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Abdomen Registry > Liver > Flashcards

Liver Flashcards

1
Q

AFP is a tumor marker for what?

A

hepatocellular carcinoma, germ cell tumors, and testicular cancer

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2
Q

CA 19-9 is a marker for what?

A

pancreatic cancer, cholangiocarcinoma, GI cancer, lung cancer, colorectal cancer

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3
Q

beta HCG is a marker for what tumor?

A

germ cell tumor, or testicular tumor

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4
Q

CEA- carcinoembryonic antigen is a marker for what tumor?

A

colorectal, bile duct, breast, GI, esophageal, lung, thyroid, bladder, uterine

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5
Q

PSA is what?

A

prostate specific antigen which is a marker for prostate cancer

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6
Q

what is monitored prior to an invasive procedure to insure proper clotting?

A

PT (INR), PTT and platelets

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7
Q

what is AFP?

A

alpha fetoprotein. this is a marker for liver and gonadal tumors. it is a protein synthesized by the fetal liver and levels decrease during the first year of life.

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8
Q

elevated AFP is what?

A

HCC ( hepatoma), germ cell tumors, METS to liver, hepatoblastoma

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9
Q

high levels of hCG over 500 is an indicator for what?

A

HCC

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10
Q

what is low platelet concentration?

A

thrombocytopenia. this is due to decreased production or increased destruction.

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11
Q

what is elevated platelet concentration?

A

thrombocytosis- either congenital, reactive, or due to unregulated production.

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12
Q

what is the INR in absence of anticoagulation therapy?

A

0.8-1.2

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13
Q

what is the target range for INR in anticoagulant use?

A

2-3

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14
Q

what monitors for heparin?

A

PTT- partial thromboplastin time

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15
Q

what characterizes blood coagulation?

A

PTT

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16
Q

what helps to diagnose the cause of unexplained bleeding or inappropriate blood clots?

A

PT

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17
Q

what enzymes does the liver use to metabolize amino acids and make proteins?

A

aminotransferase. aka transaminases.

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18
Q

when the liver cells are damage what do they spill into the blood stream?

A

enzymes AST and ALT

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19
Q

what could cause elevation in liver enzymes?

A

fatty liver, medication and herbs, alcohol, heart failure, hep ABC, autoimmune hepatitis, or inherited disorder like Wilsons.

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20
Q

what is also known as SGOT?

A

AST- aspartate aminotransferase.

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21
Q

what lab value is specific to myocardial infarction?

A

increase in AST without ALT.

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22
Q

elevated AST is _______ for liver disease.

A

non specific

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23
Q

what is elevated in almost all hepatocellular diseases?

A

AST

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24
Q

what causes the highest elevations of AST?

A

viral hepatitis.

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25
Q

what is also known as SGPT

A

ALT alanine aminotransferase

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26
Q

ALT is more _______ than AST.

A

specific for liver disease. this is because of the high concentration in liver tissue.

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27
Q

what is present in hepatocytes and bile duct epithelium?

A

GGT- gamma glutamyl transpeptidase

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28
Q

an elevation in GGT can indicate?

A

hepatocellular disease and biliary obstruction.

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29
Q

increased GGT and ALP =

A

biliary obstruction

30
Q

increased GGT with ALT=

A

hepatocellular disease

31
Q

what is LDH?

A

lactic dehydrogenase. this is a tumor marker for testicular cancer. it is widely distributed throughout the body. individual isoenzyme evaluation can indicate specific organ or tissue damage.

32
Q

what is an uncommon malignant liver neoplasm occurring in infants and children?

A

hepatoblastoma- this typically happens prior to two years of age.

33
Q

hepatoblastoma is associated with?

A

beckwith Wiedmann, lung mets, portal vein invasion, and elevated AFP

34
Q

what are the common sonographic patterns of METS?

A

hyperechoic= GI, hypoechoic = lymphoma, bulls eye= lung, calcified= mucinous adenocarcinoma of colon, cystic= leiomyosarcoma

35
Q

what causes hypoxia and necrosis at the center of METS lesion?

A

large METS outgrowing their own blood supply

36
Q

what allows malignant cells to be trapped in the space of Disse?

A

the fenestrations in the sinusoidal epithelium

37
Q

what is the most common primary malignant tumor of the liver?

A

HCC- aka hepatoma. this occurs predominantly in patients with underlying chronic liver disease and cirrhosis( occurring in 10-25% of patients)

38
Q

HCC is associated with….

A

elevated AFP, AST, and ALT

39
Q

what is associated with hepatic lipomas and angiomiolipomas?

A

tuberous sclerosis

40
Q

describe a hepatic lipoma sonographically.

A

hyperechoic, with propagation speed artifact. this is due to slower speed in fat.

41
Q

what is the propagation speed artifact?

A

decreased speed of sound in fat- 1450 m/s- results in a prolonged return time making objects posterior to a fatty mass further away. it will look misplaced.

42
Q

what is the most common hyperechoic hepatic mass? what are other hyperechoic hepatic masses?

A

most common= hemangioma, also lipoma, echogenic METS, and focal fatty infiltration

43
Q

what is known as a miss arrangement of tissue?

A

FNH- developmental hyperplastic lesion rather than a true neoplasm

44
Q

describe FNH sonographically

A

solid, typically solitary mass, typically with a central fibrous scar and stellate vascularity.

45
Q

what is the stealth lesion?

A

FNH with echogenicity equal to surrounding liver parenchyma.

46
Q

what is specific in diagnosing FNH?

A

MRI and contrast enhanced ultrasound

47
Q

what hepatic mass is associated with the use of oral contraceptives?

A

hepatic adenoma- they have the potential to be malignant

48
Q

hepatic adenomas are associated with what?

A

glycogen storage disease and pain due to tumor hemorrhage

49
Q

what is the most common benign tumor of the liver?

A

cavernous hemangioma

50
Q

why would a CAV. hemangioma enlarge?

A

pregnancy or estrogen use

51
Q

cavernous hemangiomas appear?

A

hyperechoic with posterior enhancement. this can cause slice thickness artifact

52
Q

what will appear as a cyst with internal echoes accompanied by RUQ pain and decreasing hematocrit?

A

hemorrhagic cyst

53
Q

liver cysts happen at what age

A

5th decade, if seen earlier is associated with ADPKD

54
Q

what happens to the caudate lobe in the event of Budd chiari?

A

it enlarges while the right and left lobes atrophy. the enlarged caudate can compress the IVC. the caudate love in unaffected because the emissary veins drain directly into the IVC

55
Q

what causes budd chiari?

A

it is frequently idiopathic. it can also be congenital, caused by hypercoagulable states, infections, pregnancy, or tumors.

56
Q

a patient comes in with ascites, hepatomegaly, and splenomegaly. what are the possible diagnosis?

A

Portal HTN, and Budd chiari

57
Q

what is associated with air being noted in the intrahepatic portal veins and a high mortality rate?

A

portal vein gas. aka pneumatosis intestinalis

58
Q

what is a cause of intrahepatic PV gas in infants?

A

necrotizing entercolitis

59
Q

what is the major cause of portal HTN?

A

cirrhosis

60
Q

PV diameter exceeding 13 mm indicates what?

A

portal HTN

61
Q

increased pressure in the portal venous system in known as what?

A

portal HTN

62
Q

what are the four types of portal HTN?

A

extraheptaic peresinusoidal- PV thrombosis, intrahepatic presinusoidal- schistomiasis, intrahepatic- cirrhosis, and intrahepatic postsinusoidal- HV thrombosis.

63
Q

what is the most common type of portal HTN?

A

intrahepatic- cirrhosis.

64
Q

what can be done to lower portal pressure?

A

Portacaval shunt, splenorenal/ linton shunt, distal splenorenal/ warren shunt, and TIPS.

65
Q

what are the portal systemic collaterals?

A

gastroesophogeal varices, recanalized umbilical vein, splenorenal varices, intestinal varices, and rectal varices

66
Q

what is the term used to describe tortuous collaterals around umbilicus?

A

caput medusa.

67
Q

what is the function of portal systemic collaterals?

A

to connect the portal system to the IVC, bypassing the liver.

68
Q

the left gastric vein drains into what?

A

portal vein

69
Q

what is the re opening of the umbilical vein aka ligumentum teres?

A

recanalized umbilical vein. this is a collateral from the left PV to epigastric veins to IVC

70
Q

the left gastric vein is also known as what?

A

the coronary vein

71
Q

how does the left gastric vein communicate with the lower esophageal veins?

A

several anastomotic channels.

72
Q

rectal varices are also known as what?

A

hemorrhoids.

Abdomen Registry (3 decks)

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