Review Flashcards
What are the 4 sonographic criteria for a simple cyst?
- Strong back wall
- Through transmission
- Anechoic, round, or oval
- Posterior enhancement
What is the most reliable criteria for a simple cyst?
Posterior enhancement
If septations are irregular and >1mm in thickness or solid elements are presents, the lesion must be presumed what?
Malignant
How does ADPKD differ from ARPKD with patients affected?
ADPKD presents later in life around the 4th decade, ARPKD is in paediatrics
How does ADPKD differ from ARPKD with sonographic appearance?
ADPKD: large cysts and large kidneys
ARPKD: echogenic and large
Which type of polycystic kidney disease is associated with cerebral berry aneurysms?
ADPKD
Which blood test is the most sensitive indicator of renal function?
Creatinine
What can multiple parapelvic cysts be mistaken for?
Hydronephrosis
What are medullary sponge kidneys the result of?
Dilated tubules
What will we see sonographically with medullary sponge kidneys?
Bilaterally echogenic pyramids
Which type is the most common form of choledochal cyst?
Type 1
How does Type 1 choledochal cyst present as?
Diffuse fusiform dilatation of the CBD
Type 1 choledochal cysts have a known association with what?
Cholangiocarcinoma
What are 4 benign neoplasms that affect the liver?
Lipoma, FNH, hemangioma, and adenoma
What is the most common benign neoplasm of the liver?
Hemangioma
How does a liver hemangioma appear sonographically?
Hyperechoic, homogenous, and well-defined
Which benign neoplasm of the liver would contain Kupffer cells?
FNH
What is the typical sonographic appearance of an FNH?
Isoechoic to the liver (stealth lesion)
Which benign liver neoplasm is associated with oral contraceptives?
Adenoma
What other disease are liver adenomas related to?
Von Geirks or GSD
What is the appearance of a liver adenoma of a sulfur colloid scan?
Cold
Which benign liver neoplasm is extremely rare?
Lipoma
What is a true benign neoplasm of the gallbladder?
Adenoma
How is an adenoma of the GB and a cholesterol polyp differentiated?
Not possible, cholesterol polyps are just more common
A hyperechoic focus in the GB wall demonstrating comet tail artifact is characteristic of what?
Adenomyomatosis
What is the most common benign tumor of the kidney?
Angiomyolipoma
What is an AML composed of?
Vessels, muscle, and fat
Who are AML’s more common in and what do they have an association with?
More common in female patients and have an association with tuberous sclerosis
What is the typical sonographic appearance of an AML?
Hyperechoic, round, homogenous, affecting the cortex of the kidney
What artifact can be seen with a myelolipoma of the adrenal gland?
Broken diaphragm or propagation speed artifact
What is the most common benign neoplasm affecting the abdominal wall?
Desmoid
Where do desmoid tumors develop?
Surgical or laproscopic sites
What sonographic signs would create suspicion for malignancy in the liver?
- Flow with color doppler and high velocity
- Multiple lesions or masses
- Lymphadenopathy in porta hepatis region
- Hypoechoic halo
- Solid hypoechoic mass
What is the most common primary malignant tumor of the liver?
HCC
What are risk factors for HCC?
Alcohol, hep B and C, exposure to toxins, metabolic disorders (GSD)
What lab value will be elevated in 70% of HCC cases?
AFP
Is venous invasion common with HCC?
Yes, in the portals and hepatics
What are the two types of lymphoma?
Hodgkin’s and non-Hodgkins
Which age groups do Hodgkin’s and non-Hodgkin’s affect?
Hodgkin’s: Paediatric
Non-Hodgkin’s: Elderly
What are some common sonographic findings for both Hodgkin’s and non-Hodgkin’s lymphoma?
Lymphadenopathy, retroperitoneal nodes, splenomegaly, compression and displacement of surrounding structures
GB carcinoma is a form of what?
Adenocarcinoma
GB carcinoma is more common in which gender?
Females
GB carcinoma has an association with what?
GB stones
GB carcinoma signs and symptoms are similar to what?
Chronic cholecystitis
Klatskin’s tumor is the most common form of what?
Cholangiocarcinoma
Where are Klatskin’s tumors located?
Confluence of the right and left hepatic ducts
How are Klatskin’s tumors characterized by sonographically?
Dilated intrahepatic ducts and a normal CBD
What is the most common malignancy of the pancreas?
Adenocarcinoma
Where is adenocarcinoma of the pancreas commonly located?
Head
What lab value will be elevated with adenocarcinoma of the pancreas?
Lipase
What is the most common malignant renal tumor in adults?
RCC
What is the most common malignant renal tumor in children?
Nephroblastoma
What is a nephroblastoma also called?
Wilm’s tumor
What other malignancy can a nephroblastoma be confused with?
Neuroblastoma
What is the most common tumor of the renal collecting system?
Transitional cell carcinoma
Which zone does prostate cancer typically develop?
Peripheral
What is a highly malignant adrenal tumor that occurs in children?
Neuroblastoma
What is the most common malignant tumor of the liver?
Metastatic disease
What is an AAA caused by?
Weakening of the aortic wall
What is the most common predisposing factor of an AAA?
Atherosclerosis
What is the most common type of AAA?
Fusiform
To be considered an aneurysm, the abdominal aorta must measure what?
> 3cm
When measuring an AAA, always measure where?
Outer to outer
What is the most common complication of an AAA?
Stenosis or occlusion
What is the most critical complication of an AAA?
Rupture
What is the most common primary tumor of the IVC?
Leiomyosarcoma
What is the most common tumor of the IVC?
Metastatic RCC
What is the most common abnormality of the IVC?
Thrombosis coming from the legs
What are the 2 most frequent congenital abnormalities of the IVC?
Transposition and duplication
What is the most common cause of intrahepatic portal hypertension?
Cirrhosis
What is the upper limit of normal for the MPV?
13mm
Name the 5 collateral routes often associated with portal hypertension:
- Para-umbilical
- Gastroesophageal
- Splenorenal/gastrorenal
- Intestinal
- Hemmorhoidal
Portal hypertension can be treated with what kind of procedure?
TIPS
A clot in the portal venous system is referred to as what?
Portal vein thrombosis
Portal vein thrombosis can result in what?
Cavernous transformation
What is cavernous transformation also called?
Can of worms
What is obstruction of the hepatic veins referred to as?
Budd Chiari
What does Budd Chiari have a link with?
Oral contraceptive use
What is fat accumulation within the hepatocytes referred to as?
Fatty infiltration
What are the 2 most common causes of fatty infiltration?
Obesity and alcohol use
Describe focal fatty infiltration:
Normal liver parenchyma with focal fat area
Describe focal fatty sparing:
Fatty liver parenchyma with focal normal tissue
What is a diffuse process that destroys liver cells?
Cirhossis
What is the leading cause of cirrhosis?
Alcohol abuse
What is the classic clinical presentation for this condition?
Hepatomegaly, jaundice, ascites
In the chronic stage of cirrhosis, what will the liver do in terms of size?
Decrease
With chronic cirrhosis, the liver will have a CL/RL ratio of what?
> 0.65
What are two other names for biliary sludge?
Biliary sand and microlithiasis
What is tumefactive sludge?
Sludge that mimc polypoid tumors (sludge balls)
What does GB hepatization refer to?
GB filled with sludge w/ same echogenicity as the liver
What is pseudosludge?
Artifact
What is the most common disease of the GB?
Cholelithiasis
Who is at risk for developing cholelithiasis?
Females, fat, 40, family history, and fertile
What is the most common complication of cholelithiasis?
Biliary colic
What is choledochalithiasis?
Stones in the biliary tree
What is the most common cause of choledochalithiasis?
Migration of stones from the GB
Where is the most common location for a stone to lodge in the biliary tree?
Ampulla of Vater
List 4 areas in the urinary tract where a stone might lodge:
UPJ, iliacs, UVJ, bladder outlet
Which urinary tract area is most common for a stone to lodge?
UVJ
Stones with what measurement may be passed spontaneously?
<5mm
What is a broad term used to describe poorly functioning but unobstructed kidneys?
Medical renal disease
What is the the most common cause of ARF?
ATN (acute tubular necrosis)
What is the most common cause of chronic renal failure?
Diabetes
List two ways that end stage renal failure is treated:
Dialysis and transplant
What is the classic clinical presentation for infection and inflammation?
Fever, leukocytosis, and pain
What is an inflammation of the liver?
Hepatitis
What is hepatitis caused by?
Viruses or toxins
Describe the sonographic appearance of acute hepatitis:
Hypoechoic liver with bright portals and a thick GB
Describe the sonographic appearance of chronic hepatitis:
Decreased size and increased echogenicity
What is acute cholecystitis most often due to?
Stones impacted in the GB neck
A GB wall is considered thickened if it measures what?
> 3mm
An inflamed GB without stones is characteristic of what?
Acalculus cholecystitis
The WES sign is associated with which form of cholecystitis?
Chronic
GB carcinoma has an association with which form of cholecystitis?
Chronic, porcelain
Name two causes of acute pancreatitis:
Binge drinking and biliary stones
What is the most common cause of chronic pancreatitis?
Alcoholism
How do lab findings differ between acute and chronic pancreatitis?
Acute: both amylase and lipase increased
Diverticulitis is most common in which quadrant?
LLQ
Acute pyelonephritis is most commonly caused by what?
E. coli