Lesson 1.1 - Benign Tumours

Question 1

What structure separates the medial and lateral left lobe?

Answer 1

left intersegmental fissure

Question 2

What structures lie within the left intersegmental fissure? (3)

Answer 2

Superior - LHV
Middle - Ascending LPV
Inferior - ligamentum teres

Question 3

Abnormal right lobe liver size is usually

Answer 3

Above 14 cm but compare to right kidney.

A normal liver can be larger depending on body habitus

Question 4

Portal venous normal blood flow

Answer 4

Hepatopetal direction

Question 5

Hepatic vein normal blood flow (4)

Answer 5

Phasic
Pulsatile (due to prox to heart)
W shape
Hepatofugal direction

Question 6

Hepatic artery flow resistance (high/low) and direction

Answer 6

Low resistant and hepatopetal flow

Question 7

MPV should not exceed how many mm in AP diameter

Answer 7

13 mm

Question 8

Liver normal variants (4)

Answer 8

Diaphragmatic slips
Reidels lobe
Papillary Process Caudate
Long left lobe

Question 9

What is the cause of pseudomass on liver sonography

Answer 9

diaphragmatic slips

Question 10

T/F diaphragmatic slip appearance changes with respiration

Answer 10

yes

Question 11

Location of reidels lobe

Answer 11

Right lobe - will measure large

Question 12

Artifact while scanning liver

Answer 12

mirror image - caused by diaphragm

Question 13

Which LFT enzyme is a nonspecific marker for malignancy

Answer 13

alpha-fetoprotein (AFP)

Question 14

An increase in which LFT enzyme is associated with obstructive jaundice

Answer 14

alkaline phos

ALP

Question 15

ALP is excreted through

Answer 15

the bile ducts

Question 16

Elevated alanine aminotransferase (ALT) is associated with

Answer 16

cirrhosis
hepatitis
bililary obstruction

Question 17

An enzyme present in many kinds of tissue that is released when cells are injured or damaged - levels proportional to amt of damage

Answer 17

Aspartate aminotransferase (AST)

Question 18

Elevated aspartate aminotransferase (AST) associated with (3)

Answer 18

cirrhosis
hepatitis
mononucleosis

Question 19

What LFT enzyme is used to diagnose liver disease before jaundice occurs

Answer 19

AST

Question 20

A patient has cirrhosis. what lab test markers would you expect to see elevated?

Answer 20

AST
ALT
Prothrombin
Bilirubin

Question 21

T/F

AST remains elevated longer than ALT

Answer 21

false

Question 22

Prothrombin time (clotting) depends on the amount of

Answer 22

vitiman K

Question 23

Prothrombin time elevation associated with (4)

Answer 23

Cirrhosis
Malignancy
Malabsorp. of vitiman k
Clotting failure

Question 24

A patient has hepatitis. which LFT enzyme would you expect to see elevated? (3)

Answer 24

ALT
AST
Bilirubin

Question 25

Decrease in prothrombin time associated with (5)

Answer 25

``` Biliary fistula Biliary duct injury Biliary obstruction GB carcinoma Cholecystitis ```

Question 26

Leukocytosis

Answer 26

WBC above normal range

Question 27

What is leukocytosis a sign of? (2)

Answer 27

Inflammatory or infection response (including parasitic)

Question 28

A decrease in serum albumin suggests

Answer 28

A decrease in protein synthesis

Question 29

What is bilirubin

Answer 29

A product from the breakdown of hemoglobin in old RBC -

Question 30

Elevation of direct or conjugated bilirubin is associated with (5)

Answer 30

obstruction hepatatitis cirrhosis liver mets

Question 31

Elevation of indirect or unconjugated bilirubin is associated with

Answer 31

non-obstructive conditions ie steatosis (fatty liver)

Question 32

What are 6 indications for a liver US

Answer 32

``` Abnormal LFTs Hepatocellular disease Biliary disease Pain - abdo/post prandial Palpable liver/spleen Pancreatitis ```

Question 33

Liver pathology causes (5)

Answer 33

``` Congenital abnormalities Infectious disease Parasitic Metabolism disorder Vascular abnormalities ```

Question 34

Congenital anomalies of liver (4)

Answer 34

Agenesis Partial agenesis Position: Situs inversus totalis Congenital diaphragmatic hernia (liver into thorax) Omphalocele (liver outside body)