Liver Pathology Flashcards
Which abnormal lab of cirrhosis is nonspecific?
Correct answer:
LDH
AST
GGT
conjugated bilirubin
ALT
LDH
A patient comes in after a recent trip to Haiti, and they have an elevated WBC and are running a fever. You see a complex appearing mass within the liver. Of the options below, what would you guess it most likely to be?
Fatty infiltration
Echinococcal Cyst
Liver cyst
Abscess
Abscess
The sonographic appearance of “Starry Night” is a description of which pathology?
Cirrhosis
Chronic Hepatitis
Granulomas
Acute Hepatitis
Acute Hepatitis
Alpha-fetoprotein is significantly elevated in which disease?
Hepatocellular carcinoma
Cirrhosis
Hepatitis
Fungal Abscess
Hepatocellular carcinoma
Your patient has been out of the country. They present with these symptoms: RUQ pain, diarrhea, Fever, Elev. WBC, Elev. LFT’s. You see a rounded, complex mass in the dome of the liver near the capsule. What is the most likely pathology?
Pyogenic Abscess
Amebic Abscess
HCC
Fungal Abscess
Amebic Abscess
You are scanning a patient who takes birth control and the hepatic veins appear to be obstructed. There is ascites, and splenomegaly also noted. What is the probable pathology?
Budd-Chiari Syndrome
Portal Vein Thrombosis
Mets
Cholangiocarcinoma
Budd-Chiari Syndrome
Candidiasis is also known as….
Hepatitis
Echinococcal Cyst
Amebic Abscess
Fungal Abscess
Fungal Abscess
Which part of the liver is least affected by Budd-Chiari?
Right Anterior
Right Posterior
Left Medial
Left Lateral
Caudate
Caudate
The Central Fibrous Scar and Stellate Vascularity is Sonographically related to?
Cavernous Hemangiomas
Hepatic Adenoma
Focal Nodular Hyperplasia
HCC
Focal Nodular Hyperplasia
What is the most common malignant liver tumor in early childhood?
Neuroblastoma
Wilm’s Tumor
HCC
Hepatoblastoma
Hepatoblastoma
Which pathology am I describing? Small shrunken liver, Hyperechoic liver parenchyma, decreased echogenicity of the portal vein walls.
Chronic Hepatitis
Acute Hepatitis
Echinococcal Disease
HCC
Chronic Hepatitis
______is the most common cause of portal HTN.
Cirrhosis
Schistosomiasis
Hepatitis
Fungal Abscess
Cirrhosis
Cystic Lesions within the liver include all except:
Hydatid cysts
Polycystic Liver disease
Hemangiomas
Echinococcal disease
Hemangiomas
Hemangiomas
A 40 year old male comes in for a scan. He had some mildly elevated LFT’s. What is the probable pathology?
FNH
Focal Fatty Sparing
Hemangiomas
Focal Fatty Sparing
HCC
Focal Fatty Sparing
The pathologies that create gas and/or air produce the same artifact. What is it?
Posterior Acoustic Enhancement
Reverberation
Shadowing
WES sign
Reverberation
You are scanning a patient and you notice a few small calcifications within the liver. The patient has NO symptoms. The patient tell you that he is a chicken farmer. What probably is the pathology?
Cirrhosis
Histoplasmosis
Granulomas
Hepatitis
Granulomas
Hepatic Adenomas are associated with Glycogen Storage Disease. T or F
True
False
True
With hepatitis which lab will not be elevated?
Unconjugated bilirubin
ALT
AST
Conjugated Bilirubin
Unconjugated bilirubin
If you see liver mets that are hyperechoic, which primary cancer is it most likely associated with?
Sarcoma
Gastrointestinal
Lung
Lymphoma
Gastrointestinal
The most common benign tumor of the liver is….
Hepatic Adenoma
HCC
Echinococcal Cyst
Cavernous Hemangioma
Cavernous Hemangioma
What is a hepatic lipoma?
Cancer
Cyst
Fatty Tumor
Hydatid Disease
Fatty Tumor
This parasitic infection is a major cause of Portal Hypertension worldwide.
Amebic Abscess
Hydatid Disease
Hepatitis
Schistosomiasis
Schistosomiasis
______is the most common organism causing infection in AIDS patients.
Pneumocystic Carinii
Candidiasis
cholangitis
Kaposi’s Sarcoma
Pneumocystic Carinii
The speed propagation artifact is associated with which pathology?
HCC
FNH
Fatty infiltration
Hepatic Lipoma
Hepatic Lipoma
Splenomegaly can be a result of _______.
Hydatid Disease
Liver cysts
Fatty liver
Portal HTN
Portal HTN
You have a patient that presents with splenomegaly, a portal vein with a diameter >13 mm, Ascites, and portal systemic collaterals. They have all of these findings because they are exhibiting signs of _____?
HCC
Portal HTN
Portal Vein Thrombosis
Budd-Chiari Syndrome
Portal HTN
Hepatocellular Carcinoma is the least common primary malignancy of the liver. T or F
True
False
False
The “wheel within a wheel” lesion is a sonographic appearance of which of the following?
A. Pyogenic Abscess
B. Fungal Abscess
C. Candidiasis
D. Amebic Abscess
A & C
B & C
C & D
B & C
A patient you are scanning has histoplasmosis. What pathology does this cause?
HCC
Granulomas
Hepatitis
Focal Nodular Hyperplasia
Granulomas
Your patient is running a fever and has elevated WBC. They have NOT been out of the country. You find a complex mass with reverberation and the radiologist suggests a fine needle aspiration to confirm the etiology. What pathology would this most likely demonstrate?
Cavernous Hemangioma
Hepatic Adenoma
Pyogenic Abscess
Amebic Abscess
Pyogenic Abscess
What is the most common cause of micronodular cirrhosis?
Chronic Hepatitis
Acute Hepatitis
Alcoholism
Tuberculosis
Alcoholism
A cyst with a detached endocyst describes which pathology?
Echinococcal cyst
Polycystic liver Disease
Simple liver cyst
Hemorrhagic Cyst
Echinococcal cyst
Which of the following can lead to fatty liver?
Pregnancy
FNH
Obesity
Diabetes
Obesity
_____ is a parasitic infection that can cause portal HTN.
FNH
Schistosomiasis
Pyogenic Abscess
Hydatid Disease
Schistosomiasis
______is the most common organism causing infection in AIDS patients.
Pneumocystic Carinii
Candidiasis
Pyogenic Abscess
Fungal Abscess
Pneumocystic Carinii
Cirrhosis is a liver disease that can possibly lead to….
Mets
Hepatocellular Carcinoma (HCC)
Hydatid Disease
Hepatitis
Hepatocellular Carcinoma (HCC)
Your patient went to Vietnam for an agricultural trip. They were in a very poor part of the country they tell you and the facilities were terrible. Since he came back he has been having some RUQ pain. While scanning you find this: What is it?
Echinococcal Cyst: Detached Endocyst
Liver Mets
HCC
pyogenic abscess
Echinococcal Cyst: Daughter Cysts
Echinococcal Cyst: Daughter Cysts
This patient has Von Gierks Glycogen Storage Disease. You have found this in their liver, when you go back and read the report the Dr. feels that it should be surgically removed. What do you think it is?
Hepatic Adenoma
Hemangioma
FNH
Hepatic Adenoma
What is a hepatic lipoma?
Cancer
Cyst
Fatty Tumor
Hydatid Disease
Fatty Tumor
If you see liver mets that is hyperechoic, which primary is it most likely associated with?
Lung
Gastrointestinal
Sarcoma
Lymphoma
Gastrointestinal
You are scanning a patient who takes birth control and the hepatic veins appear to be obstructed. There is ascites, and splenomegaly also noted. What is the probable pathology?
Budd-Chiari Syndrome
Portal Vein Thrombosis
Mets
Cholangiocarcinoma
Budd-Chiari Syndrome
An amebic abscess occurs because the parasite has traveled to the liver via the ____.
Hepatic Veins
Hepatic Artery
Portal Vein
Bile Ducts
Portal Vein
You see a small non-shadowing calcification in the liver. What is it more than likely?
Budd-chiari Syndrome
HCC
Portal Vein Gas
Granuloma
Granuloma
The portal triad consists of the:
main portal vein, common bile duct, and hepatic artery
main portal vein, hepatic duct, and common bile duct
main portal vein, hepatic artery, and hepatic vein
main portal vein, hepatic artery, and hepatic duct
main portal vein, common bile duct, and hepatic artery
A 20-year-old asymptomatic woman presents for an abdominal ultrasound. A round hyperechoic, subcapsular mass is identified in the right lobe of the liver. What is the most likely diagnosis?
solitary metastatic lesion
echinococcal cyst
hepatoblastoma
cavernous hemangioma
cavernous hemangioma
You have a patient with AIDS. They present with diffuse, non-shadowing echogenic foci. What is it?
Portal Vein Gas
Pneumocystis Carinii
Kaposi’s Sarcoma
Fatty liver infiltration
Pneumocystis Carinii
Pneumocystis Carinii
This patient has a history of cirrhosis. Lately his lab work was a little different than his normal. Along with the elevated liver enzymes he also has elevated alpha-feto protein. What do you think this is in the image below?
FNH
Amebic Abscess
HCC
Hepatitis
HCC
The sonographic appearance of “Starry Night” is a description of which pathology?
Cirrhosis
Chronic Hepatitis
Granulomas
Acute Hepatitis
Acute Hepatitis
Micronodular Cirrhosis is most commonly caused by
acute hepatitis
chronic hepatitis
alcoholism
alcoholism
What is the normal pressure of the portal vein?
5-10 mmhg
10-15 mmhg
15-20 mmhg
30 mmhg
5-10 mmhg
A 50-year-old diabetic patient presents with abdominal pain and slightly elevated liver function tests. Hepatomegaly and diffuse increase in the liver parenchymal echogenicity are present. This is characteristic of:
cirrhosis
hepatocellular carcinoma
pyogenic infection
fatty infiltration
fatty infiltration
Sonographic findings of Portal HTN are:
- Reversal of flow in the portal vein
- Collaterals
- Hepatomegaly
- Ascites
1, 2, 4
1, 3, 4
1, 2, 4
1, 2, 4
Which of the following is a differential of a liver cyst?
Hydatid Disease
Cavernous hemangioma
FNH
Adenoma
Hydatid Disease
A 40 year old male comes in for a scan. He had some mildly elevated LFT’s, but otherwise does not complain of any symptoms. What is the probable pathology? See the white arrow.
image.png
HCC
Focal Fatty Sparing
FNH
Hemangiomas
Focal Fatty Sparing
What are the 3 mechanisms of Cirrhosis?
fibrosis
regeneration
cell birth
cell death
dissolution
fibrosis
regeneration
cell death
A cyst within a cyst or daughter cyst is a characteristic of:
hepatoma
polycystic liver disease
echinococcal cyst
pseudocyst
echinococcal cyst
Which pathology am I describing? Small shrunken liver, Hyperechoic liver parenchyma, Decreased echogenicity of the portal vein walls.
Chronic Hepatitis
Acute Hepatitis
Echinococcal Disease
HCC
Chronic Hepatitis
A patient presents with weight loss, increased alpha fetal protein (AFP), and abdominal enlargement. This is most characteristic of:
focal nodular hyperplasia (FNH)
liver adenoma
hepatoma
lymphoma
hepatoma
An inpatient exam is ordered and you find this image. They are running a fever and their chart states immunocompromised. What is this?
Echinococcal Disease
Fungal Abscess
Amebic Abscess
Pyogenic Abscess
Fungal Abscess
Which lists the correct criteria for a simple cyst?
thick walled, posterior shadowing, hyperechoic
thin smooth walls, posterior acoustic enhancement, anechoic
irregular border, solid, no posterior artifact
thin smooth walls, posterior acoustic enhancement, anechoic
This patient has a history of IV drug use. They have not been feeling well and they had lab work done which revealed elevated AST/ALT and total bilirubin. The Dr has sent them for a scan of the liver. You start scanning and notice the liver looks as below: Which of the following pathologies have you most likely found?
Liver Agenesis
Schistosomiasis
HCC
Hepatitis
Hepatitis
Macrocellular Cirrhosis is most commonly caused by:
acute hepatitis
chronic hepatitis
alcoholism
chronic hepatitis
The most common benign tumor of the liver is….
Hepatic Adenoma
HCC
Echinococcal Cyst
Cavernous Hemangioma
Cavernous Hemangioma
Which pathology presents with a hypoechoic halo?
HCC
FNH
Adenoma
Lipoma
HCC
Which part of the liver is least affected by Budd-Chiari?
Right Anterior
Right Posterior
Left Medial
Left Lateral
Caudate
Caudate
Which of the following is a characteristic of Budd-Chiari syndrome?
thrombus of the hepatic and portal vein
thrombus in the hepatic artery and vein
thrombus in the hepatic vein and the inferior vena cava
thrombus in the hepatic artery and aorta
thrombus in the hepatic vein and the inferior vena cava
Your patient has a history of lymphoma. You are scanning their liver and find the following. Which do you most likely think it is? image.png
Bulls-eye mets
Hypoechoic mets
Diffuse mets
Echogenic mets
Hypoechoic mets
Which vessels increase in size as they course superiorly toward the diaphragm? Think of how each appears on ultrasound exams.
patent umbilical veins
hepatic veins
portal veins
hepatic arteries
hepatic veins
Abnormal labs of cirrhosis are?
GGTP
AST
conjugated bilirubin
ALT
All listed
LDH
All listed
The speed propagation artifact is associated with which pathology?
HCC
FNH
Fatty infiltration
Hepatic Lipoma
Hepatic Lipoma
Alpha-fetoprotein is most significantly elevated in which disease?
Hepatitis
Cirrhosis
Hepatocellular carcinoma
Fungal Abscess
Hepatocellular carcinoma
Sonographic finding with acute hepatitis can include all of the following except:
decreased echogenicity of portal vein walls
liver enlargement
starry night
decreased liver parenchymal echogenicity
decreased echogenicity of portal vein walls
What is the name of the porto-systemic collaterals that occur around the umbilicus?
Recanulized umbilical vein
Caput Medusa
Spleno-renal varices
Gastrointestinal varices
Caput Medusa
The fissure of the ligamentum venosum divides the liver into:
right and left lobes
left lobe and caudate lobe
left medial and lateral segments
right lobe and caudate lobe
left lobe and caudate lobe
The liver function laboratory test which is most specific to hepatocellular disease is:
CEA
hematocrit
ALT
HCG
ALT
The Pathologies that create gas and/or air seem to produce the same artifact. What is it?
Posterior Acoustic Enhancement
Comet tail/reverberation
Speed Propagation artifact
Mirror image artifact
Comet tail/reverberation
Candidiasis is the cause of which of the following?
Hepatitis
Echinococcal Cyst
Amebic Abscess
Fungal Abscess
Fungal Abscess
You are scanning a patient and you notice a few small calcifications within the liver. The patient has NO symptoms. The patient tells you that he is a chicken farmer. What probably is the pathology?
Cirrhosis
Histoplasmosis
Granulomas
Hepatitis
Granulomas
Your patient came in for a routine gallbladder scan. They have been complaining of RUQ pain, nausea, and vomiting. You start scanning their liver and find this, what do you think it is and should you look at any other organ? CHOOSE 2 ANSWERS.
Adult Polycystic Disease
Simple Liver Cyst
Hemangioma
FNH
Look at pancreas
Look at kidneys
Look at spleen
Look at kidneys
Adult Polycystic Disease
A small hyperechoic nodular liver best describes:
acute viral hepatitis
early staged cirrhosis
chronic viral hepatitis
normal pediatric liver
chronic viral hepatitis
Which pathology am I describing? Round, hypoechoic complex mass. Typically occurs in the dome of the liver. Contiguous with the liver capsule.
HCC
Focal Nodular Hyperplasia
Amebic Abscess
Hemorrhagic Cyst
Amebic Abscess
Which of the following carries the majority of the oxygen and nutrients to the liver?
hepatic artery
portal vein
common duct
celiac axis
portal vein
Which of the following is NOT a sonographic appearance of Mets in the liver?
cyst with detached endocyst
bulls eye mets
calcified mets
echogenic mets
cyst with detached endocyst
The Central Fibrous Scar and Stellate Vascularity is Sonographically related to?
Cavernous Hemangiomas
Hepatic Adenoma
Focal Nodular Hyperplasia
HCC
Focal Nodular Hyperplasia
Caudate lobe may appear enlarged due to:
hypertension
cirrhosis
hepatitis
fatty infiltration
cirrhosis
cirrhosis
This pathology is fluid filled with an epithelial lining.
Cyst
Hydatid disease
Cavernous hemangioma
Hepatic Adenoma
Cyst
This patient has Chrohn’s Disease. What do you think that this is?
Portal HTN
Portal Vein Thrombosis
Granulomas
Portal Vein Gas
Portal Vein Gas
You have an order to evaluate this patients liver post-surgery. What do you see?
TIPS shunt
Focal Fatty Sparing usually occurs where?
adjacent to the GB
porta hepatis
caudate lobe
at the liver margins
All listed
All listed
what is the normal liver size?
12.5 cm
15.5 mm
1.55 cm
15.5 cm
15.5 cm
The hepatoblastoma ranks where among childhood abdominal tumors?
First
Second
Third
Fourth
Third
The patient preparation necessary to examine the liver is:
drink 16 ounces of water
NPO for 6 hours
clear liquids
no specific preparation is needed
NPO for 6 hours
If a cyst becomes hemorrhagic and infected which of the following signs/symptoms might occur? Mark all that apply.
Elevated WBC
Elevated RBC
Decreases hematocrit
Pain
Elevated WBC
Pain
Hepatofugual portal vein blood flow may be seen in patients with:
portal hypertension
biliary disease
fatty infiltration
cavernous hemangioma
portal hypertension
How can a cavernous hemangioma appear sonographically? select all that apply
echogenic
well defined
irregular margins
cystic
well defined
echogenic
A patient you are scanning has histoplasmosis. What pathology does this cause?
HCC
Granulomas
Hepatitis
Focal Nodular Hyperplasia
Granulomas
What is the term for a malignant lesion of the liver?:
hepatoma
focal nodular hyperplasia
cavernous hemangioma
fibroma
hepatoma
When the liver is congenitally absent this is known as:
Adult Polycystic Disease
Agenesis
Schistosomiasis
Pyogenic Abscess
Agenesis
This patient has presented with portal hypertension after coming back from a trip to a third world country. You notice that the portal tracts are wider than normal and appear to be somewhat occluded. What is this possible pathology?
Hydatid Disease
Pyogenic Abscess
Fungal Abscess
Schistosomiasis
Schistosomiasis
Splenomegaly can be a result of _______.
Hydatid disease
Liver cysts
Fatty liver
Portal HTN
Portal HTN
A 30-year-old patient presents with abdominal pain and abnormal liver function tests. The abdominal ultrasound reveals a dilated portal and superior mesenteric vein with hepatofugal blood flow. This is most characteristic of:
portal aneurysm
portal atresia
portal fistula
portal hypertension
portal hypertension
The “wheel with in a wheel” lesion is a sonographic appearance of which pathology?
A. Pyogenic Abscess
B. Fungal Abscess
C. Candidiasis
D. Amebic Abscess
A & C
B & C
C & D
B & C
Your patient has a history of HCC. They come in because they have had sudden onset of severe abdominal pain. You place the probe down and start scanning their liver and see the portal vein. When you put color on it there is no color showing up. What is this?
Budd-Chiari Syndrome
Schistosomiasis
Portal Thrombosis
Normal Portal Vein
Portal Thrombosis
Which of the following cancers is the most common primary cancer of the liver that affects adults?
HCC-Hepatocellular Carcinoma
Echogenic Liver Mets
Hypoechoic Liver Mets
Hepatoblastoma
HCC-Hepatocellular Carcinoma
