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Abdominal Ultrasound > Pathology Descriptions > Flashcards

Pathology Descriptions Flashcards

1
Q

Dilated aorta >3cm
Fusiform or saccular

A

AAA

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2
Q

Asymptomatic until rupture
Abdo/back pain
Pulsatile abdominal mass
Hypotension
Syncope

↓Haematocrit
↓Haemoglobin

A

AAA

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3
Q

Saccular outpouching, localised and round/oval adjacent to artery
Hypoechoic/anechoic centre
Surrounding echogenic thrombus
Yin/Yang sign (Doppler)

A

Pseudoaneurysm

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4
Q

Localised pain/swelling
Palpable, pulsatile mass
Skin discolouration/warmth
↑WBC
↑CRP
↓Haematocrit/Haemoglobin

A

Pseudoaneurysm

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5
Q

Separates true/false lumen
Mobile, echogeni c line within aorta
May extend into branch arteries

A

Dissection aneurysm

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6
Q

Sudden, severe chest/back pain
Signs of ischaemia
Syncope/shock
↓Haematocrit
↑CRP

A

Dissection aneurysm

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7
Q

Aneurysmal dilation with thickened adventitia
Hypoechoic surrounding fibrosis of tissue around aorta
Sparing of posterior wall

Backache
Leg oedema

A

Inflammatory AAA

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8
Q

Pulsatile mass
Normal appearance of aorta
Large pelvic mass/mass elsewhere

PHx FIbroid uterus, para-aortic lymph nodes, retroperitoneal tumour

A

Pseudo-pulsatile abdominal mass

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9
Q

A congestive liver disease caused by wide array of conditions compromising HV outflow: thrombotic, non thrombotic

A

Budd-chiari syndrome

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10
Q

Reduced flow in hepatic veins, Echogenic thrombus in hepatic veins or IVC
Heterogenous/hypoechoic liver parenchyma
Anechoic fluid collection in abdomen
Dilated IVC

A

Budd-chiari syndrome

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11
Q

RUQ pain
Jaundice
Ascites
Hepatomegaly
Abnormal LFTs
IVC involvement = lower leg oedema

A

Budd-chiari syndrome

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12
Q

Dilated portal, spleen & mesenteric veins (PV >15mm)
Patent paraumbilical veins
Varices
Splenomegaly
Ascites (anechoic abdo fluid)
Atrophied live w/irregular surface

A

Portal venous hypertension

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13
Q

Causes of Pre-hepatic, post hepatic or hepatic portal venous hypertension

Congenital portal atresia, PV thrombosis, phlebitis of the PV, trauma of thrombosed portocaval shunt

A

Pre-hepatic

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14
Q

Causes of pre-hepatic, post-hepatic or hepatic portal venous hypertension?

Budd-Chiari syndrome, constrictive pericarditis, tricuspid valve incompetence

A

Post-hepatic

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15
Q

Causes of pre-hepatic, post-hepatic or hepatic portal venous hypertension

cirrhosis (alcoholic most frequent), chronic active hepatitis, parasitic diseases (schistosomiasis)

A

Hepatic

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16
Q

Marked ascites
Arterio-venous shunting
Haemorrhoids
Hypersplenism:
- Moderate anaemia, neutropaenia, thrombocytopaenia

A

Portal venous hypertension

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17
Q

Consequence of portal vein thrombosis
Ascites
Jaundice
Fatigue
WL/LOA
Abdo pain

A

Cavernous transformation of portal vein

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18
Q

Doppler: Hepatopetal, continus flow, low velocity
Extrahepatic PV not visualised
High level echoes in porta hepatis

A

Cavernous transformation of portal vein

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19
Q

Caused by biliary disease, alcohol abuse, trauma, ulcers

S&S:
Abdo pain
N,V,F
PHx gallstones, alcoholism
Jaundice, malabsorption
↑enzymes & leukocytes
↑serum amylase
↑urine amylase
↑serum lipase

A

Pancreatitis

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20
Q

Pancreas parencyhma:
Hyperechoic, homogenous, enlarged
Oedematous
Irregular borders
Peripancreatic fluid

A

Acute pancreatitis

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21
Q

Pancreas parenchyma:
Hyperechoic, heterogenous, atrophied
Irregular borders
Double duct sign - dilated pancreatic duct & dilated CBD
Calcifications in duct/ducts
Possible peripancreatic fluid

A

Chronic pancreatitis

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22
Q

PHx recurrent attacks of acute pancreatitis
PHx chronic alcoholism or Biliary disease

Pt may have:
Pseudocysts, ascites
Dilated CBD
Thrombosis of splenic vein, extending into portal vein

A

Chronic pancreatitis

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23
Q

A collection of fluid in the pancreas that arises from the loculation of inflammatory processes, necrosis, or haemorrhage
4-6 wks after onset of pancreatitis

A

Pancreatic pseudocyst

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24
Q

Well-defined cystic lesion adjacent to panc
Round/oval
Internal echoes may be seen due to debris

N,V,LOA
WL
Diarrhoea, fever
Tender abdo mass
Jaundice

A

Pancreatic pseudocyst

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25
Q

A cancer that develops in the lining or inner surface of the pancreas and usually has secretory properties

A

Pancreatic adenocarcinoma

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26
Q

Abdo/back pain
Onset of NIDDM/existing diabetes more difficult to control
LOA/WL/N/V
Diarrhoea/constipation
Jaundice, enlarged GB
Itchy skin

A

Pancreatic adenocarcinoma

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27
Q

Heterogenous, hypoechoic solid mass
May have cystic component
Double duct sign if mass in panc. head

A

Pancreatic adenocarcinoma

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28
Q

Forms in cells that make gastrin
↑gastrin & stomach acid
Forms in head of panc, sometimes small intestines
Most are malignant

Recurrent stomach ulcers
Abdo/back pain
Reflux
Diarrhoea

A

Gastrinoma

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29
Q

Forms in cells that make insulin
Slow growing, rarely spreads
Forms in head, body or tail of panc
Usually benign

A

Insulinoma

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30
Q

Hypoglycaemia w/signs:
blurred vision, headache, lightheaded
Tired, weak, shaky, nervous
Irritable, sweaty, confused
Hungry, fast HR

A

Insulinoma

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31
Q

Panc duct anomaly:
Primary duct
Extends the entire of the gland

A

Duct of Wirsung

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32
Q

Panc duct anomaly:
Secondary duct
Drains upper anterior head

A

Duct of Santorini

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33
Q

PHx obesity & aging
PHX pancreatitis, ETOH++, liver disease
Dyslipidaemia & hyperglycamia = non-alcoholic version of this

A

Fatty pancreas

34
Q

Diffuse hyperechoic pancreas parenchyma
Can be enlarged
More attenuating

A

Fatty pancreas

35
Q

Acute RUQ pain
Fever
Leukocytosis
↑serum bilirubin
↑ALP

Thickened GB wall (<3mm)
Distended GB lumen (<4cm)
Echogenic calculi
+ve Murphy’s sign
Increased vasc in GB wall
Pericholecystic fluid collection
Impacted stone in GB neck, Hartmann’s puch, cystic duct

A

Acute cholecystitis
or without ↑serum, ALP & calculi:
Acute acalculous cholecystitis

36
Q

PHx repeated acute cholecystitis
RUQ pain

Thickened GB wall
GB scarring
Atrophied
Lack/minimal pericholecystic fluid

A

Chronic cholecystitis

37
Q

Air in wall/lumen of GB, tissue adjacent or in biliary ducts
WES sign if air within GB

A

Emphysematous cholecystitis

38
Q

Thickened GB wall, de-lamination
↓vascularity
Irregular GB mucosal layer outline
Gas within GB
Possible absence of calculi
Large pericholecystic collection

A

Gangrenous cholecystitis

39
Q

When bile flow ceases or reduces significantly, caused by some of the following:
Acute hepatitis
Alcoholic liver disease
Cirrhosis (Hep B, C)
Pancreatic adenocarcinoma
Pancreatitis

A

Cholestasis

40
Q

Jaundice
Dark urine
Light-coloured stools
Itching
Abdo pain/LOA/V/F
Not specifically visible on U/S

A

Cholestasis

41
Q

PHx gallstones & inflammation of GB
S&S: same as most GB pathology

Thickened wall
Irregular shape/margins
Hypoechoic, heterogenous
Invasion of adjacent structures

A

GB adenocarcinoma

42
Q

> 40 yrs old (most pts)
Formation of Rokitansky-Aschoff sinuses
Comet tail artefact

A

Adenomyomatosis

43
Q

Calculi within bile duct
Primary: within bile ducts
Secondary: moved into biliary tree from GB

A

Choledocholithiasis

44
Q

Inflammation of bile ducts/biliary tree
Most commonly frm calculi, can be from stricture or malignancy
Segmental narrowing & dilation of bile duct
Thickened biliary duct wall

A

Cholangitis

45
Q

Bile duct cancer
PHx choledochal cyst, chronic liver disease
Abdo pain
Jaundice
WL/F
Itching

A

Cholangiocarcinoma

46
Q

Dilation of intra & extrahepatic bile ducts
Hypoechoic, heterogenous
Bile duct wall thickening/mass

A

Cholangiocarcinoma

47
Q

Caused by round worm
Come through sphincter of Oddi into biliary tree
Echogenic worm like structures in GB

A

Ascariasis

48
Q

Fatty liver disease associated with dyslipidaemia

A

Non-Alcoholic steatosis

49
Q

Fatty liver disease that can lead to hepatomegaly, hepatitis, cirrhosis

A

Alcohol-related steatosis

50
Q

Mild: Minimal diffuse increase in hepatic echogenicity

Moderate: increased echogenicity, slightly impaired visualisation, slightly grainy

Severe: Significant increase in echogenicity of liver, decreased penetration, very grainy

A

Steatosis

51
Q

Fatigue, N/V/F
Abdo pain
Dark urine
Joint pain

Liver texture may appear normal
PV more prominent than usual
Slightly hypoechoic liver parenchyma
Attenuation
Hepatospelnomegaly
GB wall thickened

A

Acute Hepatitis

52
Q

May be asymptomatic
Coarse/echogenic due to fibrosis
PV walls less discrete
Liver not enlarged
Soft shadowing due to fibrosis
Changes to liver contour

A

Chronic hepatitis

53
Q

Permanent scarring of the liver where normal liver tissue is replaced by scar tissue

A

Cirrhosis

54
Q

Hepatomegaly, jaundice, ascites
N/WL/F
Anorexia
Dark urine
Fatigue
Varicosities

Micronodular, macronodular or mixed

Irregular liver contour
enlarged caudate lobe
splenomegaly

A

Cirrhosis

55
Q

Inner layer of connective tissue layer over the liver and surrounding the portal triad within the liver
Can be cause of pain with hepatomegaly

A

Glisson’s capsule

56
Q

Present in the liver
Benign
Anechoic fluid
Well-circumscribed
Thin-walled

A

Simple liver cysts

57
Q

Genetic disease
Most often associated with autosomal dominant polycystic kidney disease
Multiple cysts throughout liver

A

Polycystic liver disease

58
Q

Symptoms:
Abdo pain
Post-prandial epigastric pain/discomfort

Sono app:
Often multiloculated
Well-defined
Anechoic
Septations

DDx:
Simple cysts
Cystadenocarcinoma
Focal nodular hyperplasia

A

Cystadenoma

59
Q

Sympt:
Maybe asymptomatic
Jaundice
WL/P/
Distension
Ascites
Dyspnoea

Sono app:
Multiloculated
Intracystic solid areas
Septations
Grows from biliary epithelium

DDx:
cystadenoma
pseudocyst
Focal nodular hyperplasia
Hepatic cysts

A

Cystadenocarcinoma

59
Q

Symp:
RUQ pain
Chest pain
F/chills/night sweats
N/V/LOA
WL

Sono app:
Poorly demarcated
Variable appearance/echogenicity
Gas may be present

A

Hepatic abscess

60
Q

Most prevalent tumour of the liver
Benign
Most often asymptomatic
Larger may cause pain/discomfort

Sono app:
well-circumscribed, echogenic solid lesions
Mostly no vascularity

A

Haemangioma

61
Q

Benign
Often asymptomatic
Arises from pre-existing arteriovenous malformation in liver

Sono app:
Well-circumscribed
Isoechoic/hypoechoic
Solid lesion
Hypervascular

A

Focal nodular hyperplasia

62
Q

Rare, presents in adult females
Mainly found in kidneys, can present in liver

Blood, muscle, fat

Sono app:
Mostly hyperechoic & homogenous
Can be heterogenous

A

Angiomyolipoma (AML)

63
Q

Well-circumscribed
Echogenic solid lesion
Posterior enhancement
Consists of fat & blood

A

Lipoma

64
Q

PHx:
Sarcoidosis
Tuberculosis
Neoplastic disease
Primary biliary cholangitis or drug induced

Sono app:
Highly echogenic solid focus
Posterior shadowing
Irregularly shaped if larger

A

Granuloma

65
Q

PHx chronic liver disease

Symp:
RUQ pain, lump
LOA/WL
N/F/V
Jaundice

Sono app:
Densely echogenic
Diffuse
Mixture of densely echogenic or diffuse
Can be solitary, multiple nodules or diffuse infiltrative masses

A

Hepatocellular carcinoma (HCC)

66
Q

Childhood tumour up to 5 yrs
Most begin in right lobe of liver

Symp:
RUQ pain, lump
LOA/WL
N/F/V
Jaundice

Sono app:
Hyperechoic, hetero
Calcifications
Vascular
Solid

A

Hepatoblastoma

67
Q

Symp:
Weakness/poor health
LOA/WL
Fever
Fatigue/bloating/itching
Leg oedema
Jaundice

Sono app:
Hypoechoic, hetero
Variable echogenicity
Target lesions
Multiple

A

Liver Metastases

68
Q

Most common metastases from colon or rectal cancer
Less commonly from breast, oesophageal, stomach, panc, lung, kidney, skin

A

Liver metastasis

69
Q

Symp:
Often non-specific
Haematuria
Flank pain
Palpable mass

Sono app:
Mostly isoechoic but can be hyperechoic

A

Renal cell carcinoma

70
Q

Rare type of kidney cancer, most common bladder/lower UT cancer

Symp:
Back pain
Haematuria
Frequency

Sono app:
Solid lesion
Hypoechoic
Originate within renal pelvis or calyx

A

Transitional Cell Carcinoma (TCC)

71
Q

Most common childhood cancer
Affects 3-4 yrs old, less common after 5

Symp:
Constipation
abdo pain/swelling
N/V/F/LOA

Sono app:
Large solitary, solid mass
Echogenic
May contain cystic areas/multiloculated
Can be present in utero

A

Wilm’s Tumour (nephroblastoma)

72
Q

Most common metastasises from carcinomas (lung, colorectal, ENT, breast, soft tissue, thyroid)

Symp:
Flank pain, haematuria
WL

A

Renal metastases

73
Q

Vesicoureteric reflux due to blockage of urine flow down ureter

A

Hydronephrosis

74
Q

Sono app:
Dilated ureter/s

Depending on grade:
2. Full pelvis, major calyces dilated

  1. Uniformly dilated minor calyces, parenchyma spared
  2. Parenchyma compromise
A

Hydronephrosis

75
Q

Symp:
Severe pain

Sono app:
Very echogenic calculi within bladder
Posterior shadowing

A

Urolithiasis

76
Q

Increased calcium levels in the kidney
Caused by hypercalcaemia due to hyperparathyroidism, medications, sarcoidosis

A

Nephrocalcinosis

77
Q

Sono app:
Calcification in medullary pyramids
Posterior shadowing depending on calcifications

A

Nephrocalcinosis

78
Q

Urine backs up into kidney causing swelling

Sono app:
Unilateral or bilateral
Hydronephrosis
Changes to renal arterial Haemodynamics
Thinned parenchyma (long term)

A

Obstructive nephropathy

79
Q

Type of blood cancer: bone marrow over-produces RBCs
Enlarged spleen
Hepatomegaly, ascites, DVT
Splenic infarctions & thromboses common

A

Polycythaemia vera

80
Q
A

Abdominal Ultrasound (4 decks)

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