Quiz 1 review Flashcards
When might we see dirty shadowing?
when air or gas is present
What does infiltrating mean?
diffuse disease process; spreading beyond where it started
What does loculated mass mean?
well-defined borders with septations
When do we usually see clean shadowing?
bones or calcifications such as gallstones
What is the difference between a sign and a symptom?
A sign is objective data that is obtained through observation and are verifiable– “my leg is red and swollen”. A symptom is subjective data that is derived from the patient– “I have back pain”.
What is the difference between hypertrophy and hyperplasia?
hypertrophy-cells enlarge (change in size); hyperplasia- number of cells increase (change in quantity)
What is the difference between benign and malignant?
Benign: not cancerous, grows in one place & cannot spread. Malignant: cancerous, not self-limited in its growth & capable of spreading/invading into adjacent tissues; can spread into further tissues (metastasizing), & enter blood vessels.
What does iatrogenic mean?
relating to illness caused by medical examination or treatment
What does degenerative mean?
causes an organ or tissue to deteriorate over time
What does neoplasm mean?
a new and abnormal growth that can be benign or malignant
What does immunologic mean?
disorders caused by abnormal or absent immunologic mechanisms
What does syndrome mean?
a set of signs and symptoms
What does etiology mean? What does idiopathic mean?
etiology- the origin or cause of a disease; idiopathic- unknown cause
When a disease is communicable, what does that mean?
it is infectious, contagious
What does pathogenesis mean?
mechanism by which the disease is caused– origin and development
What does incubation mean?
time between infection and symptoms
Difference between primary and metastasis?
Primary is cancer’s first location while metastasis is cancer’s second locations
What does morbidity mean?
a diseased state, disability or poor health due to a cause
What does mortality mean?
number of deaths from a disease
What is the function of blood?
transportation, defense against infection, maintenance of body fluid (pH)
Blood volume is approx ___ % of total body weight
9% (5 quarts in a normal sized man)
What is a virus and how can it be treated?
small infectious agent that can replicate only inside living cells of organisms– cannot be treated because it is not a bacterium, body’s immune system must fight it on its own
What is blood made up of?
plasma, red blood cells, white blood cells, platelets
What is bacteria and how can it be treated?
large domain of single-celled microorganisms– treated with antibiotics, penicillin
What is essential for the survival of bacteria?
cell wall
What is prions and how can it be treated?
infectious agent composed of protein– all are currently untreatable and universally fatal
What is inflammation?
response of vascular tissues to harmful stimuli – it is a cause of infection
General signs of infection? (MLFF)
- Muscle aches
- Loss of appetite
- Fever & chills
- Fatigue
What is the body’s response to infection?
inflammation
Difference between acute and chronic
Acute: sudden onset, short period of time, active inflammatory response, enlargement, increase in blood flow/doppler. Chronic: lasts longer, recurring, no inflammation, normal to small in size, echogenic, normal or slightly decreased blood flow/doppler.
How does the biliary system work?
drains bile from the liver and GB through the porta hepatis
What are the main cells of the liver?
hepatocytes
What are sinusoids?
vessels in the liver that filter blood from the PV and HA and empty into the central vein
What do Kupffer cells do?
Kupffer cells are special hepatic cells that remove bile pigment, old blood cells, and products of phagocytosis from the blood; they ingest bacteria and other foreign matter
What is formed by the breakdown of red blood cells?
bilirubin
Elevation of serum bilirubin results in:
jaundice
What does conjugated mean? What does unconjugated mean?
Conjugated is direct – water soluble; Unconjugated is indirect– not water soluble
Hepatic cells convert sugars into?
convert sugars into glycogen and can break down glycogen back into glucose (used for energy) to maintain blood sugar level
What is the enzyme that initiates GB contraction?
Cholecystokinin (CCK)
Where is CCK produced?
duodenum
How much bile is secreted daily?
250-1000 mL
What is bile composed of?
mostly water, bile salts, & other organic substances (incl. cholesterol)
Gallstones form as a result of?
cholesterol and bile salt deposits
Endocrine function of pancreas
pancreatic islets secrete insulin and glucagon (alpha, beta, delta cells)
_______ is the principle energy cycle of the body
glucose
______ is responsible for causing an increased rate of glucose metabolism; regulates blood glucose levels
insulin
What is caused by a decrease of insulin level?
diabetes mellitus
The most active and versatile digestive organ is the?
pancreas
Exocrine function of pancreas
digestive enzymes - Amylase, lipase, trypsin
Majority of pancreatic juice is what? What does it do?
sodium bicarbonate to neutralize gastric acid
What percentage of cardiac output is to the kidneys?
25%
3 functions of the kidneys are?
filtration, reabsorption, and secretion
Where does urine filtration occur within the kidneys?
the glomerulus
Nephron consists of:
glomerulus, bowman’s capsule, renal tubules, efferent/afferent arterioles
True-positive means
positive for disease/pathology
True-negative means
negative for disease/pathology
False-positive means
sono findings positive, but patient does NOT (negative) for disease/pathology
False-negative means
sono findings negative, but patient DOES (positive) for disease/pathology
Sensitivity:
how well sonographic examination documents whatever disease/pathology is present
Specificity:
how well sonographic examination documents normal findings or excludes patients without disease/pathology
Accuracy:
ability of the sonographic examination to find disease/pathology if present and to not find it if not present
Plasma makes up what percentage of the blood?
55%
Where are RBCs produced?
bone marrow
What is the lifespan of RBCs?
120 days
WBCs make up __% of blood
1%
What are the roles of plasma, RBCs, WBCs, & platelets?
Plasma- helps maintain body’s fluid balance; RBCs- carry oxygen to cells & tissues; WBCs- fights infection; Platelets- assists with blood clotting by sticking together
How long does it take the liver to destroy platelets?
8 days
What is the term for too many platelets? What is the term for too few platelets?
too many- thrombocytosis; too few- thrombocytopenia
What is pH?
concentration of hydrogen ions in a solution (0.0 - 14.0)
Human blood pH is:
7.34-7.44 (slightly alkaline)
What do blood plasmas contain that neutralize pH?
chemical compounds called buffers
When pH is <6.8 in blood =
acidosis (more hydrogen ions)
When pH is >7.8 in blood =
alkalosis (less hydrogen ions)
What is erythropoiesis?
production of red blood cells
What is it called when there are too many RBCs?
polycythemia
A rise in bilirubin can result in?
jaundice
What is hematocrit?
the percentage of blood volume containing RBCs
What is leucopoiesis?
WBC formation stimulated by bacteria
What are WBCs 2 main sources?
red bone marrow & lymphatic tissue
What is leukocytosis? What is leukopenia?
leukocytosis- WBCs increase with bacterial infections; leukopenia- WBCs decrease with viral infections
Normal WBC count should be:
4,500-10,000 or 4.5-10
What does leukocytosis indicate?
bacterial infection
3 most common lab tests for hepatic and biliary function
ALP, AST, ALT
What is the most common cause of elevated LFT?
fatty liver
Which liver tests elevation on its own does not indicate liver disease?
AST (aspartate aminotransferase)
Where is AST found? When is it released?
found in high energy cells; released when cells are injured
AST elevated without elevation of other liver tests can indicate?
myocardial infarction
Highest elevations of AST are with?
viral hepatitis
Which liver function is more specific to liver disease?
ALT (alanine aminotransferase)
Elevated ALT can indicate?
biliary obstruction
When AST is higher than ALT:
- cirrhosis
- metastatic cancer of liver
When ALT is higher than AST:
- acute hepatitis
- non malignant hepatic obstruction
Where is GGT found?
hepatocytes and bile duct epithelium
GGT is most commonly elevated with which patient population?
alcoholics
If GGT and ALP are elevated =
biliary obstruction
If GGT and ALT are elevated =
hepatocellular disease
Cellular damage causes elevation of which lab value?
LDH (lactic dehydrogenase)
Which lab value is commonly seen elevated with HCC?
AFP (alpha fetoprotein)
If AFP is elevated when patient is pregnant, is that bad?
No. AFP increases normally during pregnancy
What is AFP?
a protein synthesized by the fetal liver and yolk sac; levels decrease during the first year of life
What does PT (prothrombin time) and INR (international normalized ratio) evaluate for?
to ensure proper clotting will take place
What is needed to produce PT (prothrombin time)? What is it produced by?
Vitamin K by the liver
Abnormal PT is often due to?
liver disease or warfarin treatment
When is INR evaluated?
bleeding risks before/after invasive surgeries
an INR less than ____ is optimal for invasive procedure
1.5
What is bilirubin?
End product of hemoglobin breakdown in RBCs
How to calculate total bilirubin?
conjugated (direct) + unconjugated (indirect)
How to calculate indirect bilirubin?
total bilirubin - direct bilirubin
Direct (conjugated) bilirubin is more specific to what?
biliary disease/obstruction
Where is ALK PHOS (ALP) concentrated?
in the bile ducts
ALP is a very sensitive test for what?
obstruction
Lab tests for kidney function are?
-BUN
-GFR
-Creatinine
Specific gravity tests are for?
measures kidneys ability to concentrate urine
GFR is inversely related to?
serum creatinine
Elevated BUN indicates?
impaired renal function/renal failure
Where is BUN produced?
liver
What is azotemia?
an increase in BUN and creatinine due to decrease in GFR
What is hCG produced by?
trophoblastic cells (placenta)
What is choriocarcinoma?
cancer of the placenta
Which tumor marker is used for cancer, but is not specific to either benign or malignant?
CEA (carcinoembryonic antigen)
When TSH is elevated, but T3/T4 are not?
Hypothyroidism
Which hormones are elevated with hyperthyroidism?
T3/T4
Which hormones are produced by the thyroid?
-T4 (thyroxin)
-T3 (triiodothyronine)
-Calcitonin
Where is TSH produced?
pituitary gland
What does the parathyroid hormone do?
regulates calcium levels in the blood
An enzyme that increases with age and prostate volume is?
PSA (prostate specific antigen)
PSA >10 indicates?
most likely cancer
A normal PSA should be?
less than 4
4-10 = benign/potential malignancy
Which enzyme is elevated in association with prostate carcinoma?
PAP (prostatic acid phosphatase)
What is pathology? What is pathophysiology?
pathology is the study of diseases & pathophysiology is the study of how normal body processes are altered by disease
Physical and chemical changes in the body is called?
metabolism
What is homeostasis?
ability to maintain a steady and stable internal environment
What are the four main vital signs?
temperature, pulse, respiration, & blood pressure
What are the 3 abdominal planes?
-Transpyloric
-Subcostal
-Intertubercular
What is the linea alba?
a fibrous band that stretches from xiphoid to symphysis pubis
What is the most common abdominal wall mass?
lymphoceles
When do superficial abdominal wall mass usually occur?
post-op
What is a lymphocele?
a cyst that contains lymph
What is a lipoma?
fatty mass
How do lipomas appear on ultrasound? What artifact will we have?
echogenic, with prop speed artifact
What is a seroma and when do commonly find them?
a collection of serum in the tissue resulting from a surgical incision. Commonly found after mastectomy
What is a hernia?
a protrusion of peritoneal-lined sac through a defect in weakened abdominal wall
Where do most hernias most commonly occur?
umbilical area & the femoral and inguinal rings
What is the difference between incarcerated and a strangulated hernia?
incarcerated can not be reduced and strangulation is when the blood supply is interrupted & the bowel can become necrotic
What procedure do we need the patient to perform to diagnose a hernia?
valsalva
Patient presents with FUO, what locations should we look for abnormalities?
-Subdiaphragmatic (liver and spleen)
-Splenic recess and borders
-Hepatic recess and borders
-Morisons Pouch
-Pericolic gutters
-Pouch of Douglas
-Broad ligaments of females
-Anterior to urinary bladder
What is crytorchidism?
undescended testes
What are 2 potential fluids found in the abdomen?
ascites (serous fluid) & blood
If a patient has a hematoma above the arcuate line, where would the hematoma be located?
confined between the anterior and posterior rectus sheath – calling it a rectus sheath hematoma
What does subphrenic mean?
below the diaphragm
Pseudomyxoma typically occurs due to what?
cystic ovarian mass
What is the peritoneal cavity?
potential space between the parietal and visceral peritoneum
4 causes of ascites?
-Liver failure
-CHF
-Infection
-Malignancy
What are the pelvic spaces?
-Anterior cul-de-sac/uterovesical space
-Posterior cul-de-sac/Pouch of Douglas/Rectouterine space
-Space of Retzius
-Vesicorectal space (males)
Inflammatory or malignant ascites may have?
echoes
What are the organs of the true pelvis?
-Uterus
-Fallopian tubes
-Lower parts of intestines and urinary tract
-Reproductive organs
-Bladder
-Posterior cul-de-sac
The visceral peritoneum covers what?
organs
The peritoneum secretes ____ mL fluid a day?
50
What does the falciform ligament connect?
liver to anterior abdominal wall
What is the function of the greater omentum?
to prevent anterior abdominal wall parietal peritoneal tissue from adhering to visceral peritoneum
What is a urachal cyst?
cystic mass between umbilicus and bladder
What are 5 pathways bacteria spreads to the abdomen?
- Through the portal system
- By way of ascending cholangitis of the CBD (most common cause in US)
- Via hepatic artery secondary to bacteremia
- By direct extension from an infection
- By implantation of bacteria after trauma to abdominal wall
Common signs and symptoms seen with abscess?
-Fever
-Chills
-Weakness
-Pain
-Swelling
-Elevated WBCs
What is biloma?
collection of bile within the peritoneal cavity outside of the biliary tract
Bilomas are typically associated with?
liver transplant due to biliary leak
What is a urinoma?
encapsulated collection of urine from renal trauma or surgery
Urinomas are commonly associated with?
renal transplant or obstruction
What is the sandwich sign?
lymphomas of omentum and mesentery – enlarged lymph nodes anterior and posterior to AO and IVC
What does HAUL stand for?
hematoma, abscess, urinoma, lymphocele
