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SONOCAN ABD Review > Liver Review > Flashcards

Liver Review Flashcards

1
Q

In a post liver transplant patient, the hepatic artery should demonstrate
1. A sharp systolic downstroke
2. Retrograde flow in early diastole
3. Sharp systolic upstroke
4. A high resistance waveform

A
  1. A sharp systolic upstroke

The hepatic artery should demonstrate low resistance waveform with a sharp systolic upstroke and continuous antegrade flow during diastole.

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2
Q

Sonographic findings commonly associated with portal hypertension include which of the following?
1. Hypoechoic liver parenchyma and gastric varices
2. Splenomegaly and hepatofugal flow in the main portal vein
3. Hyperechoic liver parenchyma and hepatopetal flow in the main portal vein
4. Splenomegaly and decreased resistance in the proper hepatic artery

A
  1. Portal hypertension is associated with compression or occlusion of the portal veins. Sonographic findings findings may include
  2. Hepatomegaly,
  3. Splenomegaly
  4. Hepatofugal flow in the hepatic artery
  5. Formation of collaterals
  6. Increase in diameter of the MPV, SV, and SMV.

Echogenicity of the liver parenchyma is generally hyperechoic. Hypoechoic liver parenchyma is more likely associated with hepatitis.

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3
Q

Gain settings should be placed to demonstrate the normal liver: as

  1. A medium shade of gray
  2. Hypoehoic to the spleen
  3. hyperechoic to the pancreas
  4. Hyperechoic to the renal sinus
A
  1. A medium shade of gray

The liver is hyperechoic to the normal renal cortex. The normal spleen is also iso-hyperechoic to the liver.

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4
Q

A hepatic cavernous hemangioma most commonly appears on U/S as:

  1. A complex mass
  2. Hyperechoic mass
  3. Isoechoic mass
  4. Hypoechoic mass
A
  1. Hyperechoic
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5
Q

Which of the following ligaments separates the left lobe from the caudate lobe of the liver?

  1. Coronary
  2. Falciform
  3. Venosum
  4. Hepatoduodenal
A
  1. Venosum
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6
Q

The most common cause of cirrhosis in the US is:

  1. Hep B
  2. Anorexia nervosa
  3. Alcohol abuse
  4. Biliary obstruction
A

c. Alcohol abuse

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7
Q

Which of the follow symptoms is not associated with hepatocellular carcinoma?

  1. Weight loss
  2. Abdominal pain
  3. Unexplained fever
  4. Elevated serum albumin
A
  1. Elevated serum albumin
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8
Q

Clinical findings of a hepatoma may include what things? 8

A
  1. Abdominal pain
  2. Palpable mass
  3. Weight loss
  4. Hepatomegaly
  5. Jaundice
  6. Unexplained fever
  7. Elevated AST, ALT, and alkaline phosphates
  8. Positive AFP (Alpha fetal proteins)
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9
Q

In the US, A hepatic abscess is most likely to develop in which of the following conditions?

  1. Acute pancreatitis
  2. Biliary obstruction
  3. Ascending cholangitis
  4. Budd- Chiari syndrome
A
  1. Ascending cholangitis
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10
Q

Which of the following structures separate the left lobe of the liver from the right lobe?

  1. LHV and MLF
  2. MHV and Ligamentum venosum
  3. MHV and MLF
  4. LHV and right intersegmental fissure
A
  1. MHV and MLF
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11
Q

The right lobe of the liver is divided into anterior and posterior segments by the:

  1. MPV
  2. RPV
  3. RHV
  4. MHV
A
  1. RHV
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12
Q

An accumulation of triglycerides in the hepatocytes is found in which of the following?

  1. Hepatic steatosis
  2. Cavernous hemangioma
  3. Glycogen storage disease
  4. Focal Nodular hyperplasia
A
  1. Hepatic steatosis

Excessive deposition of glycogen is found in glycogen storage disease

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13
Q

Patients with a history of hep B have a predisposing risk factor for developing:

  1. An adenoma
  2. Hepatoma
  3. Focal nodular hyperplasia
  4. Cavernous hemangioma
A
  1. Hepatoma

3 and 4 are vascular malformations not related to hepatitis

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14
Q

Daughter cysts are associated with which of the following pathologies

  1. Adenoma
  2. Fungal abscess
  3. Cystadenoma
  4. Echinococcal cyst
A
  1. Echinococcal cyst
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15
Q

What is a daughter cyst?

A

Cyst containing smaller cyst.

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16
Q

Which of the following hepatic structures is interlobar in location?

  1. Hepatic artery
  2. Portal vein
  3. Hepatic vein
  4. Biliary duct
A
  1. Hepatic vein

The hepatic veins course between the lobes of the liver. (Interlobar). The others generally course parallel with one another within the lobes of the liver.

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17
Q

The normal blood flow pattern in the main portal vein is described as:

  1. Phasic
  2. pulsatile
  3. Hepatofugal
  4. Continuous
A
  1. Phasic

Continuous flow does not vary with respiration

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18
Q

The hypoechoic area documented in the sonogram most likely represents:

  1. Nodular fibrosis
  2. A lymph Node
  3. Malignant lesion
  4. Normal liver tissue
A
  1. Normal liver tissue
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19
Q

The hepatic pathology demonstrated in this sonogram most likely represents:

  1. Cirrhosis
  2. Lymphoma
  3. Fatty infiltration
  4. Liver metastasis
A

Fatty Infiltration

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20
Q

The abnormality demonstrated in this sonograph most likely represents:

  1. An adenoma
  2. Hematoma
  3. Cavernous hemangioma
  4. FNH
A
  1. Cavernous hemangioma
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21
Q

What is the most suspicious descriptor of a cavernous hemangioma?

A

Hyperechoic mass with smooth wall margins

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22
Q

The finding in this duplex image of the porta hepatis is most commonly associated with which of the following conditions? (This is a MPV)

  1. Hepatitis
  2. Portal Hypertension
  3. Budd- chiari syndrome
  4. Portal vein thrombosis
A

B. Portal Hypertension

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23
Q

The arrow identifies which of the following hepatic lobes?

  1. Caudate lobe
  2. Lateral left lobe
  3. Medial left lobe
  4. Anterior right lobe
A
  1. Medial Left lobe
24
Q

This sonogram of the right lobe of the liver is most likely demonstrating which of the following conditions? (SAG RUQ)

  1. Hepatitis
  2. Cirrhosis
  3. Riedel’s lobe
  4. Hepatomegaly
A
  1. Riedel’s lobe
25
Q

The mass identified in this sonograph is most consistent with:

  1. Biloma
  2. Simple cyst
  3. Resolving hematoma
  4. Echinococcal cyst
A

2.Simple cyst

26
Q

What kind of appearance does a echinoccocal cyst demonstrate?

A

Septated appearance

27
Q

Which of the following pathologies is also demonstrated in this sonogram?

  1. Cholecystitis
  2. Choledocholithiasis
  3. Cholelithiasis
  4. Cavernous hemangioma
A
  1. Cholelithiasis
28
Q

Which of the following liver pathologies is associated with immune- suppressed patients?

  1. Adenoma
  2. Candidiasis
  3. Echinococcal cyst
  4. Polycystic disease
A
  1. Candidiasis
29
Q

What is Candidiasis?

A

A rare fungal infection found in immune compromised patients.

30
Q

Echinococcal cysts are associated with what?

A

Recent travel to other counties

31
Q

Metastatic lesions involving the liver most commonly originate from a primary malignancy of the:

  1. Pancreas
  2. Colon
  3. Stomach
  4. Gallbladder
A
  1. Colon
32
Q

Which of the following ligaments serves as a barrier between the subphrenic space and morison’s pouch?

  1. Falciform
  2. Coronary
  3. Gastrophepatic
  4. Hepatoduodenal
A
  1. Coronary
33
Q

An abnormally enlarged or dilated vein is most commonly termed what?

  1. Shunt
  2. Varix
  3. Aneurysm
  4. Perforator
A
  1. Varix
34
Q

Traditional Lobar anatomy divides the liver into:

  1. Three lobes
  2. Four lobes
  3. Six lobes
  4. Eight lobes
A
  1. Four lobes
35
Q

Severe insult to the liver cells leading to subsequent necrosis describes:

  1. Cirrhosis
  2. Portal hypertension
  3. Budd-Chiari syndrome
  4. FNH
A
  1. Cirrhosis
36
Q

Von Gierkes disease is most commonly associated with:

  1. Cirrhosis
  2. Schistosomiasis
  3. Glycogen storage disease
  4. FNH
A
  1. Glycogen storage disease
37
Q

Prominence of the portal veins is most likely associated with which of the following pathologies?

  1. Cirrhosis
  2. Hepatitis
  3. Polycystic disease
  4. Glycogen storage disease
A
  1. Hepatitis
38
Q

A transjugular intrahepatic portosystemic shunt (TIPS) is commonly placed between the:

  1. Right hepatic vein and the right portal vein
  2. Middle hepatic vein and the inferior vena cava
  3. Right portal vein and the inferior vena cava
  4. Left portal vein and the inferior vena cava
A
  1. Right hepatic vein and the right portal vein
39
Q

The paraumbilical vein courses from the umbilicus to the:

  1. Left hepatic vein
  2. SMV
  3. Middle hepatic vein
  4. Left portal vein
A
  1. Left portal vein
40
Q

The right hepatic artery lies between:

  1. MPV and CBD
  2. RPV and CHD
  3. LPV and CHD
  4. RPV and CBD
A
  1. RPV and CHD
41
Q

Which of the following spaces is located superior to the liver and inferior to the diaphragm?

  1. Pleura
  2. Lesser sac
  3. Subhepatic space
  4. Subphrenic space
A
  1. Subphrenic space
42
Q

Enlargement of the caudate lobe is most commonly associated with which of the following pathologies?

  1. Cirrhosis
  2. Candidiasis
  3. Fatty infiltration
  4. Portal hypertension
A
  1. Cirrhosis
43
Q

On spectral doppler, the hepatic veins are characterized by which of the following flow types?

  1. Laminar
  2. Parabolic
  3. Multiphasic
  4. Turbulent
A

c. Multiphasic

44
Q

Which of the following ligaments attaches the liver to the anterior abdominal wall?

  1. Venosum
  2. Falciform
  3. Triangular
  4. Right coronary ligament
A
  1. Falciform
45
Q

A trans duplex image of the liver displays what? (this image is a sag image of the liver)

  1. Normal portal venous flow
  2. Normal hepatic venous flow
  3. Normal and abnormal portal venous flow
  4. Normal and abnormal hepatic venous flow
A
  1. Normal and abnormal hepatic venous flow
46
Q

Which of the following most accurately describes the location of the caudate lobe?

  1. Medial to the lesser sac
  2. Posterior to the inferior vena cava
  3. Posterior to the porta hepatis
  4. Lateral to the IVC
A
  1. Posterior to the Porta hepatis

The caudate lobe is located posterior to the ligamentum venosum and porta hepatis, anterior and medial to the IVC, and lateral to the lesser sac.

47
Q

The color doppler image of the LUQ is most suspicious for?

  1. Flash artifact
  2. Gastric varices
  3. Bowel Peristalsis
  4. Abdominal aortic aneurysm
A

b. Gastric varicies

48
Q

Decreases in prothrombin time are associated with which of the following?

  1. Cirrhosis
  2. Clotting failure
  3. Acute cholecystitis
  4. Malabsorption of vitamin K
A
  1. Acute cholecystitis
49
Q

The most common symptom associated with acute thrombosis of the portal veins is

  1. Weight loss
  2. Tachycardia
  3. Severe abdominal pain
  4. Lower extremity edema
A
  1. Severe abdominal pain
50
Q

Placement of a transjugular portosystemic shunt (TIPS) will normally result in which of the following?

  1. Phasic flow in the main portal vein
  2. Hepatopetal flow in the right portal vein
  3. Hepatofugal flow in the left portal vein
  4. Slow flow velocities with the shunt
A
  1. Hepatofugal flow in the left portal vein
51
Q

After the placement of a TIPS shunt. What is the flow like in the portal veins? 3

A
  1. MPV should have turbulent hepatopetal flow
  2. LPV and RPV should have hepatofugal flow
52
Q

A 30 yo female patient presents to the U/S department with postprandial pain. The patient has been taking oral contraceptives for 10 years. Based on this clinical history and sonogram, the mass is most suspicious for?

  1. Adenoma
  2. Hepatoma
  3. Cavernous hemangioma
  4. FNH
A
  1. Adenoma
53
Q

The sonographic findings are most consistent with which of the following pathologies?

  1. Cirrhosis
  2. Fatty infiltration
  3. Candidiasis
  4. Liver Metastasis
A
  1. Liver metastasis
54
Q

The fluid collection identified in this image is located in which of the following spaces?

  1. Right pleura
  2. Subhepatic space
  3. Right paracolic gutter
  4. Right subphrenic space
A
  1. Right subphrenic space
55
Q

What pathology is identified in this sonogram?

  1. Choledochal cyst
  2. Simple hepatic cyst
  3. Abnormal Lymph node
  4. Hepatic artery aneurysm
A
  1. Simple hepatic cyst
56
Q

Which of the following ligaments is demonstrated in this trans image of the liver?

  1. Coronary
  2. Venosum
  3. Falciform
  4. Triangular
A

C. Falciform

57
Q

The sonogram is most suspicious for which of the following pathologies?

  1. Candidiasis
  2. Acute hepatitis
  3. Fatty infiltration
  4. Portal vein thrombosis
A
  1. Acute hepatitis

SONOCAN ABD Review (22 decks)

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