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Abdomen Review > Liver - Part 3 > Flashcards

Liver - Part 3 Flashcards

1
Q

What are clinical indications for mets in the liver? (2)

A
  1. RUQ pain

2. Loss of appetite

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2
Q

What is discovered on a physical exam for mets in the liver? (3)

A
  1. Hepatomegaly
  2. Weight loss
  3. Jaundice
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3
Q

What is shown in the blood work of someone who has mets in the liver? (4)

A
  1. Increased AST
  2. Increased ALT
  3. Increased bilirubin
  4. Mild increase in alkaline phosphatase
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4
Q

What is the modality of choice for liver metastases?

A

CT

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5
Q

What is the sonographic appearance for liver metastases? (7)

A
  1. Hepatomegaly
  2. Irregular control
  3. Multiple hypo echoic lesions
  4. avascular
  5. Lesions vary in size
  6. Ascites around the liver, RLQ and LLQ
  7. Enlarged hyper vascular paracaval lymph nodes around the IVC
    - compressing the IVC
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6
Q

What is the most common neoplasm in an adult liver?

A

Metastasis

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7
Q

What is the liver a principle target for?

A

GI malignancies

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8
Q

What is the most common primary sites for metazoic lesions to the liver in adults? (6)

A
  1. Colon
  2. Stomach
  3. Pancreas
  4. Breast
  5. Lung
  6. Eye
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9
Q

What are 6 patterns of metastases?

A
  1. Bulls’eye or target lesion
  2. Hypoechoic masses
  3. Hyperechoic masses
  4. Cystic masses
  5. Complex masses
  6. Diffuse pattern
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10
Q

What is the differential diagnosis of mets? (4)

A
  1. Multiple abscesses
  2. Nodular cirrhosis
    - not normally associated with hepatomegaly
  3. Fatty infiltration
  4. Multiple cavernous hemangiomas
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11
Q

What is the most common benign hepatic lesion?

A

Hemangioma

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12
Q

What is the sonographic appearance of a hemangioma? (3)

A
  1. Defined borders
  2. No colour flow on doppler
  3. Hyperehcoic
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13
Q

What do hemangiomas typically arise from?

A

AV malformations

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14
Q

What are the 2 types of hemangiomas?

A
  1. Hemangioendotelioma

2. Cavernous hemangioma

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15
Q

Hemangioendotelioma

A

Blood filled spaces with multilayer endothelium

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16
Q

Cavernous hemangioma

A

Single layers endothelium

17
Q

What is the differential diagnosis of hemangioma? (5)

A
  1. Mets
  2. FNH
  3. Adenoma
  4. Hematoma
  5. Abscess
18
Q

What gender is cavernous hemangioma more common in?

A

Females

19
Q

How is cavernous hemangioma typcially discovered?

A

Incidentally

20
Q

What is the clinical presentation of cavernous hemangioma? (4)

A
  1. Hepatomegaly
  2. Obstructed jaundice
  3. Bowel obstruction
    - vomiting
  4. Respiratory insufficiency
21
Q

What is the sonographic features of cavernous hemangioma? (5)

A
  1. Well defined
  2. Hyper echoic
    - but can by hypo echoic
  3. Enhancement
  4. Vascular
  5. May calcify with PAS
22
Q

What does mesenchymal hamartoma arise from?

A

Connective tissue of the portal tracts

- congenital

23
Q

What is the clinical presentation of mesenchymal hamartoma?

A

Painless abdominal swelling

24
Q

What does mesenchymal hamartoma resemble?

A

Hemangioma

25
Q

What kind of flow does mesenchymal hamartoma have?

A

No flow

- avascular

26
Q

What is the recommended treatment for mesenchymal hamartoma?

A

Resection

27
Q

Hepatitis

A

Diffuse infection of the liver that leads to inflammation and necrosis of hepatic cells

28
Q

What are the symptoms of hepatitis? (5)

A
  1. Hepatomegaly with pain
  2. Jaundice
  3. Nausea
  4. Fever
  5. Loss of appetite
29
Q

What is the sonographic appearance of hepatitis? (3)

A
  1. Starry sky appearance
  2. Hepatomegaly
  3. Prominent portal vein
30
Q

What is the differential diagnosis of hepatitis? (2)

A
  1. It can appear as a normal liver

2. Biliary obstruction

31
Q

What is hydatid disease common with?

A

Those who have recently travel to an underdeveloped country

32
Q

What is the sonographic appearance of echinococcal? (4)

A
  1. Cystic
  2. Multiple
  3. Separated
  4. Well defined
33
Q

What is the differential diagnosis of hydatid disease? (5)

A
  1. Septated liver cyst
  2. Rsolving abscess
  3. Resolving hematoma
  4. Cystadenoma
  5. Complex cyst

Abdomen Review (12 decks)

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