My Ultrasound Tutor- Abd Flashcards
What is the most common diffuse liver disease?
Fatty liver infiltration aka hepatic steatosis
65 year old male presents to the clinic for abdominal ultrasound. Diagnosis shows elevated liver function test. When scanning you see a focal hypoechoic area next to the Gallbladder. What is the most likely diagnosis?
Fatty liver infiltration
What is the most common cause of cirrhosis?
Alcoholism
What is the most common cause of portal hypertension?
Cirrhosis
While scanning a patient you notice hepatofugal flow and a MPV measuring greater than 13mm. What is the most likely diagnosis?
Portal hypertension
To normalize blood flow in portal hypertension what is a common treatment?
TIPS
What vessels are connected when using a TIPSS?
Portal vein and hepatic vein
What is the most common cause of a portal vein obstruction?
Tumor or lymphadenopathy
What is the difference between portosystemic collaterals and cavernous transformation?
Portosystemic collaterals are due to portal HTN and reroute blood AWAY from the liver while cavernous transformation is rerouting the blood TOWARD the liver
What syndrome causes occlusion of the hepatic veins and possibly IVC?
Budd-Chiari syndrome
With Budd-Chiari syndrome what are sonographic findings you will see?
Hepatomegaly, enlarged caudate lobe and absent flow in the hepatic veins
What type of infections occur in the liver?
Acute hepatitis and abscess
What is the difference between acute hepatitis and an abscess?
Hepatitis is a diffuse infection so LFTs will always be abnormal. An abscess is focal so LFTs may be normal
What are the most common hepatitis?
Hep A and B
Which type of hepatitis is most likely the cause if needing liver transplant?
Hep C
Cyst in the liver are associated with what disease?
PKD ( poly cystic kidney disease)
What is the most common benign liver tumor?
Cavernous hemangioma
What does a cavernous hemangioma look like sonographically?
Echogenic solid mass
What focal mass in the liver is associated with oral contraceptives?
Hepatocellular adenoma
What is the 2nd most common benign liver tumor?
Focal modular hyperplasia
What is a common sonographic finding with focal nodular hyperplasia?
Central scar with vascularity
What is the most common primary liver cancer
Hepatocellular carcinoma
What tumor marker will be elevated with HCC?
Elevated AFP (alphafetoprotein)
What sonographic findings do you see with HCC?
Hypoechoic mass usually solitary and ascites
What is the most common location for metastasis?
Liver
When Mets are found in the liver what organs are common sources?
Lung, colon and breast
What is hepatoblastoma?
It is the pediatric version of HCC
Patient with Beckwith-Wiedemann syndrome have an increased for what cancer?
Hepatoblastoma
After a liver transplant what is the most common vascular complication?
Hepatic artery thrombosis
Is the gallbladder an intraperitoneal or extraperitoneal organ?
Intraperitoneal
What is the function of the gallbladder?
Gallbladder stores and concentrates bile
What hormone causes the gallbladder to contract and release the bile?
Cholecystokinin (CCK)
What allows the cystic duct to not leak out bile until gallbladder contracts?
Spiral valves of heister
What are the parts of the gallbladder?
Neck, body, fundus
What part of the gallbladder is the most dependent?
Fundus
What is the most common variant of the gallbladder?
Phrygian cap
What is a Phrygian cap?
Fold of fundus over body
What gallbladder variant causes outpouching of the neck?
Hartmann pouch
What kind of preparation does a patient need to do when coming for a gallbladder ultrasound?
Patient needs to be NPO for minimum 6 hours
What does normal gallbladder wall thickness measure?
Up to 3mm
What are tissue projections from gallbladder wall with no mobility called?
Gallbladder polyps
What is adenomyomatosis?
Muscular layers form little pockets called rokitansky-Aschoff sinuses
What is the calcification of the gallbladder wall called?
Porcelain gallbaldder
What is another name for gallbladder sludge?
Viscid bile
What causes gallbladder sludge?
Biliary Statis, bile not flowing
What are the 6 Fs more prone to gallbladder stones?
Fat, female, fertile, flatulent, fair and forty
What is the most common location in the gallbladder for stones?
Fundus due to dependency
Gallbladder packed with stones will likely show what sonographic finding?
WES (wall echo shadowing) only showing anterior wall and solid shadowing
When documenting gallbladder stones it is important to show what?
Prove mobility by placing patient in at least one other position other than supine
What are gallstones in bile ducts called?
Choledocholithiasis