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DSM Abd > Liver Pathology > Flashcards

Liver Pathology Flashcards

1
Q

What pathology is congenital,traumatic,parasitic, or inflammatory in origin. Affecting the Rt lobe most often, and affects women more than men.

A

Hepatic cysts

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2
Q

Asymptomatic, Normal liver function tests, Polycystic kidney disease

A

Clinical findings of Hepatic Cysts

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3
Q

Anechoic mass or masses with smooth walls and
posterior acoustic enhancement
May have irregular shapes Clusters of cysts may be noted

A

Sonographic findings of Hepatic Cysts

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4
Q

Infection

Pyogenic Abscess

A

Results when bacteria enters the liver from the biliary
tree,portal vein or hepatic artery
Pyo(pus filled) Most common source is E Coli, but often the etiology
is unknown
Symptoms- fever,pain,n/v,diarrhea,andpleuritic pain 100% mortality if left untreated Appears as round or oval mass,irregularwalls,internal
echoes

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5
Q

Fever Hepatomegaly Leukocytosis Possible abnormal liver function tests Right upper quadrant pain

A

Clinical findings of a pyogenic hepatic abscess

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6
Q

Complex cyst with thick walls Mass may contain debris,septations, and/or gas The air within the abscess may produce dirty
shadowing or ring-down artifact
Results from a spread of infection from an
inflammatory condition such as appendicitis, diverticulitis, endocarditis, .. Bacteria enters the liver through the PV, HA, or from a surgery

A

Sonographic findings of a pyogenic

abscess

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7
Q

Most often associated with AIDS, but also affects bone
marrow and organ transplant patients
Appears as diffuse micro-echogenic foci without
shadowing to macro-echogenic clusters of dense calcifications

A

Pneumocystis Carinii

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8
Q

Parasitic Disease

A

Amebic abscess Parasites reach the liver via the portal vein Amebiasis is contracted by eating contaminated food
or water
The organism often will remain confined to the GI
tract and patient is asymptomatic, those who are symptomatic will present with diarrhea, and abd pain, increased WBC’s
Appears as round or oval mass with internal echoes

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9
Q

Echinococcal cyst

A

Parasite is found in areas of the world where dogs
assist in cattle and sheep herding
Daughter cysts develop within a parent cyst

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10
Q

Recent travel out of the country
This infection is caused by the protozoa E histolytica,
which ascends the portal venous system
Hepatomegaly Right upper quadrant or general abdominal pain General malaise Diarrhea (possibly bloody) Fever Leukocytosis Elevated liver function tests Mild anemia

A

Clinical findings of an Amebic

Hepatic Abscess

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11
Q

Round, hypoechoic or anechoic mass or massed May contain debris Acoustic enhancement

A

Sonographic findings of amebic

hepatic abscess

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12
Q

Leukocytosis Low-grade fever Nausea Obstructive jaundice Right upper quadrant tenderness Sheep herding countries

A

Clinical findings of Hydatid Liver cyst

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13
Q

Anechoic mass containing some debris(hydatid sand) “Water lily” sign-wall of the endocyst seen floating
within the pericyst
“Mother” cyst containing one or more smaller
“daughter” cyst
Mass may contain some elements of dense
calcification

A

Sonographic findings of hydatid

liver cysts

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14
Q

Symptoms, abdominal mass and high cardiac output

due to av shunting throughout the tumor

A

Tumors-Benign- Pediatric

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15
Q

Tumors-Benign- Pediatric

A

I Most frequently see symptomatic vascular tumor of
the liver in infants
Most common in females

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16
Q

Appears as hyperechoic,hypoechoic or complex mass

AV shunting may contribute to large draining veins and dialated prox aorta

A

infantile hemangioendothelioma

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17
Q

Focal nodular hyperplasia (FNH)

A

Tumors-Benign- Adult

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18
Q

Second most common benign tumor seen in women

A

Focal nodular hyperplasia (FNH)

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19
Q

Appears as a subtle liver mass usually

A

Focal nodular hyperplasia (FNH)

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20
Q

infantile hemangioendothelioma

A

Tumors-Benign- Pediatric

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21
Q

Liver cell adenoma

A

-Benign More frequently seen in women taking oral

contraceptives

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22
Q

Symptoms are palpable mass, severe RUQ pain due to

rupture of the mass

A

Liver cell adenoma

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23
Q

Appearance is variable ranging from hypoechoic to
hyperechoic. Solitary, well defined margins. Range in size to 15 cm
Surgical resection recommended since these may
become malignant

A

Liver cell adenoma

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24
Q

Lipomas

A

Rare,comprised of mesenchymal elements All fatty liver tumors are not lipomas and differentials
include angiomyolipoma and hepatoma. Confirmation is made by CT
Benign

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25
Q

Hepatoblastoma

A

Tumors-Malignant-Pediatric
Most common malignant tumor of childhood High incidence with children who have Beckwith-
Wiedemann syndrome

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26
Q

Hepatocellularcarcinoma HCC

A

Malignant-Adult
Related to cirrhosis, hepatocarcinogens in food, and
hepatitis B and C

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27
Q

Symtoms – unexplained mild fever and weight loss,

hepatomegaly

A

Hepatocellularcarcinoma HCC

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28
Q

Appearance varies from solitary mass to diffuse
infiltration or multiple tumors
Invades portal venous system and hepatic veins

A

Hepatocellularcarcinoma HCC

29
Q

Elevated alpha-fetoprotein Abnormal liver function tests Cirrhosis Chronic hepatitis Unexplained weight loss Hepatomegaly Fever Palpable mass Ascites

A

Clinical findings of Hepatocellular

Carcinoma

30
Q

Solitary, small hypoechoic mass Heterogenous masses scatered throughout the liver Mass with a hypoechoic halo

A

Sonographic findings of

Hepatocelluar Carcinoma

31
Q

Metastasis

A

Primary source is from colon,lung and breast Spread to the liver via the portal vein,hepatic artery
and lymphatics
Appears as one of four patterns discrete echogenic,
target or bullseye,discrete hypoechoic, cystic or diffusely inhomogenous

32
Q

GI tract and pancreas tend to be calcified tumors Hypoechoic masses may be from the breast, lung, or
lymphoma
Hyperechoic masses may be from the kidney and
pancreas
“Target” or “bulls-eye” lesion may be from lung or
colon

A

Sonographic findings of Hepatic

Metastasis

33
Q

Most common post op complication of Liver transplant

A

hepatic artery

thrombosis and infection

34
Q

Ultrasound is used for pre and post-op evaluation for Liver transplant

A

Pre-op, main focus is to evaluate portal vein size and

patency. Patency of hepatic veins and hepatic artery

35
Q

affects the hepatocytes and interferes

with liver function

A

Diffuse disease

36
Q

An acquired and reversible disease Benign Increased lipid accumulation in the hepatocytes
leading to impaired or excessive metabolism of fat

A

Fatty Infiltrate

37
Q

Asymptomatic Alcohol abuse Chemotherapy Diabetes mellitus Elevated liver function test Obesity Pregnancy

A

Clinical findings of Fatty Liver Disease

38
Q

Diffusely echogenic liver Liver may appear patchy, inhomogenous due to focal
sparing
Liver is enlarged(hepatomegaly) Increased attenuation of the sound beam Walls of the hepatic vasculature and diaphragm will
not be easily imaged(secondary to increased attenuation)
Compare the echogenicity of the right kidney to the
liver.

A

Sonograhic findings of Fatty Liver Disease

39
Q

Locations for Focal Fatty Sparing

A

Adjacent to the gallbladder Near the porta hepatis Entire medial segment of the left lobe Can appear much like pericholecystic fluid when seen
adjacent to the gallbladder

40
Q

Hepatitis

A

Broadly defined as inflammation of the liver

41
Q

Contracted through contact with fecal

matter,contaminated food, body fluids, and blood.

A

Hepatitis

42
Q

Acute and Chronic
Results from infection by a group of viruses that
specifically target the hepatocytes

A

Hepatitis

43
Q

spread primarily by feces since the

virus lives in the alimentary tract. Found worldwide, accounts for 20% of cases. Acute

A

Hep A(HAV) viral

44
Q

spread by transfusions of infected

blood or plasma or through contaminated needles

A

Hep B(HBV) viral

45
Q

Can also be transmitted from body fluids. Greatest risk for Health Care workers, accounts for 60% of cases

A

Hep B(HBV) viral

46
Q

diagnosed by the presence in blood

of the antibody to HCV. Seen mostly in Italy and other Mediterranean countries

A

Hep C(HCV) viral

47
Q

entirely dependent on HBV for its

infectivity, rare in North America, seen primarily in IV drug users Must have HBV to aquire

A

Hep D (HDV) viral

48
Q

caused by fecally infected waters

May be seen in liver transplantation

A

Hep E (HEV) viral

49
Q

newly discovered, first described in

1996, caused by blood transfusion

A

Hep (HGV)viral

50
Q

Clinical findings of Hepatitis

A

Chills Dark urine Elevated liver function tests Fatigue Fever Hepatosplenomegaly Jaundice Nausea Vomiting

51
Q

Sonographic findings of hepatitis

A

Normal liver Enlarged, hypoechoic liver Periportal cuffing with “starry sky” Gallbladder wall thickening

52
Q

Diffuse process characterized by fibrosis and

conversion of normal liver parenchyma into structurally abnormal nodules

A

Cirrhosis

53
Q

Cirrhosis

A

Generalized involvement of the liver by parenchymal
necrosis, regeneration, and diffuse fibrosis
Scarring is progressive and irreversible leading to liver
cell failure and portal hypertension

54
Q

A leading cause of death in the US

A

Cirrhosis

55
Q

Most common causeof micronodular cirrhosis

A

Alcohol Abuse

56
Q

Most common cause of macronodular (1.0-5.0 cm)

cirrhosis

A

Viral Hepatitis

57
Q

drug

abuse,obesity,chronic bile retention, cardiac insuffiency,and some medication

A

Other causes of cirrhosis

58
Q

Clinical findings of cirrhosis

A

Ascites Diarrhea Elevated liver function tests Fatigue Hepatomegaly(initial) Jaundice Splenomegaly Weight loss

59
Q

Hepatomegaly( initially) Shrunken right lobe of the liver Enlarged caudate and left lobe Nodular surface irregularity Coarse echotexture Splenomegaly Ascites Monophasic flow within the hepatic veins Hepatofugal flow within the portal veins

A

Sonographic findings of Cirrhosis

60
Q

Portal Hypertension

A

> 90% due to cirrhosis
Can also be due to obstruction of the portal,hepatic
veins, and/or IVC, or longstanding CHF
Contributes to the formation of ascites,splenomegaly
and GI bleeding
Varices and collateral venous channels Caput medusal sign- collateral vessels on the
abdominal wall

61
Q

Portal vein enlarge (>13mm)

A

Portal Hypertension

62
Q

If red is the top color on the color scale, this means

blood flow is toward the probe, toward the liver. The normal color than for the PV is

A

red

63
Q

Echogenic thrombus within the portal vein
Cavernous transformation of the portal veins will
appear as wormlike or serpiginousvessels within the region of the portal vein

A

Sonographic findings of Portal Vein

Thrombosis

64
Q

Obstruction of the hepatic venous outflow
Etiologies include hypercoaguable states,oral
contraceptives,collagen vascular diseases,hepatic tumors
Portal vein thrombosis has been reported in approx
20%

A

Budd-Chiari Syndrome

65
Q

Ascites Elevated liver function test Hepatomegaly Splenomegaly Upper abdominal pain

A

Clinical findings of Budd-Chiari Syndrome

66
Q

Most common benign mass in liver

A

Cavernous hemangeoma

67
Q

Sonographic findings of Budd-

Chiari Syndrome

A

Nonvisualizationor reduced visualization of the
hepatic veins
Thrombus within the hepatic veins Enlarged caudate lobe Lack of flow within the hepatic veins with color
Doppler
Narrowing of the inferior vena cava

68
Q

Extrahepatic

A

anterior displacement of the RK.

Anteromedial shift of the IVC. Discontinuity of the liver capsule,

69
Q

Intrahepatic

A

Posterior displacement of the IVC.

Displacement of the hepatic vascular radicles. External bulging of the liver capsule

DSM Abd (9 decks)

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