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ARDMS Abdominal Review > Liver > Flashcards

Liver Flashcards

1
Q

What classification system divides the liver into functional segents

A

Couinaud

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2
Q

When was the couinaud classification system created

A

1957

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3
Q

The liver is divided into 3 lobes. What are they

A

1) right
2) left
3) caudate

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4
Q

What lobe of the liver is divided into anterior and posterior segments

A

Right lobe

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5
Q

What lobe of the liver is divided into medial and lateral segments

A

Left lobe

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6
Q

What is another name for the left lobe

A

quadrate lobe

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7
Q

What lobe of the liver lies on the posterior-superior surface of the liver between the IVC and medial left lobe of the liver

A

caudate lobe

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8
Q

segment 1 is called

A

caudate lobe

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9
Q

segment 2 is called

A

left lateral posterior

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10
Q

segment 3 is called

A

left lateral anterior

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11
Q

segment 4 A is called

A

left medial superior

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12
Q

segment 4 B is called

A

left medial inferior

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13
Q

segment 5 is called

A

right anterior inferior

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14
Q

segment 6 is called

A

right posterior inferior

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15
Q

segment 7 is called

A

right posterior superior

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16
Q

segment 8 is called

A

right anterior superior

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17
Q

The right lobe of the liver is supplied by the

A

right portal vein

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18
Q

the left lobe is supplied by the

A

left portal vein

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19
Q

what lobe receives branches from both the right and left portal veins

A

caudate lobe

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20
Q

What veins course between the lobes and segments

A

hepatic veins

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21
Q

intersegment is called

A

hepatic veins

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22
Q

intrasegmental is called

A

portal triad

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23
Q

The portal triad is encased by a fibrofatty sheath called

A

Glissons capsule

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24
Q

The portal triad consists of

A

1) main portal vein
2) proper hepatic artery
3) common hepatic duct

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25
Q

What fissure divides the right and left hepatic lobes by an oblique plan between the IVC and the gallbladder fossa

A

Main lobar fissure

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26
Q

Name 3 landmarks for the main lobar fissure

A

1) gallbladder
2) IVC
3) Middle hepatic vein

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27
Q

What fissure divides the right lobe into anterior and posterior segments

A

Right intersegmental fissure

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28
Q

What landmark is used for the right intersegmental fissure

A

Right hepatic vein

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29
Q

What fissure divides the left lobe into medial and lateral segments

A

Left intersegmental fissure

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30
Q

Name the 4 landmarks used for the left intersegmental fissure

A

1) left hepatic vein
2) ascending left portal vein
3) falciform ligament
4) ligamentum teres

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31
Q

What separates the left lobe from the caudate lobe and is a remnant of the ductus venosus

A

ligamentum venosum

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32
Q

This is a remnant of the umbilical vein which runs from the umbilicus to the left portal vein

A

Ligamentum teres

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33
Q

This is a remnant of the ductus venosus. it runs from the left portal vein to the IVC separating the left lobe from the caudate lobe of the liver.

A

Ligamentum venosum

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34
Q

Flow toward the liver is called (above the baseline)

A

Hepatopedal

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35
Q

Flow away from the liver is called (below the baseline)

A

Hepatofugal

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36
Q

The liver receives blood via the

A

1) hepatic artery

2) portal vein

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37
Q

How many mm is the upper limits of portal vein diameter

A

13 mm

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38
Q

The portal vein provides what % of the livers blood flow and what % of its oxygen

A

75% blood flow

60% oxygen

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39
Q

a large diameter portal vein may be seen in patients with

A

Portal hypertension

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40
Q

Hepatic vein waveforms are typically

A

Triphasic

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41
Q

What artery runs parallel to the main portal vein

A

Hepatic artery

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42
Q

Doppler waveforms of the hepatic artery demonstrates flow throughout diastole, indicating a _______ system

A

Low-resistance

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43
Q

What ligament is anterior to the ligamentum teres

A

falciform ligament

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44
Q

what ligament is peritoneal reflection or fold created by the passage of the embryonic umbilical vein from the umbilicus to the left branch of the portal vein

A

falciform ligament

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45
Q

What ligamentis a peritoneal reflection which suspends the liver from the diaphragm this ligament is also surrounded by the bare area

A

Coronary ligament

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46
Q

What ligaments are peritoneal reflections to the far right and left of the bare area

A

Right and left triangular ligament

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47
Q

Hepatomegaly is indicated with a greater than how many cm

A

15 cm

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48
Q

What is an inferior projection of the right lobe which is commonly seen in women

A

Riedel’s lobe

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49
Q

Riedel’s lobe may be mistaken for ______ when only measuring the superior-inferior dimension of the liver

A

hepatomegaly

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50
Q

What is the largest solid organ in the body

A

Liver

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51
Q

the exact weight of a normal liver varies, but usually ranges from ____g in adult women and _____ g in adult men

A 
women= 1,200 g
men= 1,600 g
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52
Q

What capsule contains blood, lymphatic vessels, and nerves and completely covers the liver

A

Glisson capsule

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53
Q

What is the area of the liver that is a small triangular area where the liver connects to the diaphragm

A

Bare area

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54
Q

clinically why is the bare area of the liver important

A

It represents an area where infection can spread from the abdominal cavity to the thoracic cavity

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55
Q

What lobe of the liver occupies the right hypochondrium

A

Right lobe

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56
Q

What is the name of the portion of the liver that is not covered by the peritoneum

a) quadrate lobe
b) intraperitoneal
c) Riedels lobe
d) bare area
e) hepatopetal

A

d) bare area

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57
Q

Which of the following is true about the extrahepatic portion of the falciform ligament

a) courses between the IVC and GB
b) is visualized when massive ascites is present
c) connects the liver to the lesser sac
d) is visualized when peritonitis is present
e) is visualized when there is recannalization of the umbilical vein

A

b) is visualized when massive ascites is present

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58
Q

the division by using Couinauds sections into right and left lobes of the liver is

a) main lobar fissure
b) ligamentum venosum
c) falciform ligament
d) hepatoduodenal ligament
e) hepatic arteries

A

a) main lobar fissure

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59
Q

In a patient with acute hepatitis, what is the appearance of the liver parenchyma sonographically

a) hypoechoic
b) echogenic
c) complex
d) normal
e) anechoic

A

d) normal

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60
Q

The ligament of venosum separates which 2 lobes of the liver

a) right and left lobes
b) medial portion of the left lobe and lateral portion of the left lobe
c) caudate lobe and left lobe of the liver
d) anterior portion of the right lobe and posterior portion of the right lobe
e) quadrate lobe and the left lobe of the liver

A

c) caudate lobe and left lobe of the liver

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61
Q

What is the most common benign neoplasm of the liver

a) hemangioma
b) angiomyolipoma
c) focal nodular hyperplasia
d) abscess
e) wilms tumor

A

a) hemangioma

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62
Q

Which of the following separates the right and left lobes of the liver

a) coronary ligament
b) main lobar fissure
c) falciform ligament
d) ligament of venosum
e) interhemispheric fissure

A

b) main lobar fissure

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63
Q

Identify the laboratory value that is specific for a hepatoma of the liver

a) alkaline phosphatase
b) alpha-fetoprotein
c) serum amylase
d) bilirubin
e) serum albumin

A

b) alpha-fetoprotein

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64
Q

Where can a patent umbilical vein be found

a) ligamentum venosum
b) main lobar fissure
c) ligamentum teres
d) intersegmental ligament
e) gallbladder fossa

A

c) ligamentum teres

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65
Q

Which of the following is not a remnant of the fetal circulation

a) ligamentum teres
b) ligamentum venosum
c) falciform ligament
d) coronary ligament

A

d) coronary ligament

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66
Q

What artery branches off the celiac axis

A

Common hepatic artery

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67
Q

Which vein is the largest of the hepatic veins

A

The right hepatic vein

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68
Q

In which of the following ways does ascites sonographically affect the liver

a) there will be no effect
b) the liver will appear more echogenic
c) the ascites will attenuate the liver, resulting in decreased echoes
d) the ascites will cause the liver to appear inhomogenous

A

b) the liver will appear more echogenic

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69
Q

All of the following are associated with cirrhosis except

a) ascites
b) splenomegaly
c) jaundice
d) hepatomegaly
e) collateral vessel development

A

d) hepatomegaly

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70
Q

Which of the following anatomical structures is not seen anterior to the IVC in the abdomen

a) main lobar fissure
b) man portal vein
c) left hepatic vein
d) caudate lobe
e) right renal artery

A

e) right renal artery

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71
Q

Sonographically, one can recognize fatty infiltration of liver by all of the following except

a) hepatomegaly
b) parenchymal echoes are echogenic
c) decreased vascular structure
d) decreased through transmission
e) a focal mass

A

e) a focal mass

72
Q

Fatty infiltration of the liver can be asses sonographically by visualizing which of the following

a) echogenic vessel walls seen throughout the liver
b) hypoechoic diaphgram
c) increased liver echogenicity
d) multiple echogenic focal masses
e) small nodular liver

A

c) increased liver echogenicity

73
Q

Which of the following terms describes a normal variant of the liver in which the right lobe of the liver extends below the lower pole of the right kidney

a) murphys lobe
b) caudate lobe
c) duplication of the right lobe
d) Riedels lobe
e) extra lobed

A

d) Riedels lobe

74
Q

A patient presents with polycystic liver disease. What other organ should also be evaluated by sonogram

a) spleen
b) pancreas
c) gallbladder
d) adrenal glands
e) kidneys

A

e) kidneys

75
Q

Identify the pre-exisiting condition that occurs in patients with hepatomas

a) hematomas
b) abscesses
c) gallstones
d) developmental cysts
e) cirrhosis

A

e) cirrhosis

76
Q

A 3 year old with a clinical history or intermittent pain, jaundice, and a palpable mass presents for an abdominal sonogram. A cystic dilatation of the CBD is seen in the liver. This is most characteristic of which of the following diagnoses?

a) biliary atresia
b) hepatitis
c) choledochal cyst
d) hypertrophy pyloric stenosis
e) normal liver findings

A

c) choledochal cyst

77
Q

What is Riedels lobe

a) enlongation of the left lobe
b) a duplication of the caudate lobe
c) tongue-like extension of the right lobe
d) a small right lobe
e) transposition of the liver lobes

A

c) tongue-like extension of the right lobe

78
Q

The MPV divides into

a) middle, left, and right branches
b) left and right branches
c) anterior and posterior branches
d) medial and lateral branches

A

b) left and right branches

79
Q

The main lobar fissure contains

a) right hepatic vein
b) middle hepatic vein
c) MPV
d) right portal vein

A

b) middle hepatic vein

80
Q

Which of the following is true concerning the portal veins

a) portal veins carry deoxygenated blood away from the liver
b) portal veins have brighter walls than hepatic veins
c) portal veins should demonstrate hepatofugal flow
d) portal veins increase in diameter as they approach the diaphragm

A

b) portal veins have brighter walls than hepatic veins

81
Q

Which fetal circulation pathway connects the left portal vein to the IVC

a) ductus arteriosus
b) ligamentum teres
c) umbilical vein
d) ductus venosus
e) ligamentum venosum

A

d) ductus venosus

82
Q

The ligamentum venosum is all of the following except

a) a remnant of the umbilical vein
b) a remnant of the ductus venosus
c) a remnant of the fetal circulation which shunts blood from the umbilical vein to the IVC bypassing the liver
d) divides the caudate lobe from the left lobe of liver

A

a) a remnant of the umbilical vein

83
Q

The caudate lobe is located on the

a) anteroinferior surface of the liver
b) anterosuperior surface of the liver
c) posteroinferior surface of the liver
d) posterosuperior surface of the liver

A

d) posterosuperior surface of the liver

84
Q

Cystic lesions within the liver include all except

a) congenital cysts
b) polycystic liver disease
c) carolis disease
d) hemangiomas

A

d) hemangiomas

85
Q

the ligametum teres

a) resides in the left intersegmental fissure
b) is a remnant of the umbilical vein
c) recannalizes in severe cirrhosis
d) is an echogenic spot on transverse liver images
e) all the above

A

e) all the above

86
Q

If a liver mass i located between the middle hepatic vein and the right portal vein, in what lobe of the liver is the mass located

a) posterior right lobe
b) caudate lobe
c) anterior right lobe
d) medial left lobe

A

c) anterior right lobe

87
Q

The medial segment of the left lobe lies between

a) the ligamentum venosum and IVC
b) the right hepatic vein and middle hepatic vein
c) the ligamentum teres and spleen
d) the middle hepatic vein and ligamentum teres

A

d) the middle hepatic vein and ligamentum teres

88
Q

What vessels drain the blood from the caudate lobe

a) left portal vein
b) emissary veins
c) umbilical vein
d) coronary vein

A

b) emissary veins

89
Q

The abdominal organ that produces the majority of alkaline phosphatase is

a) gallbladder
b) pancreas
c) spleen
d) liver

A

d) liver

90
Q

The caudate lobe lies between what 2 structures

a) IVC and medial left lobe
b) IVC and lateral left lobe
c) right and left portal veins
d) main lobar fissure and GB

A

a) IVC and medial left lobe

91
Q

Which of the following is NOT a layer of the scrotal sac

a) dartos muscle
b) tunica vaginalis
c) detrusor muscle
d) epithelial/skin

A

c) detrusor muscle

92
Q

What is the most common cause of acute liver failure in the United States

A

Overdose of acetaminophen

93
Q

What type of hepatitis is transmitted by a fecal-oral route

A

Hepatitis A

94
Q

What type of hepatitis occurs most frequently from sexual contact, blood transfusions, or sharing a contaminated needle and persists longer

A

Hepatitis B

95
Q

What type of hepatitis is usually spread through direct contact with the blood or body fluid of a person who has the disease typically from sharing needles or unprotected sex

A

Hepatitis C

96
Q

What organ is the body is the only organ that can regenerate new healthy tissue

A

Liver

97
Q

All of the following are true regarding Couinaud liver segmentation except:

a) allows for liver resection/surgery without negatively affecting other segments
b) each of the 8 segments has its own branch of the portal, hepatic vein, and bile duct
c) divides liver into 8 functional segments
d) right and left lobes are divided by the branches of the main hepatic vein

A

d) right and left lobes are divided by the branches of the main hepatic vein

98
Q

What blood vessel separates the right and left lobes of the liver

a) common hepatic artery
b) left hepatic vein
c) right portal vein
d) middle hepatic vein

A

d) middle hepatic vein

99
Q

All of the following are true regarding the ligametum teres except

a) round, hyperechoic foci near the porta hepatis
b) located in the left intersegmental fissure
c) is a remnant of the umbilical vein
d) recannalizes with cirrhosis

A

a) round, hyperechoic foci near the porta hepatis

100
Q

Which liver vessel courses within the main lobar fissure

a) main portal vein
b) common hepatic artery
c) right hepatic vein
d) middle hepatic vein

A

d) middle hepatic vein

101
Q

The right and left hepatic ducts come together to form the common hepatic duct

a) deep within the liver parenchyma
b) inside the liver near the porta hepatis
c) at the level of the ampulla of vater
d) at the pancreas head

A

b) inside the liver near the porta hepatis

102
Q

A patient presents for a liver ultrasound due to a history of advanced cirrhosis. What is the expected doppler tracing from the hepatic veins in this patient

a) triphasic with exaggerated respiratory phasicity
b) very minimal to absent flow
c) triphasic with exaggerated cardiac pulsatility
d) monophasic with minimal respiratory phasicity

A

d) monophasic with minimal respiratory phasicity

103
Q

Name 5 indications for transplantation in adults

A

a) cirrhosis due to hepatitis
b) inborn errors of metabolism
c) sclerosing in cholangitis
d) budd-chiari syndrome
e) unresectable hepatoma

104
Q

What is an indication for liver transplantation in children

A

Biliary atresia

105
Q

Postoperatively, what artery provides the only blood supply to the biliary tree

A

Hepatic artery

106
Q

Name 4 sonographic findings of portal vein thrombosis

A

a) hypoechoic thrombus within the portal vein
b) increased portal vein caliber
c) cavernous transformation
d) portal systemic collaterals

107
Q

Name 3 tumoral causes of portal vein thrombosis

A

a) hepatocellular carcinoma
b) metastatic liver disease
c) pancreatic carcinoma

108
Q

Name the 7 non-tumoral causes of portal vein thrombosis

A

a) pancreatitis
b) cirrhosis/hepatitis
c) inflammatory bowel disease
d) trauama
e) splenectomy
f) hypercoagulation
g) portal lymphadenopathy

109
Q

What are numerous wormlike venous collaterals that parallel the chronically thrombosed portal vein

A

Cavernous transformation

110
Q

What disorder is characterized by hepatic vein obstruction by thrombus or tumor

A

Budd-Chiari syndrome

111
Q

What syndrome is typically seen in young adult women taking birth control pills

A

Budd-Chiari syndrome

112
Q

A patient who has Budd-Chiari syndrome presents with

A

a) ascites
b) hepatomegaly
c) splenomegaly

113
Q

Name the 5 causes of Budd-Chiari syndrome

A

a) membranous obstruction of IVC
b) hypercoagulation
c) hepatic vein compression
d) tumor invasion
e) majority of cases are undetermined

114
Q

The _____ lob is often spared because the ____ veins drain directly into the IVC

A

caudate lobe

emissary veins

115
Q

Air within the intrahepatic portal veins describes

A

Portal vein gas

116
Q

Portal vein gas is associated with what 2 types of ischemic bowel diease

A

a) ulcerative colitis

b) Crohns disease

117
Q

In infants, intrahepatic portal vein gas is due to

A

Necrotizing entercolits

118
Q

What type of cyst is defined as a fluid filled space lined by biliary epithelium

A

Liver cyst

119
Q

If a liver cyst is seen at an earlier stage what organ should be evaluated

A

Kidneys are autosomal dominant PKD

120
Q

Differential diagnosis of liver cysts include

A

a) simple cyst
b) polycystic liver disease
c) hydatid cyst
d) cystic tumors
e) abscess

121
Q

What type of cyst will appear as a cyst with internal echoes accompanied by pain and a decreasing hematocrit

A

Hemorrhagic cyst

122
Q

What is the most common benign tumor of the liver

A

Cavernous Hemangioma

123
Q

What are the sonographic findings of cavernous hemangiomas

A

a) hyperechioc

b) posterior enhancement

124
Q

What is a benign solid liver mass that is believed to be a developmental hyperplastic lesion related to an area of congenital vascular malformation

A

Focal Nodular Hyperplasia

125
Q

Name the sonographic findings of focal nodular hyperplasia

A

a) solid mass
b) central fibrous scar
c) stellate vascularity

126
Q

What is a solid liver mass that is associated with the use of oral contraseptive agents

A

Hepatic adenoma

127
Q

A patient that has a hepatic adenoma may present with pain due to a

A

tumor hemorrhage

128
Q

hepatic adenoma is associated with

A

glycogen storage disease

129
Q

sonographic findings of hepatic adenoma include

A

a) nonspecific echogenicity
b) cystic component with hemorrhage
c) intraperitoneal blood

130
Q

What type of lipoma is an extremely rare fatty tumor

A

Hepatic lipoma

131
Q

What is associated with hepatic lipomas and angiomyolipomas

A

tuberous sclerosis

132
Q

sonographic findings of hepatic lipomas include

A

a) hyperechoic mass

b) propagation speed artifact

133
Q

Name 4 types of hyperechoic hepatic masses

A

a) hepatic lipoma
b) hemangioma
c) echogenic metasis
d) focal fatty infiltration

134
Q

What is the most common primary malignancy of the liver

A

Hepatocellular carcinoma

135
Q

etiologic factors of hepatocellular carcinoma include

A

a) alcoholic cirrhosis

b) hepatitis B and C

136
Q

Hepatocellular carcinomas commonly invade what venous structures

A

a) portal veins

b) hepatic veins

137
Q

sonographic findings of hepatocellular carcinoma include

A

a) variable appearance

b) most are hypoechoic

138
Q

hepatocellular carcinoma are associated with an increase of

A

a) Alpha fetoprotein *
b) AST
c) ALT
d) alkaline phosphatase

139
Q

What are the most commonly encountered solid masses of the liver

A

metastatic disease

140
Q

The most common source of metastatic involvement of metastatic disease is from

A

a) gastrointestinal
b) breast cancer
c) lung cancer

141
Q

Name 6 sonographic appearances of metastatic disease

A

a) hyperechoic metastases- gastrointestinal tract
b) hypoechoic metastases- lymphoma
c) bulls eye or target metastases- lung cancer
d) calcified metastases-mucinous adenocarcinoma
e) cystic metastases- sarcoma
f) diffuse metastases

142
Q

what is the most common malignant liver tumor in early childhood

A

Hepatoblastoma

143
Q

Hepatoblastoma is associated with what 2 genetic conditions

A

a) beckwith-wiedemann syndrome

b) familial adenomatous polyposis

144
Q

hepatoblastoma has increased levels of what

A

AFP (serum alpha fetoprotein)

145
Q

Hepatoblasoma is associated with

A

a) lung metastases

b) portal vein invasion

146
Q

Periportal cuffing is a sign of

a) caroli disease
b) hepatitis
c) intrahepatic biliary tree obstruction
d) extrahepatic biliary tree obstruction

A

b) hepatitis

147
Q

Cirrhosis causes reduced serum albumin levels. what complication does this cause

a) ascites and peripheral edema
b) jaundice
c) recanalization of the umbilical vein
d) increased ammonia production

A

a) ascites and peripheral edema

148
Q

A patient presents with a history of AIDS and recent pneumocystis carinni infection. What changes to the liver do you expect to see on an ultrasound exam

a) gas producing abscess near the porta hepatis
b) diffuse echogenic foci throughout the liver tissue
c) diffuse increase in liver tissue echogenicity with ascites
d) formation of multiple abscess within the liver tissue

A

b) diffuse echogenic foci throughout the liver tissue

149
Q

A TIPS shunt is placed into the liver circulation to alleviate portal HTN. What 2 vessels are usually connected?

a) hepatic artery connects to the portal vein
b) right portal vein connects to the left portal vein
c) portal vein connects to the right hepatic vein
d) right hepatic vein connects to the left hepatic vein

A

c) portal vein connects to the right hepatic vein

150
Q

A new liver mass in a patient with sclerosing cholangitis should cause suspicion of

a) the development of cholangiocarcinoma
b) portal HTN
c) the development of schistosomiasis
d) a peribilliary peak

A

a) the development of cholangiocarcinoma

151
Q

A pyogenic abscess in the liver has been associated with all of the following except:

a) osteomyelitis
b) diverticulitis
c) cholangits
d) sickle cell anemia

A

d) sickle cell anemia

152
Q

Children with Beckwith-Wiedemann syndrome have a significant risk of developing

a) portal HTN
b) nephroblastoma
c) cholelithaisis
d) hyperparathyroidism

A

b) nephroblastoma

153
Q

What is another name for glycogen storage disease

A

Von Gierke Disease

154
Q

A 55 year old male presents with a history of Budd-Chiari syndrome. What vessels should be evaluated with Doppler on this exam?

a) hepatic arteries
b) hepatic veins
c) renal veins
d) aorta

A

b) hepatic veins

155
Q

What is the most common primary malignancy of the retroperitoneum

A

Liposarcoma

156
Q

The main lobar fissure:

a) separates the anterior and posterior right lobes
b) seperates the IVC and medial left lobe
c) seperates anterior right lobe and medial left lobe
d) separates the medial and lateral left lobes

A

c) seperates anterior right lobe and medial left lobe

157
Q

The_______ lobe of the liver is located between the right and middle hepatic vein

a) medial left
b) caudate
c) lateral left
d) anterior right

A

d) anterior right

158
Q

The______ is located within the inferior margin of the falciform liagment

a) ligamentum teres
b) middle hepatic vein
c) ligamentum venosum
d) left hepatic vein

A

a) ligamentum teres

159
Q

Which lobe of the liver receives blood from the left and right portal veins

a) anterior right lobe
b) medial left lobe
c) posterior right lobe
d) caudate lobe

A

d) caudate lobe

160
Q

All of the following are intrasegmental vessels of the liver except

a) portal veins
b) hepatic arteries
c) bile ducts
d) hepatic veins

A

d) hepatic veins

161
Q

The right and left hepatic ducts come together to form the common hepatic duct

a) deep within the liver parenchyma
b) at the level of the Ampulla of vater
c) inside the liver, near the porta hepatis
d) at the pancreas head

A

c) inside the liver, near the porta hepatis

162
Q

All of the following are true regarding the ligamentum teres, except

a) recanalizes with cirrhosis
b) located in the left intersegmental fissure
c) round, hyperechoic foci near the porta hepatis
d) is a remnant of the umbilical vein

A

c) round, hyperechoic foci near the porta hepatis

163
Q

Which liver vessel courses within the main lobar fissure?

a) middle hepatic vein
b) right hepatic vein
c) common hepatic artery
d) main portal vein

A

a) middle hepatic vein

164
Q

The caudate lobe occupies much of the_____ surface of the liver

a) anterior superior
b) anterior inferior
c) posterior superior
d) posterior inferior

A

c) posterior superior

165
Q

The liver’s exocrine function includes producing

a) bile
b) heparin
c) hemoglobin
d) urea

A

a) bile

166
Q

The ligamentum venosum travels between

a) caudate lobe and right lobe
b) the left portal vein and the IVC
c) the main portal vein and the IVC
d) the right portal vein and the IVC

A

b) the left portal vein and the IVC

167
Q

A 6 month old female is referred for an abdominal ultrasound due to suspected Kasabach-Merritt syndrome. What are you looking for on the exam?

a) ascites, pleural effusion and abscess formation in the abdominal wall
b) pancreatic divisum
c) liver or spleen hemangioma formation
d) absence of the biliary tree

A

c) liver or spleen hemangioma formation

168
Q

Liver elastography is used for

a) staging of primary malignancy
b) staging of fibrosis
c) staging of secondary malignancy
d) staging of steatosis

A

b) staging of fibrosis

169
Q

Liver transplant evaluation requires PW Doppler evaluation of all of the following except:

a) portal anastomosis
b) biliary anastomosis
c) IVC anastomosis
d) hepatic arterial anastomosis

A

b) biliary anastomosis

170
Q

Which of the following is a contraindication to placement of a TIPS shunt

a) portal thrombosis
b) cirrhosis
c) hepatocellular carcinoma
d) hepatic artery aneurysm

A

a) portal thrombosis

171
Q

While scanning the liver in a patient with chronic cirrhosis, you notice a tubular vessel connecting to the left portal vein and exiting the liver coursing inferiorly. Flow within the vessel is very low velocity, continuous and moving in a caudal direction. Which of the following explains the ultrasound finding?

a) a dilated coronary vein is present which is a common complication of cirrhosis
b) A dilated SMV is present with flow reversal which is a common complication of cirrhosis
c) A dilated umbilical vein is present which is a common complication of cirrhosis
d) The ductus venosus is dilated with antegrade flow which is a common complication of cirrhosis

A

c) A dilated umbilical vein is present which is a common complication of cirrhosis

172
Q

The most common finding with congestive hepatomegaly is

a) portal vein aneurysm
b) AAA
c) liver atrophy
d) IVC dilatation

A

d) IVC dilatation

173
Q

Which of the following is caused by drinking water contaminated with protozoan parasites and is most found in countries outside the US

a) schistosomiasis
b) amebic abscess
c) pyogenic abscess
d) candidasis

A

b) amebic abscess

174
Q

A patient presents with a history of RUQ pain. He currently uses anabolic steroids. The exam demonstrates multiple irregular anechoic areas throughout the liver parenchyma. No internal flow is documented in these areas on color Doppler evaluation. These findings are most suggestive of

a) hepatocellular carcinoma
b) Budd Chiari syndrome
c) pellosis hepatis
d) metastatic liver disease from colon primary

A

c) pellosis hepatis

175
Q

Which of the following describes the most common sonographic appearance of a hepatoma

a) solid mass that may be more or less echogenic than liver parenchyma
b) usually causes multiple diffuse solid mass formation
c) most commonly demonstrates diffuse coarse liver texture in the affected lobe
d) echogenic mass with a central scar

A

a) solid mass that may be more or less echogenic than liver parenchyma

176
Q

Which of the following terms can be used to describe the normal flow in the portal vein

a) continuous
b) pulsatile
c) biphasic
d) hepatofugal

A

a) continuous

177
Q

Which of the following is a potential collateral pathway formed in patients with cirrhosis

a) blood moves from the emissary veins to the umbilical vein
b) blood moves form the superior rectal vein to the middle rectal vein
c) blood moves from the gastric vein to the splenic vein
d) blood moves from the splenic vein to the coronary vein

A

b) blood moves form the superior rectal vein to the middle rectal vein

ARDMS Abdominal Review (14 decks)

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