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Liver - DMS > Path Slides > Flashcards

Path Slides Flashcards

1
Q
  1. Diffuese liver disease:
A

It is diagnosis by abnormal LFT’s
Alk Phos and Biliruben increase.
This disease process includes the entire liver and may or may not include sonographic findings
It affects the heptocytes, which control all the functions of the liver
chronic hepatitis and fatty liver fall under this category

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2
Q

Fatty Infiltration

A

Fatty infiltration is a benign process that can be reversed with a patients lifestyle change
Common causes are alcoholic abuse, diabetes, and obesity

It occurs from fat accumulation in the hepatocytes which causes damage to these cells
On ultrasound the liver looks hyperechoic and can even be enlarged
The vascular structures may be difficult to visualize because of the increased attenuation

The most common areas for FFS is the gallbladder, caudate lobe, and portal vein areas

Sparing, DENSE

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3
Q

Focal fatty sparing

A
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4
Q

Hepatitis

A

Imflamed liver

ABC most common

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5
Q

HEP A

A

Fecal contamination

oral and contact

not washing hands food contamination

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6
Q

Hep B

A

Greatest threat to health workers

blood and peircing

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7
Q

Hep C

A

Drugs Sex often asymptomatic

chronic, scarring of liver

continue to liver cancer

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8
Q

Acute Hep

A

Pain sudden multi symptom

flu like sym normal LFT

may have mild necrosis possibly liver failure

SONO

may appear normal

extra promanant portal veins

gall bladder thickened

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9
Q

Chronic Hep

A

Inglamatory process of liver is longlasting

lead to cirrhosis and liver failure

SONO

bumpy borders, hertero, fiobrosis is a disease process that gives liver coarse texture.

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10
Q

Cirrhosis

A

parachyma degernerates and lobes infiltate with fat

most common cause ALCHOL

SYM: nauses weight loss flatulence varicosities

SONO

Not advanced: hyperechoic, enlargment, decreased vasculature

ENd stage small noduar, ascites suround

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11
Q

Biliary Obstruction Proximal

A

MASS

Biliary obstruction proximal is caused by a mass that evades the porta hepatis
Clinically the patient will be jaundiced and the LFT’s will be elevated
Ultrasound is important to document mass location and size

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12
Q

Biliary obstruction distal

A

STONES

A biliary obstruction distal to the cystic duct is usually caused by stones in the CBD
Stones in the duct usually cause significant amount of RUQ pain, jaundice and elevated labs
On ultrasound you will see a dilated duct with hyperechoic shadowing stones

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13
Q

Hepatic Cysts

A

More commonly in women, thick fluid, cyst can hemorage. Leads to more serious conditions.. infection, absess, necrosis

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13
Q

Hepatic Cysitc Lesion

A

Liver custs are common, usual Benign

Asymotomatic

Large cyst are at risk for compressing hepatic vasculature and duct syspe,

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14
Q

Simple Cyst lesion

A

SONO

Thin, smooth walled, posterior enhancemnt

increase thru transmision

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15
Q

Polycistic Liver diease

A

Multiple cysts

2-3 cm cysts

1 in 500 people

asymotomatic

Also have polycistic renal disease!

16
Q

Inflamatory dieseae of liver

Pyogenic Absess

A

Pus , arise because of trauma, surgery, biliary diease or wound.

fever, increased WBC and RUQ pain

Mass is hypoechoic in echo texture

Floating debris

Gas hyperechoic with posterior shadowing

17
Q

Hepatic Candidiasis

TARGET LESION

A

Caused by FUNGUS

HIV CHEMO

Fever localized pain

SONO

hypoechoic mass with echogenic center “TARGER LESION”

shows diffuse, homogeneous, hypoechoic foci

Small amount of fluid in morrisons pouch

18
Q

Chronic Granulomatous

A

genetic diease

cant ward off bacteria

frequently children

Hypoechoic mass is id with calcifications

19
Q

Amebic Abscess

A

COntracted by ingesting a parasite found in food or water.

pus collection found in liver

Out of contry???

Reaches liver through portal v

non specific sono findings

20
Q

Echinococcal cyst

A

TAPEWORM DOG

Larvae burrow through the intestinal wall inter portal circulation

Parasite causes liver to form CYCSTS

which impince hepatic vessels

SONO

simple cyst, complex mass, honeycomb

*if daughter cell is found specific for chinococcal cyst

21
Q

Hepatic Tumor

A

Neoplasm, new growth can be benign or malignant does not invade other structures

Ex mole

22
Q

Cavernous Hemangioma

A

Very common

Bengin

blood filled spaces

asymptomatic

pain arises if it bleeds

SONO:

Hyperechoic with acoustic enhancment

23
Q

LIver cell adenoma

A

Women

Birth control

RUQ pain

SONO:

mass with nonspecific findings

Child bearing age???

Feamale??? Birthcontrol??

24
Q

Hepatic Cystadenoma

A

Rare neoplasm presents itself as abdominal mass

cystic structures within mass

25
Q

Focal Nodular Hyperplasia #2

A

Second most common benign liver mass after #1 hemangioma

asymptomatic, unless bleeding

FNH is a condition is which nodule composed of scar tissue and clumps of surrounding liver cells is found within a liver.

SONO:

hyperchoci to isoechoic patterns

WOMAN 40 and under

Birthcontrol/ oral contraseptives

26
Q

Portal Hypertension

A

Pressur in venous syptem

results from chronic liver disease or thrombus Fibrosed nature impedes flow of blood into liver

Normal PV should not exceed 16mm in AP diameter

Dialated and tortuous

Ascited usually noted

Splenomegaly

Varacies depelop, re route blood - bleeding umbilical v may be come recanalized secondary to portal hypertension

27
Q

Metastases

A

Acoustic apperance of liver metastases are extremely variable.

Metastases nat be hyperchoic, hypom iso or complex.

Tend to be solid, ill defined margins

Internal echoes within major veins suggest tumor invasion

Primary Sites:

Colon, lung, breast

28
Q

Hepatocellular Carcinoma (HCC)

A

Related to cirrhosis 80% develop from

papable mas in liver, signs of cirrhosis

Multiple or solitary, Increase in AFP (Prego)

MEN

HCC causes no abnormal LFT’s

29
Q

AFP

A

Pregnacy

HCC

Germ cell cancer or testies of ovaries

Metastic cancer of liver

30
Q

Congestive Cardiac Disease

A

Patients with cardiac failure frequently demonstrate

dialated hepatic veins

31
Q

Budd Chiari Syndrome

A

Partial or complete occlusion of hepatic veins

causes: coagulation disorders, tumor, congenital web obstructing IVC

Acute stages juperechoic and elarged

Caudate lobe hypertrophy

TX: anticoagulants, shunts, transplant

32
Q

Hepatic Trauma

A

Need for surgery by laceration size and patient clincal status.

Hematomas are usually seen with large lacerations

Liver - DMS (6 decks)

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