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Case Studies > Liver Powerpoints > Flashcards

Liver Powerpoints Flashcards

1
Q

What is the most common reason for malignant neoplasms in the liver?

A

Metastatic Disease

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2
Q

Where is the primary areas that mets of the liver originates from and how does it get there?

A

colon, GB, stomach, pancreas, lung and breast

travels through lymph or portal system

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3
Q

What is the most common primary malignant mass in liver, and who is it more common in? men or women?

A

HCC

Hepatocellular Carcinoma

Men

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4
Q

What common disease predisposes someone for hepatic CA?

A

cirrhosis

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5
Q

What are S/S of HCC?

A 
n/v
fatigue
weight loss
appetite disorder
fever 
hepatomegaly
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6
Q

What does HCC looks like on ultrasound?

A
  • solitary
  • multiple nodules
  • diffuse infiltration
  • can invade vascular structures
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7
Q

Name a few malignant liver diseases.

A
  • hepatocellular carcinoma
  • mets
  • lymphoma
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8
Q

What is 2nd most common benign liver tumor?

A

Focal Nodular Hyperplasia

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9
Q

Is FNH more common in the right lobe or left?

A

right

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10
Q

What age range and gender is FNH more common in?

A

females under 40 ( hormone related)

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11
Q

Focal Nodular Hyperplasia has a central scar on ultrasound.

t/f

A

true

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12
Q

rare cystic structure within a large lesion

A

hepatic cyst adenoma

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13
Q

tumor of glandular epithelium that is more common in females.

A

liver cell adenoma

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14
Q

What is the sonographic appearance of a hemangioma?

A

hyperechoic, enhancement, well defined borders, over time calcifications, complexity and anechoic, vascular

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15
Q

What does a hemangioma consist of?

A

blood-filled cystic spaces that is more common in females

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16
Q

Hemangioma’s can sometimes change echotexture due to degeneration, fibrosis, and calcification.

t/f

A

true

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17
Q

tumor of glandular epithelium

is usually hyperchoic with central hypoechoic structure.

A

Liver Cell Adenoma

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18
Q

What are the symptoms of a liver cell adenoma?

A

RUQ pain with rupture

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19
Q

What are patients at risk for with liver cell adenomas?

A

hemorrhage and can turn into malignancy

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20
Q

a cystic structure within a larger lesion.

is palpable

A

hepatic cyst adenoma

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21
Q

damage to liver cells that causes decreased liver function?

A

Hepatocellular disease

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22
Q

What will be elevated with Hepatocellular disease?

A

increased bilirubin, AST ALT and decreased albumin

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23
Q

Explain the process of how hepatocellular disease happens.

A

As damage to the hepatocytes increases, the liver function decreases. this affects the livers ability to conjugate bilirubin or reeive blood from PV. The hepatocytes become unable to perform their functions because of the fatty liver. Ascites can accumulate in the abdominal cavity as well.

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24
Q

What are some causes of fatty infiltration?

A

fat accumulated in liver cells, diabetes, alcoholism, obesity, hepatitis.

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25
Q

What are the clinical findings of fatty livers?

A

asymptomatic or general RUQ pain

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26
Q

Is a fatty liver reversible?

A

YES

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27
Q

Explain the different gradings of fatty livers?

A

grade 1-slight echogenic echotexture vessels and diaphragm still seen

2-moderate echogenicity, slightly difficult to see vessels

3-severe echogenicity and cannot see vessles.

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28
Q

Where is the most common area for focal sparing to be found in the liver?

A

around the GB

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29
Q

Describe the sonographic findings of fatty infiltration.

A

Ducts not visualized well, hyperechoic, decreased penetration

30
Q

What is hepatitis?

A

inflammatory disease of the liver

31
Q

Type of hepatitis

fecal contamination 3-6 months

A

Hep A

32
Q

type of hepatitis

virus blood and body fluids acute and chronic

A

Hep B

33
Q

type of hepatitis

virus, bloods, and body fluids, mostly chronic

A

Hep C

34
Q

What is the difference between acute and chronic hepatitis?”

A

Acute is 3-6 months with mild dysfunction of liver and chronic is longer than 6 months.

35
Q

What is the sonographic findings of a Hep patient?

A

it depends on extent of disease

if acute- there will be a larger, more echogenic liver with portal borders more prominent, splenomegaly and thickened GB wall

Chronic-echogenic and coarse liver, smaller, and vessels harder to see

36
Q

Hepatitis may show up on US as a _______ mass like areas.

A

hypoechoic

37
Q

What type of pathology has a “starry sky appearance” that has to do with the echogenic portal walls?

A

hepatitis

38
Q

What is the dengenerative disease of the liver called?

A

cirrhosis

39
Q

What are some causes of cirrhosis?

A

alcoholism, hepatitis, drug induced, poor nutritioni and infectious disease

40
Q

What are the symptoms for acute cirrhosis?

A
  • N/V
  • flatulence
  • ascites
  • light colored stool
  • fatigue/weak
  • abdominal pain
  • Varicosities
41
Q

What are the symptoms for chronic cirrhosis?

A
  • anorexia
  • n/v
  • weight loss
  • jaundice
  • dark urine
  • fatigue
  • varicosities
42
Q

What will the liver look like in the early to middle stages of cirrhosis?

A
  • coarsened
  • nodularity
  • hepatosplenomegaly
  • decreased visualization of vessels
  • caudate and lt lobe enlarged.
43
Q

What is the sonographic findings of chronic cirrhosis?

A
  • shrunken
  • coarsened
  • isoechoic nodules
  • portal hypertension
  • risk of hepatoma
44
Q

What pathology is portal hypertension often associated with?

A

long standing liver diseases such as cirrhosis

45
Q

What causes the portal hypertension?

A

fibrosis from cirrhosis causes thrombosis

46
Q

What pathology is a recanalized umbilical vein often associated with?

A

cirrhosis

47
Q

When there is too much glycogen storage and lack of enzymes it is called ______?

A

glycogen storage disease

48
Q

What is the most common form of glycogen storage disease?

A

Von Gierke’s disease

49
Q

What will glycogen storage disease look like on ultrasound?

A

echogenic enlarged liver with increased attenuation and focal adenomas and hyperplasia

50
Q

What is an metabolic disorder that includes having excess iron?

A

Hemochromatosis

51
Q

What can cause biliary obstruction?

A

gallstones, CBD carcinoma, or a tumor invasion.

52
Q

What are the symptoms of biliary obstruction>?

A

jaundice, itching, dilated intrahepatic ducts, elevated ALK and direct bilirubin.

53
Q

There could be a mass at the head of the pancreas that could cause ductal dilation

T/F

A

True

54
Q

When is a CBD stricture often seen?

A

after a cholecystectomy

55
Q

What are some differentials for focal hepatic disease?

A

primary carcinoma, mets, cysts, abscesses, or hematoma.

56
Q

What will Intrahepatic Focal Hepatic Disease look like on Ultrasound

A

vessel displacement, bulging of liver capsule, and shifting of IVC

57
Q

What will Extrahepatic Focal Hepatic Disease look like on Ultrasound

A

invagination of the liver capsule, displacement of IVC anteriormedial
and displacement of right kidney anteriorly.

58
Q

a genetic disorder often associated with PKD

A

Polycystic Liver Disease

59
Q

Polycystic liver disease will appear as multiple small cysts that will looks like an abscess when clumped together

T/F

A

True

60
Q

What type of cyst is from tapeworm from dogs and not common in the US?

A

echinococcal cysts

61
Q

Sonographically, what will an echinococcal cyst look like on US?

A

simple to complex cyst with calcifications having a

“honeycomb” appearance

62
Q

Where is an echinococcal cyst usually found in?

A

the lungs

63
Q

a collection of pus and necrosis of tissue

on US, it will look hypoechoic but variable-complex, lack of walls, and posterior enhancement.

A

amebic abscess

64
Q

what is a congenital pathology in which white blood cells ingest bacteria but does not kill it?

A

Chronic Granulomatous

65
Q

What is chronic granulomatous caused by and when is it usually found?

A

it is caused by repeated infections and is commonly found in pediatric patients.

66
Q

What is hepatic candidiasis caused by

A

caused by candida (fungal infection)

67
Q

what type of patients are at risk for hepatic candidiasis? And what will the patient present with?

A

immunocompromised patients

fever and localized pain

68
Q

What will hepatic candidiasis look like on ultrasound?

A

multiple, small, hypoechoic lesions with a bulls-eye appearance.

69
Q

bacteria from an infection somewhere else in the body that travels to the liver and forms an abscess

A

pyogenic abscess

70
Q

What will pyogenic abscesses look like on ultrasound?

A

small-large, mostly on the right lobe, cystic or complex

Case Studies (14 decks)

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