Pathology of the Liver Ch 10

Question 1

lab test that, alone is nonspecific for liver disease

Answer 1

AST or SGOT

Question 2

increase in ____ without ALT is seen with myocardial infarction, hear failure and muscle injury

Answer 2

AST

Question 3

lab test for liver disease-if elevated probable liver disease

Answer 3

ALT or SGPT

Question 4

found in the cells of many body tissues (will not be an answer to a question for the registry test)

Answer 4

LDH

Question 5

lab test, produced by liver, bone, intestines, and placenta; elevated with biliary obstruction**, metastasis, abscesses, or cirrhosis

Answer 5

alkaline phosphatase

Question 6

product of breakdown of hemoglobin in tired RBC’s, elevation results in jaudice**

Answer 6

bilirubin

Question 7

usually seen with anemias, trauma from a hematoma, or hemorrhagic pulmonary infections

Answer 7

indirect bilirubin (unconjugated bilirubin)

Question 8

**is usually related to obstructive jaundice from stones or neoplasm

Answer 8

direct bilirubin (conjugated bilirubin)

Question 9

prothrombin time/partial prothrombin time

Answer 9

PT/PTT

Question 10

increase in alk. phos. and ___ indicates a biliary obstruction

Answer 10

GGT

Question 11

marked elevations occur with hepatocellular carcinoma and hepatoblastoma

Answer 11

AFP

Question 12

• acquired, reversible disorder of metabolism, resulting in an accumulation of triglycerides within the hepotcytes
• fatty infiltration implies increased lipid accumulation in the hepatocytes (benign)

Answer 12

fatty liver

Question 13

causes of fatty liver**

Answer 13

obesity, alcohol abuse, poorly controlled hyperlipidemia, diabetes mellitus, excess cortocosteriods, pregnancy, total parenteral hyperalimentaion (nutrition), severe hepatitis, glycogen storage disease, cystic fibrosis, pharmaceutical, chronic illness

Question 14

focal areas of normal liver parenchyma within a fatty infiltrated liver

Answer 14

focal fatty sparing

Question 15

hepatitis type spread primarily by fecal/oral contamination-virus lives in the alimentary tract

Answer 15

hepatitis type A

Question 16

hepatitis type that exists in the bloodstream, saliva and semen/spread by infected blood via needle stick or sexual contact
greatest risk to health care professionals**

Answer 16

hepatitis type B

Question 17

hepatitis type spread by blood/body fluids

Answer 17

hepatitis type C

Question 18

hypoechoic, enlarged liver with heperechoic portal vein walls, thickened GB walls

Answer 18

acute hepatitis**

Question 19

hyperechoic, small liver with decreased echogenicity of portal vein walls, ascites, 6 months of hepatic inflammation present

Answer 19

chronic hepatitis**

Question 20

what lab values are increased in hepatitis?**

Answer 20

increased ALT, AST, and bilirubin (acute and chronic)

Question 21

clinical findings for hepatitis**

Answer 21

flu-like symptoms, fatigue, abnormal liver functions test, RUQ pain

Question 22

simultaneous parenchymal necrosis, regeneration and diffuse fibrosis resulting in disorganization of lobular architecture

Answer 22

cirrhosis

Question 23

micronodular (nodules ____) most commonly the result of chronic alcohol abuse, but can be the result of nutritional deprivation, hepatitis or infection **

Answer 23

.1-1cm

Question 24

macronodular (nodules up to 5cm) is cause by ______ or other infections

Answer 24

chronic viral hepatitis

Question 25

recannalization of the umbilical vein is seen in _______

Answer 25

ligamentum teres/falciform ligament

Question 26

cirrhosis increase the risk for _____

Answer 26

Hepatocellular carcinoma hepatoma (HCC)**

Question 27

acute cirrhosis symptoms **

Answer 27

asymptomatic or may include nausea, flatulence, ascities, light-colored stools, weakness, abdominal pain

Question 28

chronic cirrhosis symptoms**

Answer 28

nausea, anorexia, weight loss, jaundice, dark urine, fatigue

Question 29

the liver size is ______ with acute cirrhosis, and _____ with chronic cirrhosis

Answer 29

enlarged, small (with enlargement of the caudate lobe in comparison to the right lobe)

Question 30

with _____ cirrhosis the liver has a nodular surface-ascites accentuates

Answer 30

chronic**

Question 31

an inherited disease characterized by the abnormal storage and accumulation of glycogen in the tissues, especially liver, and kidneys

Answer 31

glycogen storage disease

Question 32

most common type of glycogen storage disease. abnormally large amounts of glycogen are deposited in the liver and kidneys

Answer 32

Type 1 (Von Gierke's) **

Question 33

sonograhic appearance of Von Gierke's **

Answer 33

- hepatomegaly - inclreased echogenicity and attenuation - hepatic ademoma****** - focal nodular hyperplasia

Question 34

- increased pressure within the portal venous system which will lead to liver ischemia** - enlarged portal veins

Answer 34

portal venous hypertension

Question 35

when the portal venous pressure is above 10mmHg or the hepatic venous gradient is more than 5mmHg

Answer 35

portal venous hypetension

Question 36

develops when normal veins become occluded causing hepatofugal flow

Answer 36

portal systemic collaterals

Question 37

may lead to life threatening hemorrhage**

Answer 37

gastroesophogeal varices

Question 38

re-opening of the umbilical vein (ligamentum teres) begins at LPV - exits at ligamentum teres **

Answer 38

recanalized umbilical vein

Question 39

splenorenal varices, intestinal and rectal varices **

Answer 39

.

Question 40

a disorder characterized by hepatic vein obstruction by thrombus or tumor. typically seen in young adult women taking birth control pills**

Answer 40

Budd-Chiari Syndrome

Question 41

in Budd-Chiari syndrome the _____ lobe is often spared and enlarges with atrophy of the right and left lobes**

Answer 41

caudate

Question 42

causes of Budd-Chiari syndrome

Answer 42

- membranous obstruction of intrahepatic IVC - hypercoagulations states leading to thrombosis of the hepatic veins - mechanical compression due to liver tumors and cirrhosis - tumor invasion - ** unknown etiology 30%

Question 43

differential diagnosis for focal diseases of the liver include:

Answer 43

- cysts - abscess - hematoma - primary tumor - metastases

Question 44

- focal imhomogenous mas within the liver capsule - displacement of hepatic vascular radicals - external bulging of the liver capsule - posterior shift of the IVC

Answer 44

intrahepatic mass**

Question 45

- irregular ill-defined hypoechoic, heterogenous lesion inthe area of porta hepatis - intrahepatic ductal dilation - discontunuity and internal invagination of the liver capsule - formation of a triangular fat wedge - anteromedial shift of the IVC - anterior displacement of the right kidney

Answer 45

**extrahepatic mass

Question 46

Pyogenic abscess primary occurs in the

Answer 46

Central right lobe of the liver

Question 47

Most prevalent is cattle raising countries, common in the Middle East, liver is most common site for virus growth

Answer 47

Echinococcus cyst (hydatid disease)

Question 48

Simple cyst- two layers, cyst within a cyst, water lily sign, honeycomb appearance,

Answer 48

Echinococcus cyst (hydatid disease)

Question 49

If a daughter cyst is found, it is specific for

Answer 49

Echoincoccal disease

Question 50

Most common organism causing infection in AIDS

Answer 50

Pneumocystis carinii

Question 51

Major cause of portal hypertension worldwide

Answer 51

Schistosomiasis

Question 52

Most common benign tumor in the liver, Doppler does not deme strange flow within

Answer 52

Hemangioma

Question 53

More common in women, associated with use of oral contraceptives -hepatic cystadenoma

Answer 53

Liver cell adenoma, hepatic adenoma

Question 54

-solid mass with carying echogenicity - star appearance -well defined peripheral and central blood vessels

Answer 54

Focal nodular hyperplasia

Question 55

Rare fatty tumors, confirmed with CR

Answer 55

Hepatic lipomas

Question 56

Most common primary malignancy of the liver, increased risk with cirrhosis, more frequent in men

Answer 56

HCC

Question 57

Increase in AFP,AST, ALT, hx of cirrhosis, hep B or C | -RUQ pain, palpable mass, weight loss, abd swelling with ascities

Answer 57

HCC

Question 58

Commonly invades venous structures (portal and hepatic) with tumor or thrombosis -buds-Chiari

Answer 58

HCC

Question 59

Most common malignant tumor in early childhood

Answer 59

Hepatoblastoma

Question 60

Most common form of neoplastic involvement of the liver

Answer 60

Metastatic disease

Question 61

Hyperechoic metastases

Answer 61

Gastrointestinal tract

Question 62

Hypoechoic metastases

Answer 62

Lymphoma

Question 63

"Bull's eye or "target" metastases

Answer 63

Lung

Question 64

Calcified metastases

Answer 64

Mucinous adenocarcimoma

Question 65

Cystic metastases

Answer 65

Sarcoma

Question 66

Most common hepatic tumor in AID's patients

Answer 66

Kaposi's sarcoma