Liver Part 2 Flashcards
Viral hepatitis can lead to (3)
Portal hypertension
Cirrhosis
Hepatocellular carcinoma
How is Hep a spread
Fecal oral route
Hep a is epidemic in developing countries affecting
THE YOUth
Hep a is a _____ infection
Acute
Hep a causes death by
ACUTE LIVER FAILURE
Hep B is transmitted
Parenterally but also from blood
Where is hep c a major health problem
Italy and mediterranean
Hep c spreads throug h
Blood
Hep C is detected in lab tests by
Presence of antibodies
Hep D is dependent on
Having Hep B first
Geographically hep D is where
Same as hep B
uncommon in NA
Hep D is common in what type of people
IV drug users
Sign of viral hepatitis
Jaundice
7 symptoms of viral hep
Fatigue, headache, anorexia, fever, abdominal pain, nausea and vomiting
Acute hepatitis implies recovery within ____ months
4
Acute hepatitis shows the parenchyma as more _______ leading to the appearance of _____________ ______ Walls
Hypoechoic
Bright periportal
Sonographic appearance of Acute hepatitis is
Starry night sign
Chronic hep biochemical abnormalities persist beyond
6 months
Chronic hep will show have ________ present in tests
Antibodies
On sonogaphy we will see _____ and ______ with Chronic hep
Hepatomegaly & thickening of GB wall
Can Liver appear normal with Chronic hep
Yup
Chemicals that are harmful to liver (2)
Alcohol
Presecription meds
4 disorders of liver metabolism
Steatosis (fatty liver)
Glycogen storage disease- neonatal
Cirrhosis- chronic liver disease
NASH- non-alcoholic steatohepatitis
Steatosis (fatty liver) is a ______ and _____ disorder of metabolism
Acquired and reversible
Steatosis (fatty liver) is most common cause of _____ recent increase
Obesity
Steatosis (fatty liver) affects the _____ in the hepatocytes
Triglycerides (fat)
10 causes of Steatosis (fatty liver)
Excessive alcohol —> causes lipolysis Severe hepatitis Hyperlipidemia (cholesterol) Diabetes Excess corticosteroids Pregnancy Hyperalimentation Obesity bypass surgery Cystic fibrosis Toxins
Steatosis (fatty liver) is the precursor for
Significant chronic disease
Steatosis (fatty liver) may lead to ____ in some patients
Hepatocellular carcinoma (HCC)
Steatosis (fatty liver) deposits may be ____ or _____
Focal or diffuse
Mild Steatosis (fatty liver) has
Minimal diffuse increase in hepatic echogenicity
Moderate Steatosis (fatty liver) has (2)
Moderate diffuse increase in hepatic echogenicity
Slightly impaired visualization of intrahepatic vessels and diaphragm
Severe Steatosis (fatty liver) has (4)
Increase in echogenicity
Poor penetraion of posterior liver
Poor to no visualization of hepatic vessels and diaphragm
Hepatomegally often present
3 other sonographic appearances of fatty liver
Focal fatty infiltration
Fatty sparing
Focal fat
What do we see with focal fatty infiltration
Regions of increase echogenicity in background of normal liver
Can mimic a mass
Fatty sparing appears as
Islands of normal liver parenchyma appear as hypoechoic masses within a dense fatty infiltrated liver
Sonographic appearance of Steatosis (fatty liver) (4)
Rapid change in appearance and resolution over 6 days
No mass effect
No liver contour abnormality
Focal fat appear rounded, nodular or interspersed
4 other tests for testing Steatosis (fatty liver)
CT for low attenuation areas
Contrast enhanced to differentiate fatty from neoplasia
MRI - distinguish diffuse from focal fatty infiltration
Nuclear medicine scintigraphy
