Pathology Flashcards

Question

Symptoms of cirrhosis...

Answer 1

``` Fatigue and weakness Abdominal bloating Anorexia Jaundice Later symptoms - GI bleeding, varicose veins on the ABD, red palms, clubbing of nails and fingers ```

Answer 2

AST, ALT, and bilirubin increased

Answer 3

``` Coarse Decreased vascular As cites Hepatosplenomegaly progresses to smaller size Nodularity Dilated portal vein ```

Answer 4

Early stage - liver enlarged Advanced stage - liver small ** caudate lobe increases in size

Answer 5

Waveform is abnormal Hepatic veins develop luminal narrowing with increased velocities and turbulence of the flow patterns Doppler gets pointier

Answer 6

Type 1 - VON GIERKE genetic disorder of carbohydrate metabolism Abnormally large amounts of glycogen are deposited in the liver and kidneys

Answer 7

Hepatomegaly Increased echogenicity Adenomas Associated nephromegaly

Answer 8

Rare Iron metabolism Sonographically - hepatomegaly, cirrhostic changes

Answer 9

Origin of bile in the liver Prox biliary tree is within the liver Distal biliary tree in closest to pancreatic head Biliary dilatation usually occurs prox to level of obstruction MOST COMMON obstruction is distal CBD with dilatation CBD, BG, intrahepatic ducts

Answer 10

``` Gallstones, CA, mets Jaundice pruritus (itchy) Elevated bilirubin and Alk Phos Sonographic - dilated duct, GB normal in size "Railroad sign" ```

Answer 11

``` Stones in CBD Mass Stricture RUQ pain, jaundice, pruritus Increased bilirubin and Alk Phos Sonographic - dilated ducts, GB size may be small, gallstone ```

Answer 12

In porta hepatis Sonographic - ductal dilation, hydropic GB (distended), lesions may be lymph or pancreatic CA

Answer 13

Jaundice, previous cholecystectomy, increased bilirubin and Alk Phos Sonographic - dilated ducts

Answer 14

Secondary to CHF Hepatomegaly Sonographic - dilation of IVC, SMV, HV, PV, SV

Answer 15

``` Cysts Abscess Hematoma Tumors Metastases ```

Answer 16

``` Well defined Anechoic Enhancement Thin smooth walls Round or oval ```

Answer 17

Congenital Developmental defects in bile duct formation Cystic masses that result from trauma are not true cysts Sonographic - solitary, varied in size

Answer 18

Autosomal dominant Associated with polycystic kidneys Sonographic - cyst criteria Small, less than 2-3 cm, & multiple throughout the hepatic parenchyma

Answer 19

Bacterial - ecoli and anaerobes Multiple infection symptoms Sonographic - various appearances, usually solitary, debris, complex, micro air bubbles or pus cause shadowing

Answer 20

Fungal Immunocompromised hosts such as cancer patients and organ transplant patients Sonographic - multiple hypoechoic masses, target or bulls eye lesions "Wheel within a wheel" sign - early

Answer 21

Congenital defect in the leukocytes Pediatric Sonographic - hypoechoic mass, calcification with shadowing

Answer 22

``` Parasitic - entamoeba histolytica Contaminated water and food Enters liver through portal vein RUQ pain and fever, traveling outside the us Sonographic - variable appearance ```

Answer 23

Parasitic Hydatid cysts - sheep and cattle herding, parasite causing hydatid disease, tapeworm lives in feces, food contaminated Clinically - fever, RUQ tenderness Sonographic - honeycomb, cyst within a cyst, daughter cyst, "water lily" sign

Answer 24

Parasitic - contaminated water Sonographic - thickened portal walls and dilation (portal hypertension), splenomegaly, collaterals

Answer 25

Benign - cavernous hemangioma, adenoma, cystadenoma, focal nodular hyperplasia Malignant - carcinoma, metastatic

Answer 26

``` MOST COMMON benign tumor of the liver Large network of vascular endothelium Females Sonographic - hyperechoic CT and MRI helpful; biopsy may be indicated ```

Answer 27

Glandular Female - oral contraceptive May be malignant Sonographic - hyperechoic with central hypoechoic

Answer 28

SECOND MOST COMMON benign liver mass Women under 40 Sonographic - well defined, multiple nodules, STEALTH LESION

Answer 29

``` Infantile Benign overgrowth Females Presents with ABD mass Sonographic - multiple lesions with hyperechoic margins ```

Answer 30

``` Rare Benign Children under 2 Palpable ABD mass Sonographic - well defined large complex mass ```

Answer 31

``` MOST COMMON primary malignant neoplasm Related to cirrhosis Male Unexplained mild fever Invasive Destroy vessels Sonographic - halo lesions, hepatomegaly ```

Answer 32

``` Elevated alpha fetoprotein Abnormal liver function tests Unexplained weight loss Palpable mass Ascites ```

Answer 33

Solitary massive tumor Multiple nodules throughout the liver Diffuse infiltrative masses in the liver

Answer 34

Focal lesion Invasive lesion with necrosis and hemorrhage Poorly defined lesion

Answer 35

Invade the be | ASIC veins to produce Budd-Chiari syndrome

Answer 36

Malignant from the blood vessels Rare 60-80 year olds Sonographic - solid mass

Answer 37

MOST COMMON form of neoplastic involvement of the liver Primary: breast, colon, lung Abnormal LFT Sonographic - multiple nodes, bulls eye lesions, calcifications

Answer 38

HCC and carcinoma of the pancreas, stomach, and esophagus

Answer 39

Head and neck carcinoma and carcinoma of the colon

Answer 40

Hodgin's and non-Hodgin's Hepatomegaly Sonographic - bull's eye, multiple

Answer 41

Hepatoblastoma - liver Neuroblastoma - adrenal gland Wilm's - kidney Leukemia

Answer 42

``` Associated with beckwith-wiedemann Genetic growth disorder - defect in chromosome 11 Before age 5 Elevation in alpha fetoprotein Palpable mass Weight loss ```

Answer 43

Infections - neonate - hepatomegaly Baby contracts TORCH in the uterus Toxoplasmosis, other infections, rubella, cytomegalovirus, herpes

Answer 44

Sonographic but CT more specific Free fluid Hematoma Decrease in hematocrit and hemorrhage

Answer 45

Post operative air Surgical clips

Answer 46

Indications - cirrhosis, hepatitis, cholangitis, hepatoma, Budd-Chiari Complications - rejection, thrombosis, infection, neoplasia, biliary stricture Sonographic - evaluate the portal system and hepatic artery, ascites may be present

Answer 47

Vascular structures are assessed for size and patency Liver parenchyma should be examined to rule out the presence of hepatic architecture disruption

Answer 48

Cirrhosis causes the blood pressure in the hepatic circulation to increase and leads to the development of portal hypertension

Answer 49

Increase in portal venous pressure or hepatic venous gradient present Cirrhosis (most common), thrombus, tumor Collateral damage - coronary and esophageal vein - varices tortuous dilations

Answer 50

In an effort to relieve pressure, collateral veins are formed that connect to the varicose veins Varicose veins occur most frequently in the area of the esophagus, stomach, rectum Rupture of these veins can cause massive bleeding that may result in death

Answer 51

Portal vein greater than 1.3 cm Splenic vein greater than 1.0 cm No change in respiration Recanalization of the umbilical vein (ligamentum teres) - medusa's head Color Doppler - flow should be hepatopetal - towards

Answer 52

Suspected secondary to liver disease Portal vein compression or thrombosis Acute onset of hepatic vein occlusion (Budd-Chiari), constrictive pericarditis, or congestive heart failure with tricuspid regurgitation Congenital, traumatic, or neoplastic arterioportal fistula

Answer 53

Collaterals develop - wormlike at the porta hepatis

Answer 54

Portacaval - PV confluence - IVC - wall stent Mesocaval - SMV - IVC Splenorenal - SV - LRV TIPS - transjugular intrahepatic portosystemic shunt

Answer 55

Placement of a stent between the portal and hepatic veins to shunt blood and reduce the pressure Temporary treatment

Answer 56

``` Initially hepatomegaly Shrunken right lobe Enlarged caudate and left lobe Nodular surface Coarse texture Splenomegaly Ascites Mono phasic flow in hepatics Hepatofugal flow in portals Enlarged PV, SMV Reversed flow in splenic vein ```

Answer 57

Thrombosis of hepatic vein or IVC Ascites, jaundice, ABD pain, hepatomegaly, edema of legs, vomiting, diarrhea Poor prognosis - 2 types: primary (congenital) and secondary (thrombosis) Sonographic - caudate lobe enlarged, atrophy of rt hepatic lobe thrombosis vein enlarges, splenomegaly