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Abdominal Pathology > Lesson 1B (Part 2) > Flashcards

Lesson 1B (Part 2) Flashcards

1
Q

What are the 3 characterizations of steatosis?

A
  1. Mild
  2. Moderate
  3. Severe
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2
Q

Mild steatosis

A

Minimal diffuse increase in hepatic echogenicity

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3
Q

Moderate steatosis (2)

A
  1. Moderate diffuse increase in hepatic echogenicity

2. Slightly impaired visualization of intrahepatic vessels and diaphragm

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4
Q

Severe steatosis (4)

A
  1. Marked increase in echogenicity
  2. Poor penetration of posterior liver
  3. Poor or no visualization of hepatic vessels and diaphragm
  4. Hepatomegaly often present
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5
Q

What are some sonographic appearances of fatty liver? (3)

A
  1. Focal Fatty Infilitration
  2. Fatty Sparing
  3. Focal Fat
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6
Q

Focal fallt infiltration

A

Regions of increased echogenicity are present within a background of normal liver
- can mimic a MASS

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7
Q

Fatty sparing

A

Islands of normal liver parenchyma appear as hypoechoic masses within a dense fatty infiltrated liver “no mass effect”
- most of the liver is fat with little bits of normal liver

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8
Q

What are the sonographic features of steatosis? (4)

A
  1. Rapid change in time in both appearance and resolution
    - 6 days
  2. NO Mass Effect
  3. No liver contour abnormality
  4. Focal fat may appear rounded, nodular, or interspersed with normal tissue
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9
Q

What is the preferred site for focal fat in steatosis?

A

Anterior to the portal vein at the porta hepatis

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10
Q

Where is the preferred site for focal fatty sparing or infiltration?

A

Anterior to the portal vein at the porta hepatis, gallbladder fossa, and liver margins

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11
Q

When does glycogen storage disease occur?

A

During neonatal period

- large amounts of glycogen are deposited in the liver and kidneys

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12
Q

How do glycogen storage diseases appear?

A

Indistinguishable from diffuse fatty infiltration

- need to remember different age group

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13
Q

Cirrhosis

A

Diffuse process characterized by fibrosis and the conversion of normal liver architecture into structurally abnormal nodules
- coarse texture

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14
Q

What are 3 major pathological mechanisms that combine to create cirrhosis?

A
  1. Cell death
  2. Fibrosis
  3. Regeneration
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15
Q

What is the most common cause of micronodular form?

A

Alcohol consumption

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16
Q

What is the most frequent cause of macronodular?

A

Chronic viral hepatitis

17
Q

Is cirrhosis usually acute or chronic?

A

Chronic

18
Q

What is the most common cause of portal hypertension?

A

Cirrhosis

19
Q

What are 3 clinical presentations of cirrhosis?

A
  1. Hepatomegaly
  2. Jaundice
  3. Ascites
20
Q

What are 4 other causes of cirrhosis?

A
  1. Biliary cirrhosis
  2. Wilsons disease
  3. Primary sclerosing cholangitis
  4. Hemochromatosis
21
Q

What is the sonographic appearance of cirrhosis? (5)

A
  1. Volume redistribution
    - enlarged/irregular contour (early)
    - small (advanced)
  2. Coarse echotexture
  3. Nodular surface
    - ascites
  4. Nodules (colour doppler)
    - regenerative and dysplastic
  5. Portal hypertension
    - ascites, splenomegaly and varices
22
Q

NASH

A

Nonalcoholic steatohepatitis

23
Q

What is nonalcoholic steatohepatitis commonly known as?

A

Silent liver disease

- resembles alcoholic liver disease, but occurs in people who drink little or no alcohol

24
Q

What is the major feature of NASH? (3)

A
  1. Fat in the liver
  2. Inflammation
  3. Damage
25
Q

What can NASH lead to?

A

Cirrhosis

26
Q

What is NASH related to?

A

Obesity

- can lead to diabetes and high blood cholesterol, which can further complicate the health of someone with NASH

27
Q

What are signs and symptoms of NASH? (4)

A
  1. Fatigue
  2. Weight loss
  3. Weakness
    - may begin once the disease is advanced or cirrhosis is present
  4. Increased LFTs
28
Q

What is the treatment for NASH? (2)

A
  1. Reduce weight
    - eat a balanced diet
    - engage in physical activity
    - avoid alcohol and unnecessary medications
  2. Liver transplant may be necessary if cirrhosis ensues
29
Q

What is the sonographic appearance of NASH? (2)

A
  1. Dense fatty infiltration

2. Cirrhosis

Abdominal Pathology (49 decks)

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