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Generalist Exam Questions > Liver > Flashcards

Liver Flashcards

1
Q

In what plane is the liver typically measured and what measurement is considered hepatomegaly?

A

SAG plane
> 16

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2
Q

What is the name of the capsule that covers the liver?

A

Glissons

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3
Q

What is the potential space between the liver and right kidney?

A

Morrisons

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4
Q

What is the fibrous cord resulting from the obliterated left umbilical vein?

A

Ligamentum Teres

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5
Q

What ligament separates RT and LT lobes?

A

Falciform

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6
Q

What vessels are intersegmental and intrasegmental?

A

Inter = between = Hepatic V

Intra = within = PV, Hepatic Artery, Bile duct

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7
Q

What lobes does the ligamentum venosum separate?

A

Lt lobe and caudate lobe

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8
Q

The hepatic artery branches off what?

A

CT

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9
Q

What measurement constitutes intrahepatic duct dilation?

A

> 2mm

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10
Q

What LFT is the most indicative of alcoholism?

A

GGT

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11
Q

What causes increase in AFP in adults and paediatrics?

A

Adults = HCC
Pediatrics = Hepatoblastoma

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12
Q

HCC is associated with what kind of cirrhosis?

A) Micronodular
B) Chronic
C) Macronodular
D) Acture

A

Macrodnodular

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13
Q

What type of hepatitis is contracted via the fecal-oral route?

A

Hep A

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14
Q

What type of hepatitis is contracted via contaminated drinking water?

A

Hep E

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15
Q

What type of hepatitis is contracted via mother/infant route?

A

Hep B

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16
Q

What pathology is seen with the “starry sky” sign and GB wall thickening?

A

Acute Hepatitis

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17
Q

What is the m/c type of glycogen storage disease?

A

Von Gierk’s

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18
Q

What kind of solid liver masses may be seen with glycogen storage disease?

A) Adenoma
B) Lipoma
C) Angiomyoma
D) Sarcoma

A

Adenoma - hyperechoic with hypoechoic halo

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19
Q

What is Budd Chiari?

A

Occlusion of some or all HV’s and IVC

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20
Q

Budd Chiari triad?

A

Hepatomegaly
Ascites
Abdominal pain

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21
Q

Sonographic features on the screen show cavernous transformation in portal vein and a dilated SMV and SV, what is the possible diagnosis?

A

Portal venous thrombosis

22
Q

Caput Medusa sign is seen in what pathology?

A

PV hypertension - severe cases seen around umbilicus

23
Q

What is the most common cause of intra-hepatic portal hypertension?

A

Cirrhosis

24
Q

SF = comma-shaped portal trunk, increased periportal echogenicity, dilated SMV & SV, ascites, splenomegaly. What is the most likely diagnosis?

A

PV hypertension

25
Q

What does TIPS stand for and what is the vessel connection?

A

Transjugular Intrahepatic Portosystemic Shunt - connects PV and HV

26
Q

Congenital liver cysts most commonly affect what side?

A

RT

27
Q

With polycystic liver disease, what other organs should be assessed? (3)

A

Kidneys, pancreas, spleen - most commonly detected in 30’s and 40’s and most common in women

28
Q

What are the stages of a clot?

A

Freshly echogenic, then will become complex, then will become anechoic (seroma)

29
Q

What pathology is known as a cluster of tubular-appearing cysts that parallel the bile ducts and PV’s in the center of the liver?

A

Peribiliary cysts

30
Q

SF of pyogenic abscess?

A

Hypoechoic
Homogenous
Round or ovoid

31
Q

What kind of hepatic infection causes black tarry stools?

A) Pyogenic abscess
B) Amebic Abscess
C) Schistosomiasis
D) Hydatid disease

A

Amebic

32
Q

What abnormality has a “clay pipe stem” appearance and echogenic thickened PV walls?

A) Pyogenic abscess
B) Amebic Abscess
C) Schistosomiasis
D) Hydatid disease

A

Schistosomiasis

33
Q

What abnormality has a “water lily sign”

A) Pyogenic abscess
B) Amebic Abscess
C) Schistosomiasis
D) Hydatid disease

A

Hydatid - patient may experience anaphylactic shock

34
Q

What pathology consists of numerous tiny bright reflective parenchymal echoes (“starry sky” pattern), may find multi-organ calcification?

A

HIV/AIDS and hepatitis

35
Q

What kind of liver lesion contains a “wheel within a wheel” sign?

A

Fungal

36
Q

Patient presents with no symptoms. You see an isoechoic lesion with a central stellate scar that is 3cm. The patient currently uses OCP. What may be this pathology?

A

FNH

37
Q

What liver lesion is associated with long term OCP use but can go away with cessation of OCP and has malignant potential?

A

Liver adenoma

38
Q

SF of liver adenoma?

A

Hyperechoic with hypoechoic halo - has peripheral and central vascularity

39
Q

What two pathologies are linked to hepatic AML’s?

A

Tuberous sclerosis and renal AML’s

40
Q

What is typical of a patient to have when HCC is diagnosed?

A

Cirrhosis

41
Q

What is the m/c liver malignancy?

A

Hepatoma / HCC - most commonly occurs in men in 6th decade - Increased AFP!

42
Q

SF of HCC?

A

Can vary but in cirrhotic livers, it is hypoechoic and has chaotic vascularity.

Will invade PV in 60% of cases and HV in 15%

43
Q

What are hemangiosarcomas and angiosarcomas usually associated with?

A

Carcinogens - aggressive tumor and typically present in 60-80’s

44
Q

What is the M/C source of mets in the liver?

A

Colon

45
Q

Where do METS come from based on the SF in liver?

Hyperechoic
Cystic
Hypoechoic
Target/bulls eye
Calcified

A

1) RCC, colon, neuroendocrine
2) leiomyosarcomas, ovarian cancer
3) Lymphoma
4) Lung
5) Colon, stomach, ovary, breast

46
Q

Which of the following is seen in patients with late stage cirrhosis?

A) Less sound attenuation
B) Caudate lobe atrophy
C) Hepatofugal flow in the PV
D) Shrunken, strophic spleen

A

Hepatofugal flow in PV

47
Q

What is the obliterated fetal remnant of the left umbilical vein known as and where on ultrasound can it be seen?

A

Ligamentum teres - lower left segment continuous with the falciform ligament

48
Q

What separates the left lobe from the caudate lobe?

A

Ligamentum venosum - remnant of ductus venosus

49
Q

What fissure separates the left lobe into medial and lateral?

A) Ligamentum venosum
B) Ligamentum teres
C) Falciform ligament
D) Main lobar fissure

A

Ligamentum teres in TRV plane

50
Q

What vessel courses within the MLF?

A) Rt HV
B) Main PV
C) Lt HV
D) Middle HV

A

Middle hepatic V

Generalist Exam Questions (21 decks)

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