Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

*Ultrasound* > Liver Abnormalities > Flashcards

Liver Abnormalities Flashcards

1
Q

_____ of the liver is incompatible with life (not having one).

A

Agenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Often, with agenesis of the RLL, the _____ lobe is also absent.

A

caudate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T or F? With agenesis, compensatory hypertrophy of the remaining lobes normally occurs and the LFTs are normal.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

This position abnormality is when the liver is found in the left hypochondrium.

A

situs inversus totalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In congenital diaphragmatic hernias or omphalocele, varying amounts of liver may herniate into the _____ or outside the _____ cavity.

A

thorax

abdominal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If someone has kidney cysts, they probably have _____ cysts too.

A

liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T or F? Kidney cysts are more common than liver cysts.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Liver cysts occurrence increases past the age of _____.

A

80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Benign hepatic cysts are _____ (echogenicity) with well-demarcated _____ (thickness) walls and posterior acoustic enhancement.

A

anechoic

thin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Is active intervention of cysts recommended in patients without symptoms?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Occasionally, the patient may develop pain and fever secondary to cyst hemorrhage or infection. In this case, the cyst may contain internal _____ and _____, a _____ wall, or may appear _____ .

A

echoes
septations
thickened
solid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

T or F? Cyst ablation with alcohol can be performed using U/S guidance.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Rather than ablation with alcohol, what is another treatment for cysts?

A

surgical excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

A hemorrhagic liver cyst will appear as a cyst with _____ _____, accompanied by (2)

A

internal echoes
acute RUQ pain
decreased hematocrit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If you see cysts in the kidneys, always check the _____ for cysts as well.

A

liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The adult form of _____ _____ disease is inherited in an autosomal dominant pattern. The frequency with liver cysts in association with this disease is high.

A

polycystic kidney disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

_____ is a term for liver inflammation due to viruses or toxins.

A

Hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hepatitis is _____ when it lasts for less than 6 months.

A

acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

This kind of hepatitis is more likely to be asymptomatic in younger people. The convalescent stage is 7 to 10 days, with the total illness lasting 2 to 6 weeks.

A

acute viral hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If you see a hypoechoic liver parenchyma, hepatomegaly, and hyperechoic PV walls, this is a sign of

A

acute hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

This hepatitis shows diffuse swelling of the hepatocytes, proliferation of Kupffer cells, and infiltration of the portal areas by lymphocytes and monocytes.

A

acute hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

More specific symptoms of acute hepatitis are (6)

A 
profound loss of appetite
aversion to smoking (in smokers)
dark urine
yellowing of the eyes
jaundice
abdominal discomfort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

These 2 symptoms of the most common presenting symptoms of acute hepatitis.

A

jaundice

hepatomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the 6 kinds of hepatits?

A 
A
B
C
D
E
G
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Hepatitis A is also called

A

infectious jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Hepatitis A is transferred by what route?

A

fecal-oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Does Hepatitis A have an acute and chronic stage?

A

No, just acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Hepatitis A occurs most frequently in _____ world countries. There is a vaccine that prevents it for up to _____ years. People with Hep A are advised to _____, _____, _____ . Hep A can spread through consumption of raw sea food or contaminated _____ .

A 
third
10
rest
stay hydrated
avoid alcohol
water
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which hepatitis is the least serious?

A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

The combination of these two forms of hepatitis can cause a _____, and even without cirrhosis, leading to a life-threatening form of fulminant hepatitis.

A

Hep A and Hep C

superinfection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Does Hep B have both acute and chronic versions?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

A vaccine for Hep B exists that prevents infection for how long?

A

life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

This form of hepatitis can lead to hepatocellular carcinoma.

A

Hep B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

The methods of transmission for Hep B are

A

blood and body fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Symptoms of this kind of hepatitis occur long after the initial infection, around 4 to 24 weeks and patients may not even experience them. The pain can resemble arthritis, affecting specific joints and accompanied by redness and swelling.

A

Hep B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

5-10% of people with Hep B eventually develop

A

cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Hep B poses a risk for _____ cancer.

A

liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Hep C is also called

A

Non-A/Non-B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

This is the most common blood-borne infection.

A

Hep C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

People can get this type of hepatitis from inadequately sterilized medical or dental equipment.

A

Hep C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Hep C is spread by contact with

A

infected human blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

T or F? Hep C can be passed from an infected mother to her baby during birth.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Does breastfeeding increase transmission of Hep C?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Before 1990, Hep C was primarily transmitted by

A

blood transfusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Most patients with Hep C _____ (do/do not) experience symptoms.

A

do not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

If someone experiences symptoms from Hep C, it is often after _____ months of infection.

A

12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Chronic hepatitis C can be present for _____ - _____ years, and _____ or _____ can sometimes develop before patients experience any clear symptom.

A

10-30 years
cirrhosis
liver failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Nearly 40% of liver transplant patients are infected with Hep _____.

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Is liver transplantation a cure for Hep C?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

This kind of hepatitis is only dangerous if you also have Hep B.

A

Hep D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Hep D is also called

A

hepatitis delta virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

T or F? Hep D was discovered as an antigen in Hep B virus by Dr. Mario Rizzetto in 1977.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Hep D is an uncommon infection in North America, but the people who are primarily infected are

A

IV drug users

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

How is Hep D spread?

A

thought to be similar to Hep B, blood

possibly sexual transmission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Is there any specific treatment for Hep D? But what is a possible alternative-type treatment that has been used in the past with some success? And what is another possible treatment?

A

No

High dose of interferon given for over 12 years

orthotopic liver transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Persistence of biochemical abnormalities beyond 6 months is

A

chronic hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is the sonographic appearance of chronic hepatitis?

A

hyperechoic parenchyma
small, shrunken liver
decreased echogenecity of PV walls

(opposite of acute hepatitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Abscesses = ? and ?

A

leukocytosis

fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

This is a puss-filled area in the liver.

A

Pyogenic liver abcess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What are some of the causes of liver abscesses?

A
  • Abdominal infection such as appendicitis, diverticulitis, or a perforated bowel
  • Infection in the blood
  • Infection of the liver secretion (biliary) tract
  • Recent endoscopy of the biliary system
  • Trauma that damages the liver
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

The most common presenting features of pyogenic liver abscess are:

A 
Chalk-colored stool 
Dark urine 
Fever, chills, leukocytosis 
Loss of appetite 
Nausea, vomiting 
Pain in right upper abdomen (more common) or throughout the abdomen (less common) 
Unintentional weight loss 
Weakness 
Yellow skin (jaundice)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Pyogenic liver abscesses most commonly occur in the ______ lobe.

A

right lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

How do pyogenic liver abscesses reach the liver (4)?

A

Bile ducts
PVs
HAs
lymphatic channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Varied appearances of pyogenic liver abscesses are:

A

There is “air” within the abscess

Purulent abscesses appear cystic with the fluid ranging from echofree to highly echogenic

Early suppuration may appear solid with altered echogenicity, usually hypoechoic

The abscess wall can vary from well-defined to irregular and thick

Gas-producing organisms give rise to echogenic foci with a posterior reverberation artifact.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

For true diagnosis of pyogenic liver abscesses, what must be done?

A

aspirate the abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Treatment for pyogenic liver abscesses is

A

surgery

draining the abscess
along with this procedure, you will receive long-term antibiotic therapy (usually 4 - 6 weeks).

sometimes antibiotics alone can cure the infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

With pyogenic liver abscesses, what life-threatening condition could develop?

A

sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Even with treatment, pyogenic liver abscesses can be life-threatening in _____% to _____% of patients.

A

10% - 30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

When you hear “air in the abscess”, you should automatically think

A

pyogenic liver abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

This is a liver infection that occurs when a parasite that came from the intestines reaches the liver, and travels through the portal vein.

A

amebic abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

This is the most common extraintestinal complication of amoebic dysentery

A

amebic abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Transmission of amebic abscess is by the _____-_____ route. The most common bacterial agent related to this is ______.

A

fecal-oral

e-coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

The most common presenting symptoms of amebic abscess are

A

right upper quadrant pain

diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Sonographic signs of amebic abscesses are (7)

A

Round or oval-shaped lesion

Absence of a prominent abscess wall

Hypoechoic compared to a normal liver

Fine low-level internal echoes

Distal enhancement

Contiguity with the diaphragm/liver capsule

Typically occurs in the dome of the liver (RLL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

T or F? For amebic abscesses, amebicidal drugs are effective and symptoms improve by 24-48 hours but complete resolution of the abscess varies from 1.5 – 23 months with a median of 7 months.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Possible dangerous risks of amebic abscesses are

A

may rupture into the abdominal cavity, the lining of the lungs, the lungs, or the sac around the heart

could spread to the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

This is a mycotic (fungal) infection of the blood that results in small abscesses in the liver. The appearance of these lesions can change over the course of the disease process.

A

candidiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

The ultrasonic appearance of Candida infection in the livers of immunosuppressed patients is quite characteristic:

A

“Wheel Within A Wheel”: a lesion with a peripheral hypoechoic zone, an inner echogenic wheel and a hypoechoic center. This is the earliest manifestation of a fungal infection and the most recognizable.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

After some time, later the “wheel within a wheel” turns into a “______” appearance when the hypoechoic center ______.

It will then turn into a(n) uniformly ______ (echogenecity) focus and then a(n) ______ (echogenecity) focus representing scar formation.

A

“bullseye”
calcifies
hypoechoic
echogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What is the most common cause of hydatid disease?

A

echinococcal cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

This is a result of a parasite infestation (tapeworm) associated with sheep and cattle raising countries.

A

echinococcal cyst

82
Q

Eggs of Echinococcus granulosus are swallowed by the intermediate host (man) and pass into the ______ ______ system where the larva hatch and move into the ______.

A

portal venous system

liver

83
Q

The tapeworm of the parasite infestation for an echinococcal cyst is ______-______ mm in length and usually lives in the intestines of the definitive host (dog), excreted in the dog’s feces and swallowed by the intermediate hosts (sheep, cattle, goats or humans).

A

3-6 mm

84
Q

The sonographic signs for an echinococcal cyst are (5)

A

Simple cyst
Cysts with detached endocysts secondary to rupture (a cyst within a cyst)
Cyst with multiple daughter cysts
Cyst with detached membrane (water lily sign)
Calcified mass

85
Q

An old test used to diagnose hydatid disease was called the ______. It was usually about ______% sensitive.

A

Casoni skin test

70%

86
Q

For treatment of an echinococcal cyst, _____ is the conventional treatment, but success has been obtained with _____ as well.

A

surgery

percutaneous drainage

87
Q

The fluid within the echinococcal cyst is very toxic, so if a cyst ruptures _____ can occur.

A

anaphylatic shock

88
Q

This is one of the most common parasitic worm infections in humans, affecting 200 million people worldwide found in parts of the world where the water is contaminated.

It is a major cause of portal HTN worldwide.

A

Schistosomiasis

89
Q

Explain how schistosomiasis occurs

A

Freshwater becomes contaminated by Schistosoma eggs when infected people urinate or defecate in the water. The eggs hatch, and if certain types of snails are present in the water, the parasites grow and develop inside the snails. The parasite leaves the snail and enters the water where it can survive for about 48 hours.

Adult worms are about 10 mm long.

Parasites reach maturity in 6 to 8 weeks, at which time they begin to produce eggs.

Up to half the eggs released by the worm pairs become trapped in the mesenteric veins, or will be washed back into the liver, where they will become lodged. Worm pairs can live in the body for an average of four and a half years, but may persist up to 20 years.

Eggs travel to the liver or pass into the intestine or bladder, causing inflammation or scarring.

90
Q

Eggs from schistosomiasis reach the liver through the _____ inciting a _____ reaction resulting in _____ .

A

portal vein
granulomatous
peri-portal fibrosis

91
Q

The peri-portal fibrosis caused by schistosomiasis causes _____ which will lead to _____.

A

thrombosis

portal HTN

92
Q

What is seen sonographically with schistosomiasis? (5)

A

intrahepatic PVs occlude

resulting in 
portal HTN
splenomegaly
varices
ascites
93
Q

This is the most common fungal organism causing opportunistic infection in patients with AIDS.

It is the most common cause of life-threatening infection in patients with HIV.

A

pneumocystis carini

94
Q

This condition also affects patients undergoing bone marrow and organ transplants, as well as those receiving corticosteroids or chemotherapy.

A

pneumocystis carini

95
Q

The sonographic appearance and medical results of pneumocystis are (10)

A 
Fatty liver infiltration
Hepatomegaly
Hepatitis
Non-hodgkins lymphoma
Candidiasis
Cholangitis
Acalculous cholecystitis
Kaposi’s sarcoma

May involve the liver with diffuse, nonshadowing hyperechoic foci.

May cause the bile ducts and GB wall to be thickened.

96
Q

This infection and this malignancy can signal the final stages of HIV/AIDS.

A

pneumocytosis

Kaposi’s sarcoma

97
Q

Another word for pneumocystis carini is

A

pneumocytosis

98
Q

2 other AIDS related findings are

A

cholangitis (thickend bile ducts)

Kaposi’s sarcoma (intrahepatic mass)

99
Q

A fatty liver is an acquired, reversible disorder of metabolism, resulting in an accumulation of _____ within the hepatocytes.

A

triglycerides

100
Q

The most common causes of a fatty liver are ______ and ______.

A

obesity

alcohol abuse

101
Q

The 2 patterns of a fatty liver are

A

focal fatty infiltration (diffuse)

focal fatty sparing (focal)

102
Q

The echogenicity of the liver compared to the kidney is more ______ than the kidney.

A

hyperechoic

103
Q

A potential problem in the presence of diffuse fatty infiltration is

A

misdiagnosis of a hypoechoic solid lesion as a simple cyst

104
Q

How does the misdiagnosis of a hypoechoic solid lesion as a simple cyst occur?

A

Since the overall gain is turned down to compensate for a bright liver, low level echoes within a solid lesion may be missed. With the TGC turned up to compensate for reduced through transmission, the hypoechoic solid lesion may have posterior enhancement.

105
Q

What visual finding can help distinguish between a solid lesion and simple cyst?

A

The solid lesion will lack the specular reflection seen in the posterior wall of a cyst, as it does not have a fluid tissue interface.

Fine-needle aspiration may be necessary if the ultrasound findings are equivocal.

106
Q

Focal regions of increased echogenicity within normal liver parenchyma is

A

focal fatty infiltration

107
Q

Focal regions of normal liver parenchyma within a fatty infiltrated liver.

A

focal fatty sparing

108
Q

Sparing commonly occurs adjacent to the ______, in the porta hepatis, the ______, and at the liver margins.

A

GB

caudate lobe

109
Q

A genetically acquired disorder that results in the excess deposit of glycogen in the liver and tubules of the kidney.

A

glycogen storage disease

110
Q

This is associated with diffuse fatty infiltration and hepatic adenomas (well-demarcated, solid masses of variable echogenicity).

A

glycogen storage disease

111
Q

______ is a diffuse process of fibrosis and distortion of normal liver architecture.

A

cirrhosis

112
Q

Patients with cirrhosis are at an increased risk for ______.

A

hepatocellular carcinoma

113
Q

With cirrhosis, initially there is ______ enlargement, but continued insult results in ______. Parenchymal changes compress the biliary and ______ channels resulting in ______ and ______.

A 
liver
hepatic atrophy
vascular 
jaundice
portal HTN
114
Q

The 2 most common causes of cirrhosis are

A 
ETOH abuse (alcohol abuse)
Hepatitis C
115
Q

ETOH was once the main cause of cirrhosis in the U.S. ______ has emerged as the leading cause now

A

Hep C

116
Q

The 3 major pathologic mechanisms which create cirrhosis are

A

Cell death
Fibrosis
Tissue Regeneration (bad kind)

117
Q

Cirrhosis is classified as ______ (nodules 0.1 – 1 cm in diameter) or ______ (nodules up to 5 cm in diameter).

A

Micronodular

Macronodular

118
Q

______ is the MOST COMMON cause of micronodular cirrhosis.

A

alcohol consumption

119
Q

______ is the MOST FREQUENT cause of macronodular cirrhosis.

A

chronic viral hepatitis

120
Q

Clinical presentations of cirrhosis are (3)

A

Hepatomegaly
Jaundice
Ascites

121
Q

This condition can cause you to be “crazy” because the liver cannot get rid of the toxins and ammonia, which causes encephalopathy.

A

cirrhosis

122
Q

Cirrhosis - match the volume distribution with the type:

Acute
Chronic
Small liver, large Caudate lobe
Hepatomegaly

A

Acute - Hepatomegaly

Chronic - Small liver, large Caudate lobe

123
Q

The 3 sonographic patterns for cirrhosis are:

A

1) volume redistribution
2) coarse echotexture
3) nodular surface

124
Q

The nodularity with cirrhosis corresponds to the presence of regenerating ______ and ______.

A

nodules

fibrosis

125
Q

Late stages of cirrhosis characteristics are (2)

A

ascites

shrunken liver

126
Q

This is defined as increased pressure in the portal venous system.

A

portal HTN

127
Q

Normal portal pressure is ______-______ mm Hg which is slightly ______ than the normal IVC pressure.

A

5 - 10 mm Hg

higher

128
Q

Normal portal vein diameter is < ______ mm

A

13 mm

129
Q

______ flow in the MPV is a sign of portal HTN.

A

hepatofugal

130
Q

What are the 2 major causes of portal HTN?

A

cirrhosis

schistosomiasis

131
Q

Portal HTN is asymptomatic. Patients typically present with sudden painless upper GI ______ due to rupture of esophageal ______.

A

hemorrhage

varices

132
Q

What are the 4 types of portal HTN?

A

A. Extrahepatic pre-sinusoidal = portal vein thrombosis

B. Intrahepatic pre-sinusoidal = schistosomiasis

C. Intrahepatic = cirrhosis (most common) accounting for 90% of the cases in the West

D. Intrahepatic post-sinusoidal = hepatic vein thrombosis

133
Q

What is the most common type of portal HTN?

A

intrahepatic

134
Q

What are the secondary signs of portal HTN? (3)

A

splenomegaly ( >13 cm)
ascites
portosystemic venous collaterals

135
Q

What are 5 major sites of portosystemic venous collaterals?

A

1) Gastroesophageal junction
2) Paraumbilical vein
3) Splenorenal and gastrorenal
4) Intestinal
5) Hemorrhoidal

136
Q

Gastroesophageal junction: between the coronary and ______and the ______ .

A

short gastric veins

esophageal veins

137
Q

Paraumbilical vein: runs in the ______ ligament and connects the LPV to the ______ near the umbilicus, recanalizing the ______.

A

falciform ligament
epigastric veins
ligamentum teres

138
Q

Splenorenal and gastrorenal: tortuous veins may be seen in the region of the ______ and ______.

A

splenic

left renal hilum

139
Q

Intestinal: regions in which the gastrointestinal tract becomes ______, so that the veins of the ascending and descending ______, ______, ______, and ______ may anastomose with the renal, phrenic and ______ veins.

A 
retroperitoneal
colon
duodenum
pancreas
liver
lumbar
140
Q

Hemorrhoidal: ______ region where the superior rectal veins anastomose with the ______ and ______ rectal veins.

A

perianal
middle
inferior

141
Q

These are created to decompress the portal system to avoid the development or rupture of gastroesophageal varices with portal HTN.

A

portosystemic shunts

142
Q

The 3 types of traditional portosystemic shunts are

A

mesocaval
splenorenal (Warren)
portacaval

143
Q

What does TIPS stand for?

A

Transjugular
Intrahepatic
Portal
Systemic shunting

144
Q

A TIPS shunt is placed between a ______ and a ______. Usually the ______ (right/left).

A

HV
PV
right

145
Q

______ ______ ______ is utilized to detect early shunt compromise for prompt shunt revision, usually every 3-6 months.

A

routine doppler evaluation

146
Q

What are the 4 criteria for TIPS malfunction?

A
  1. Shunt velocity < 50 cm/sec
  2. Focal velocity increase (usually at the hepatic end)
  3. Hepatopedal flow in the LPV or RPV
  4. Hepatofugal flow in the MPV
147
Q

Hepatopedal flow in the LPV or RPV is a sign of what (involving shunts)?

A

TIPS malfunction

148
Q

Hepatofugal flow in the MPV is a sign of what (involving shunts)?

A

TIPS malfunction

149
Q

Echogenic thrombus within the lumen of the portal vein

A

PV thrombosis

150
Q

The 6 causes of PV thrombosis are

A 
Hepatocellular Carcinoma
Pancreatic Carcinoma
Metastatic Liver Disease
Pancreatitis
Cirrhosis
Hypercoagulation (women on birth control pills)
151
Q

With traditional shunts for lowering portal pressure, the mesocaval shunt connects the ______ and the ______.

A

SMV

IVC

152
Q

With traditional shunts for lowering portal pressure, the splenorenal (Warren) shunt connects the ______ and the ______.

A

SV

RV

153
Q

With traditional shunts for lowering portal pressure, the portacaval shunt connects the ______ and the ______.

A

PV

IVC

154
Q

Wormlike vessels at the porta hepatis, which represent periportal collateral circulation, occurring in longstanding PV thrombosis, requiring up to 12 months to occur.

A

cavernomatous transformation

155
Q

Cancer = ______ (increased/decreased) risk of blood clots.

A

increased

156
Q

A relatively rare disorder characterized by occlusion of the hepatic veins with or without occlusion of the IVC by either thrombus or tumor. Typically seen in young adult women taking birth control pills.

A

Budd-Chiari syndrome

157
Q

The main cause of Budd-Chiari syndrome is

A

Coagulation abnormalities

158
Q

With Budd-Chiari syndrome, the ______ lobe is often spared. And why?

A

caudate lobe

because of emissary veins drain directly into the IVC at a lower level than the main HVs

159
Q

These are sonographic signs of ______:

Ascites is an invariable observation.

Liver is typically large and bulbous acutely. Hemorrhagic infarction may produce significant altered regional echogenicity.

Membranous webs may be identified as echogenic or focal obliterations of the lumen.

A

Budd-Chiari syndrome

160
Q

______ liver transplantation is performed to eliminate irreversible disease.

A

orthotopic

161
Q

The main indication for liver transplants in adults is

A

Cirrhosis due to Hep C

162
Q

The main indication for liver transplants in children is

A

biliary atresia

163
Q

Before orthotopic liver transplant surgery is done, these details should be checked sonographically (4)

A

Liver size and extent of pathology
PV, HA, IVC patency/size
Presence of venous collaterals
Presence of complicating factors( like AAA or extrahepatic malignancies)

164
Q

A postoperative U/S for orthotopic liver transplant should include (5)

A 
Liver parenchyma
Biliary tree (CBD)
HA, PV, HV patency***
IVC patency
Perihepatic fluid collections
165
Q

Unfortunately, in about _____ (fraction) of all patients with chronic hepatitis, the disease recurs after transplantation.

A

half

166
Q

Most common benign tumor of the liver is

A

cavernous hemangioma

167
Q

The majority of hemangiomas are asymptomatic and discovered incidentally, usually in the _____ lobe of the liver.

A

right

168
Q

Is it possible to see the flow in the tiny vessels that make up hemangiomas on U/S?

A

no

169
Q

Hyperechoic, homogeneous

Posterior enhancement

May appear hypoechoic within the background of a fatty infiltrated liver

Color or duplex Doppler does not routinely demonstrate flow

These are sonographic signs of what?

A

cavernous hemangioma

170
Q

This liver mass may enlarge with pregnancy or administration of estrogens.

A

cavernous hemangioma

171
Q

This is a benign solid liver mass that is believed to be related to an area of congenital vascular malformation. It is typically an incidentally detected liver mass in an asymptomatic patient.

A

focal nodular hyperplasia

172
Q

Focal nodular hyperplasia is a mass more common in ______ (men/women).

A

women

173
Q

Well defined solid mass

Central fibrous scar (liver mass with an echogenic line through it)

Stellate vascularity

It is often difficult to differentiate in echogenicity from the adjacent liver parenchyma

These are sonographic signs of what?

A

focal nodular hyperplasia

174
Q

This is a solid liver mass associated with the use of oral contraceptive agents.

A

hepatic adenoma

175
Q

Patient may present with pain due to tumor hemorrhage. Associated with glycogen storage disease.

These are signs of what liver mass?

A

hepatic adenoma

176
Q

Surgical resection is recommended for hepatic adenomas due to the risk of

A

malignant transformation

177
Q

Sonographic signs of hepatic adenoma are (3)

A

Nonspecific echogenicity

Cystic component with hemorrhage

Intraperitoneal blood

178
Q

Hepatic Adenoma is often difficult to distinguish from ______ on an U/S.

A

focal nodular hyperplasia

179
Q

Extremely rare fatty tumors in the liver are

A

hepatic lipoma

180
Q

Tuberous sclerosis, a congenital familial disease, is associated with ______ and ______.

A

hepatic lipomas

angiomyolipomas

181
Q

Hyperechoic mass
Propagation speed artifact

These are sonographic signs of

A

hepatic lipomas

182
Q

This may be seen as a broken diaphragm posterior to the fatty mass on an U/S (and diaphragms don’t break).

A

hepatic lipomas

183
Q

The MOST COMMON PRIMARY malignancy of the liver is

A

hepatocellular carcinoma

184
Q

Another term for hepatocellular carcinoma is

A

hepatoma

185
Q

Etiology factors:

Alcoholic cirrhosis and Hep B and C

Commonly invades PVs, HVs, and IVC

Variable sonographic appearance

Serum alpha-fetoprotein level will be increased

These are signs of what?

A

hepatoma (hepatocellular carcinoma)

186
Q

One of the biggest signs of ______ is the increase of serum alpha-fetoprotein levels.

A

hepatocellular carcinoma (hepatoma)

187
Q

______ are the most commonly encountered solid masses in the liver.

A

metastatic tumors

188
Q

The most common source of metastatic involvement is from ______, ______, or ______ cancer.

A

gastrointestinal
breast
lung

189
Q

Metastatic tumors:

Hyperechoic mets come from

A

the gastrointestinal tract

190
Q

Metastatic tumors:

Hypoechoic mets come from

A

lymphoma

191
Q

Metastatic tumors:

Bulls eye or target mets come from

A

lung

192
Q

Metastatic tumors:

Calcified mets come from

A

mucinous adenocarcinoma

193
Q

Metastatic tumors:

Cystic mets come from

A

sarcoma

194
Q

Metastatic tumors can also present as mass of ______ echogenicity.

A

mixed

195
Q

The most common malignant liver tumor in early childhood is

A

hepatoblastoma

196
Q

Hepatoblastoma is the 3rd most common intra-abdominal childhood malignancy after ______ neuroblastoma and ______ tumor.

A

adrenal

Wilm’s

197
Q

With hepatoblastoma, most occurrences are prior to ______ years of age. Patients present with an enlarging ______ ______ ______ (10-12 cm). Non-specific sonographic appearance.

A

2

asymptomatic abdominal mass

198
Q

What is the earliest manifestation of a fungal infection (and most easily seen) in the liver?

A

Wheel within a wheel

199
Q

Since they are difficult to tell apart, how can you possibly distinguish between a pyogenic abscess and an amebic abscess?

A

If the patient has traveled outside the US it might be amebic abscess

200
Q

Central fibrous scar =

A

Focal nodular hyperplasia

201
Q

Echinococcal = ? = ?

A

Echinococcal =. sheep = water lily sign

*Ultrasound* (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions