Metabolic Diseases Flashcards
What is hepatocellular disease?
A diffuse dysfunction of the hepatocytes where normal liver tissue is replaced with fat or fibrosis and the liver size is often affected.
What lab values would you expect to affected by hepatocellular disease?
LFT’s
What is another name for fatty infiltration?
Steatosis
What is fatty infiltration?
Accumulation of triglycerides (fat) within hepatocytes
What are the 2 most common causes of fatty infiltration?
Alcohol abuse and obesity
What is fatty infiltration a precursor to?
Significant chronic disease (Cirrhosis)
What four things should be looked for when evaluating the liver for fatty infiltration?
- Echogenicity changes
- Echotexture changes
- Attenuation characteristics
- Ability to visualize vessels
What is the sonographic appearance of fatty infiltration?(3)
- Difficult penetration
- Paucity of vessels
- Echogenicity change
What is the prognosis of fatty infiltration and the prognosis of focal fatty changes?
Infiltration - Can be reversed by fixing lifestyle habits
Fatty changes - Can resolve rapidly (as fast as 6 days)
Describe the sonographic characteristics of MILD fatty infiltration: (2)
- Slight increase in liver echogenicity
- Diaphragm and vessels clearly defined
Describe the sonographic characteristics of MODERATE fatty infiltration: (2)
- Increase in liver echogenicity
- Vessels and diaphragm not sharply defined
Describe the sonographic characteristics of SEVERE fatty infiltration: (2)
- Liver echogenicity increased markedly
- Extremely difficult to define diaphragm and vessel walls
What are two types of focal fatty change?
Infiltration and sparing
Describe the sonographic characteristics of focal fatty infiltration:
Focal areas of increased echogenicity and mostly normal liver parnechyma
Describe the sonographic characteristics of focal fatty sparing:
Majority of liver parenchyma has fatty infiltration, focal hypoechoic areas (normal liver tissue)
What lab values could potentially be elevated with fatty infiltration?
ALT, AST, possibly GGT
What is cirrhosis?
A diffuse process that destroys the liver cells and results in fibrosis of liver parenchyma with nodular changes
What is the most common cause of cirrhosis and what are the other underlying?
Most common = Alcohol abuse
Other:
- Chronic viral hepatitis
- Primary sclerosing cholangitits
What are the three stages of progressive change in cirrhosis?
Cell death, fibrosis, and regeneration (of fibrotic tissue)
Is cirrhosis reversible?
No, it’s irreversible
What are the two types of nodular change with cirrhosis?
Micro nodular and macro nodular
What would micro nodular cirrhosis likely be due to?
Alcohol consumption
What would macro nodular cirrhosis likely be due to?
Chronic viral hepatitis
How does acute cirrhosis appear?
Same as severe fatty infiltration