Module 4- Hepatobiliary

Question 1

Case 1: 11 YO Jack Russell Terrier. History of lethargy and vomiting. Currently elevated bilirubin.

Which of the following describes the area surrounding the gall bladder and the gall bladder abnormalities itself?

1. Enlarged gall bladder with formed echogenic material (kiwi fruit appearance)
2. Hyperechoic liver surrounding the gall bladder
3. Hyperechoic mesentery surrounding the gall bladder
4. Severe thickening of the gall bladder wall

Answer 1

1. Enlarged gall bladder with formed echogenic material (kiwi fruit appearance)
2. Hyperechoic mesentery surrounding the gall bladder

Question 2

Case 2: 8 YO Mixed breed dog, FN, Febrile and elevated alkaline phosphatase

The changes seen in and around the gall bladder are most consistent with which of the following?

1. Cholecystitis
2. Cholecystoliths and biliary mass at the neck of the gall bladder
3. Extrahepatic bile duct obstruction - chronic
4. Mucocele

Answer 2

1. Cholecystitis

Question 3

Case 3: 10 YO, poodle FN, PU/PD and glucosuria.

Which of the following changes were present in this examination?

1. Left adrenal gland nodule
2. Renal cortical cysts
3. Left renomegaly with perinephric effusion
4. Septated cysts in the liver

Answer 3

1. Left adrenal gland nodule
2. Renal cortical cysts
3. 4. Septated cysts in the liver

Question 4

Case 4: 12 YO maltese, chronic hypothyroidism, currently PU/PD

In this dog, the liver is noted to be _________ relative to the expected echogenicity.

1. Hyperechoic
2. Hypoechoic
3. Anechoic

Answer 4

Hyperechoic

Question 5

Case 5: 10 YO DSH, MN, Currently icteric. Rule out extrahepatic obstruction and pancreatitis.

The bile duct adjacent to the duodenum is:

1. Abnormally dilated with a stone located at the level of the duodenal papilla
2. Mildly dilated
3. Inflamed with marked thickening of the ductal walls
4. Normal

Answer 5

1. Abnormally dilated with a stone located at the level of the duodenal papilla

Question 6

Case 6: 8 YO FN DSH, History of inappetance and weight loss x 3 weeks. (couldnt find a pic of it, but what should it not be)

In this cat, the liver is noted to be ______ relative to the falciform fat.

1. Hyperechoic
2. Hypoechoic
3. Isoechoic

Answer 6

Hyperechoic