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Abdomen 3 > Metabolic Disease > Flashcards

Metabolic Disease Flashcards

1
Q

Diffuse process that is dysfunction of hepatocytes and normal tissue is replaced with fat or fibrosis

A

Hepatocellular disease

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2
Q

Fat accumulation within the hepatocytes that is acquired and reversible

A

Fatty infiltration (steatosis)

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3
Q

The liver becomes more hyperechoic and heterogenous with a change in the ability to visualize vessels

A

Fatty infiltration

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4
Q

The grades of fatty infiltration

A

Grade 1: Mild: slight increase in echogenicity, diaphragm and vessels clearly visible
Grade 2: Moderate: increased echogenicity, diaphragm and vessels not well defined
Grade 3: Severe: markedly increased echogenicity, very difficult to see diaphragm and vessels

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5
Q

Focal areas of increased echogenicity (fat deposits) within mostly normal liver tissue

A

Focal fatty infiltration

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6
Q

Focal hypoechoic areas (normal liver tissue) within a mostly fatty liver

A

Focal fatty sparing

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7
Q

Which area is mostly involved in focal fatty changes? What are some characteristics?

A

Medial left lobe. Map like boundaries and rapid change over time

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8
Q

A diffuse process that destroys liver cells and is not reversible

A

Cirrhosis

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9
Q

Appears as severe fatty infiltration and enlarged liver

A

Acute cirrhosis

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10
Q

Small liver, coarse echotexture, nodular surface, small vessel sizes

A

Chronic cirrhosis

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11
Q

What are some lab values associated with cirrhosis?

A

AST, ALT, LDH, ALP, bilirubin (conjugated)

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12
Q

What are the 3 main clinical presentations of cirrhosis?

A

Hepatomegaly, jaundice, ascites

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13
Q

Autosomal recessive disorder that causes excess glycogen deposits in hepatocytes

A

Glycogen storage disease/ Von Gierke’s

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14
Q

GSD sonographic appearance

A

Diffuse fatty infiltration and adenomas

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15
Q

2 types of ascites

A

Transudate: anechoic (little/no protein or cells), suggests non-inflammatory process
Exudate: echogenic, high protein content (blood, pus, chylous), inflammatory or malignant cause

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16
Q

Free vs loculated fluid

A

Free fluid: changes with patient position, conforms to organs
Loculated: no change with movement, round/mass like effect

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17
Q

The 3 most dependent spaces in the abdominopelvic cavity?

A

Morison’s Pouch, paracolic gutters, Pouch of Douglas

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18
Q

A mixture of particulate matter and bile that can be a precursor to GB disease, most commonly caused by bile stasis

A

Biliary sludge

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19
Q

When sludge becomes the same echogenicity as the liver and camouflages the GB

A

GB hepatization

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20
Q

Pseudo sludge

A

Artifact due to excessive gains

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21
Q

The presence of pus in bile

A

Empyema

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22
Q

Blood in the bile

A

Hemobilia

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23
Q

GB filled with semi solid deposits

A

Milk of calcium (limey bile)

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24
Q

Most common disease of the GB

A

Cholelithiasis (gallstones)

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25
Q

Three factors that affect gallstone formation

A
  • abnormal bile composition
  • biliary stasis
  • infection
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26
Q

3 different types of GB stones

A
  1. Cholesterol
  2. Bilirubin
  3. Calcium
27
Q

Who’s most at risk for GB stones? (5 f’s)

A

Female, fat, fertile, forty, family history

28
Q

What are some of the clinical presentations for gallstones?

A

Asymptomatic, RUQ pain, N&V, belching

29
Q

What is the WES sign?

A

Wall, echo, shadow.

When the GB is completely filled with stones

30
Q

What lab values may indicate stones?

A

AST, ALT, ALP, BILI

31
Q

What are 3 complications associated with gallstones?

A

Biliary colic (most common), obstruction of cystic duct or CBD, bacterial infection, cholecystitis, ascending cholangitis

32
Q

Differentiate painful/painless jaundice

A

Painless: neoplastic condition, choledochal cysts
Painful: acute obstruction or infection of the biliary tree

33
Q

What are some S/S of biliary obstruction

A
  • jaundice
  • clay coloured stool
  • abnormal LFT’s
  • pain
  • nausea
34
Q

Stones in the biliary tree

A

Choledocholithiasis

35
Q

Most common location for choledocholithiasis

A

Distal CBD at Ampulla of Vater

36
Q

Stones in the urinary system

A

Urolithiasis

37
Q

Stones in the renal collecting system

A

Nephrolithiasis

38
Q

Calcifications in the renal parenchyma

A

Nephrocalcinosis

39
Q

Where are the narrowings in the ureter that are common for stones to get lodged? What size stones can be passed?

A

1.UPJ
2. Iliac vessels
3. UVJ (most common)
stones <5mm can pass

40
Q

What artifact is associated with stones?

A

Twinkling artifact

41
Q

Dilatation of the renal collecting system

A

Hydronephrosis

42
Q

Obstructive vs non obstructive hydro

A

Obstructive: intrinsic/extrinsic obstruction of flow. Look for jets
Non-obstructive: reflux, infection, polyuria

43
Q

Grade hydronephrosis

A

Grade 1: slight separation of the renal sinus
Grade 2: separation of the entire central sinus, clubbed calyces
Grade 3: severe, cortical thinning, loss of individual calyx definition

44
Q

Anderson-Carr Kidney on U/S

A

Non-shadowing echogenic rims of pyramids

45
Q

Poorly functioning but unobstructed kidneys

A

Medical renal disease

46
Q

Diffuse increase in cortical echogenicity with prominent CM junction, enlarged kidneys

A

Acute medical renal disease

47
Q

Chronic medical renal disease

A

Small, echogenic kidney

48
Q

Most common cause of ARF and is reversible

A

Acute tubular necrosis

49
Q

Necrosis of the cortex with sparing of the pyramids

A

Acute cortical necrosis

50
Q

Acute glomerulonephritis

A

Autoimmune reaction

51
Q

Amyloid deposits in the kidneys

A

Amyloidosis

52
Q

Most common cause of chronic renal failure

A

Diabetes mellitus

53
Q

Inability of kidneys to remove waste from blood and results in azotemia

A

Renal failure

54
Q

What are the 3 causes of renal failure?

A
  1. Pre-renal: sepsis, stenosis
  2. Renal: tissue
  3. Post renal: obstruction of collecting system
55
Q

What lab values may be abnormal with renal disease?

A
  • Creatinine **
  • BUN
  • Uric acid
  • RBC/WBC in urine
  • proteinuria
56
Q

Excessive cortisol secretion

A

Cushing’s syndrome

57
Q

Cushing’s disease

A

Due to malfunctioning pituitary (too much ACTH)

58
Q

Hyperadrenalism vs hypoadrenalism

A

Hyper: too much hormone
Hypo: not enough hormone

59
Q

Excessive aldosterone secretion

A

Conn’s Disease

60
Q

MEN type 2

A

Bilateral, autosomal dominant, malignant

61
Q

Tumours developing in several endocrine glands

A

MEN

62
Q

Chronic primary hypoadrenalism that is usually autoimmune & affects mostly females

A

Addison’s disease

63
Q

Acute hypoadrenalism

A

Waterhouse-Friderichsen Syndrome

64
Q

Which enzyme is most sensitive indicator of biliary obstruction

A

ALP

Abdomen 3 (8 decks)

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