis?

A

Chronic bladder infection

282
Q

What is the etiology of interstitial cystitis?

A

Unknown cause

283
Q

What can interstitial cystitis mimic sonographically?

A

Bladder cancer

284
Q

What is neurogenic bladder?

A

Loss of voluntary control of voiding

285
Q

What might we see with neurogenic bladder? 4

A
  1. Trebeculated bladder
  2. Debris
  3. Stones
  4. Hydroneprhosis
286
Q

What is the etiology of retroperitoneal fibrosis?

A

Unknown etiology

287
Q

What might retroperitoneal fibrosis look like? What does it do? 2

A

Sheets of fibrous tissue in the retroperitoneum, which
1. Drape over great vessels
2. Surround ureters

288
Q

What is the modality of choice in terms of imaging retroperitoneal fibrosis?

289
Q

How does retroperitoneal fibrosis look like on u/s? 2

A
  1. Hypoechoic, homogenous masses
  2. Enveloped/ obstructed retroperitoneal structures
290
Q

What does BPH stand for?

A

Benign prostatic hyperplasia

291
Q

What is BPH?

A

Enlargement of the prostate

292
Q

What is the common age of occurrence for BPH?

A

Over 50 years of age

293
Q

What is the upper limits of normal for the prostate?

294
Q

What area of the prostate enlarges with BPH?

A

Transition zone which also becomes nodular

295
Q

Does s/s always correlate?

296
Q

What is the s/s of the BPH? 2

A
  1. Nocturia
  2. Difficulty voiding
297
Q

What are some features of BPH sonographically? 6

A
  1. Enlargement of the inner gland
  2. Hypoechoic inner region
  3. Calcifications
  4. Degenerative cyst s
  5. Nodules
  6. Heterogenous
298
Q

What is TURP

A

Endoscope into penile urethra and the prostrate is respected using electrocautery used to control bleeding

transurethral retrograde prostatectomy

299
Q

What is the new method of turp?

A

Laser surgery

300
Q

How is laser TURP done?

A

Tissue is not cut but heated rapidly

301
Q

Destroyed tissue with laser turn is removed how?

A

It is absorbed into the body

302
Q

What does TURP do?

A

Relives symptoms of BPH

303
Q

What is Prostatits? 2

A
  1. Inflammation of prostate and SV
  2. Organisms from lower urethra invade ducts in peripheral zone
304
Q

How many different forms of prostatitis are there?

A

Acute or chronic forms

305
Q

What is the S/S of prostatitis? 3

A
  1. Low back pain
  2. Dysuria
  3. Perineal pressure
306
Q

What do we see in lab with prostatitis?

A

Increase PSA

307
Q

What is the role of TRUS with acute prostatitis?

A

Limited role

308
Q

What do we see with acute prostatitis on u/s? 3

A
  1. Hypoecohic areas
  2. Hypervascularity
  3. Possible abscess
309
Q

What is a main symptom of acute prostatitis?

310
Q

What does chronic prostatitis look like on u/s? 5

A
  1. Focal masses
  2. Varying echogenicity
  3. Calcifications
  4. Periurethral gland irregularity
  5. Dilated SV
311
Q

What is a pleural effusion?

A

Fluid in thoracic cavity between visceral and parietal pleura

312
Q

What does transudative pleural effusion look like? And what conditions is it seen with? 2

A
  1. Anechoic fluid
  2. Seen with CHF and Cirrhosis
313
Q

How does exudative pleural effusion look like? 3

A
  1. Echogenic fluid
  2. Septations
  3. Pleural thickening
314
Q

What is exudative pleural effusions seen with? 2

A
  1. Infection
  2. Neoplasms
315
Q

What is the most frequent cause of LUQ mass?

A

Splenomegaly

316
Q

What are symptoms of Splenomegaly? 3

A
  1. LUQ fullness
  2. Pain
  3. Palpable spleen
317
Q

What are causes of Splenomegaly? 6

A
  1. Infection
  2. Inflammation
  3. Hematological disorders
  4. Neoplasia (benign and malignant)
  5. Congestion (PV thrombosis, portal hypertension)
  6. Infiltration
318
Q

What are some infection causes of Splenomegaly? 3

A
  1. Mono
  2. TB
  3. Malaria
319
Q

What is an example of inflammation causes of Splenomegaly?

A

Sarcoidosis

320
Q

What is mild to moderate Splenomegaly affected by? (Most likely) 3

A
  1. Portal hypertension
  2. Infection
  3. AIDS
321
Q

What does Marked Splenomegaly include? 2

A
  1. Leukaemia
  2. Lymphoma
322
Q

What are some complications of splenomegaly?

A

Spontaneous rupture with minimal trauma or even a cough

323
Q

What is AIDS?

A

Syndrome of opportunistic infections (those that can be eliminated in people with healthy immunity)

324
Q

AIDS is the final stage of what?

325
Q

What is seen with AIDS 5

A
  1. Moderate Splenomegaly
  2. Candida
  3. Pneumocystis carinii
  4. Kaposi’s sarcoma
  5. Lymphoma
326
Q

Is kaposi’s sarcoma seen on U/S?

327
Q

What is Kaposi’s sarcoma? 2

A
  1. Hyperechoic nodules in the liver
  2. Adrenal gland
328
Q

What is Lymphoma?

A

Hypoehcoic liver masses

329
Q

Kaposi’s gland usually affects what?

A

Adrenal gland and GI tract

330
Q

What is acute thyphlitis? 2

A
  1. Inflammation of cecum/ ascending colon
  2. Concentric uniform thickening
331
Q

What does this image represent?

A

Intussusception

332
Q

What does this image represent?

A

Acute pyelonephritis

333
Q

What does this image represent?

A

Chronic pyelonephritis

334
Q

What does this image represent?

335
Q

What does this image represent?

A

Pyonephrosis

336
Q

What does this image represent?

A

Fungal balls

337
Q

Label

338
Q

What does this image represent?

339
Q

What does this image represent?

A

Retroperitoneal fibrosis

340
Q

What does this image represent ?

A

Features of BPH

341
Q

What does this image represent?

342
Q

What does this image represent?

A

Pleural effusion

343
Q

What does this image represent?

A

Splenomegaly

DMST ABD 3 (11 decks)

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