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Chapter 9 Vascular > Test 10 liver > Flashcards

Test 10 liver Flashcards

1
Q
  1. The liver is suspended from the diaphragm and anterior abdominal wall by the:
    a. Ligamentum teres
    b. Falciform ligament
    c. Round ligament
    d. Triangular ligament
A

B Falciform ligament

The falciform ligament extends from the umbilicus to the diaphragm

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2
Q

Fatty infiltration may be observed in all patients except those with:

a. Diabetes mellitus
b. Chronic alcoholism
c. Hepatoportal fistula
d. Hepatitis

A

ANS: C
A common cause of fatty infiltration includes alcoholic liver disease, diabetes mellitus, obesity, pregnancy, severe hepatitis, chronic illness, and the use of steroids.

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3
Q

Sonographic findings of acute hepatitis include:

a. Accentuated brightness, more extensive demonstration of portal vein radicles, and an overall decreased echogenicity of liver
b. Decreased brightness and echogenicity of liver
c. Increased brightness and echogenicity of liver, and no demonstration of portal vein radicles
d. Ascites, decreased brightness, and echogenicity

A

ANS: A
In patients with acute hepatitis, the liver demonstrates accentuated brightness, more extensive demonstration of portal vein radicles, and an overall decrease in parenchyma echogenicity.

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4
Q

Budd-Chiari syndrome is a rare disorder caused by obstruction of the:

a. Portal veins
b. Superior mesenteric vein
c. Hepatic veins
d. Splenic vein

A

ANS: C
Budd-Chiari syndrome is an uncommon, often dramatic, illness caused by thrombosis of the hepatic veins or inferior vena cava (IVC).

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5
Q

Echinococcal cysts have the highest incidence in countries in which:

a. Fishing is common.
b. Rock climbing is prevalent.
c. Poultry is abundant.
d. Sheep grazing is common.

A

ANS: D

Hepatic echinococcosis is an infectious cystic disease common in sheep-herding areas of the world.

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6
Q

The most common benign tumor of the liver is:

a. Mesenchymal hamartoma
b. Adenoma
c. Cavernous hemangioma
d. Infantile hemangioendothelioma

A

ANS: C

The cavernous hemangioma is the most common benign tumor of the liver

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7
Q

What benign liver tumor has been found in patients with type I glycogen storage disease?

a. Lipoma
b. Adenoma
c. Cavernous hemangioma
d. Hamartoma

A

ANS: B

Glycogen storage disease is associated with adenomas, focal nodular hyperplasia, and hepatomegaly.

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8
Q

Patients who have hepatocellular carcinoma are likely to have had:

a. Hemochromatosis
b. Adenosis
c. Cirrhosis
d. Carcinosis

A 
ANS:	C
Eighty percent (80%) of patients with preexisting cirrhosis develop hepatocellular carcinoma.
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9
Q

The most common form of neoplastic involvement of the liver is:

a. Metastases
b. Hepatocellular carcinoma
c. Hepatoma
d. Hamartoma

A

ANS: A
Metastatic disease is the most common form of neoplastic involvement of the liver. Primary sites include the colon, breast, and lung. Metastasis to the liver occurs as the tumor erodes the wall and travels through the lymphatic system or through the bloodstream to the portal vein or hepatic artery to the liver.

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10
Q

. The fossae of the right portal vein (RPV) and gallbladder are found in the:

a. Main lobar fissure
b. Left intersegmental fissure
c. Right intersegmental fissure
d. Left lobar fissure

A

ANS: A
The main lobar fissure is a hyperechoic line extending from the RPV to the neck of the gallbladder. It is used as a landmark leading to the gallbladder fossa

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11
Q

In severe hepatocellular destruction, the aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels are:

a. High
b. Moderately high
c. Moderate
d. Mild

A

ANS: A
In severe hepatocellular destruction, such as acute, viral, or toxic hepatitis, a striking elevation of AST and ALT may be observed. Levels frequently exceed 1000 units

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12
Q

Elevation of alkaline phosphatase is associated with:

a. Biliary obstruction
b. Cavernous hemangioma
c. Fatty infiltration
d. Simple hepatic cysts

A

ANS: A
A significant elevation of alkaline phosphatase is typically associated with biliary obstruction or the presence of mass lesions in the liver.

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13
Q

. Diminished vascular structures within the liver parenchyma most likely represent:

a. Obstructive portal disease
b. Cirrhosis
c. Budd-Chiari syndrome
d. Acute viral hepatitis

A

ANS: B
Sonographic findings in cirrhosis may include coarse liver texture (fibrosis and nodularity). Increased attenuation may be present with a decrease in vascular

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14
Q

The falciform ligament extends from the umbilicus to the diaphragm in a parasagittal plane containing the:

a. Ligamentum venosum
b. Ligamentum teres
c. Quadratus ligamentum
d. Ligamentum falciforme

A

ANS: B
The falciform ligament extends from the umbilicus to the diaphragm in a sagittal plane and contains the ligamentum teres.

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15
Q

Elevation of serum bilirubin results in:

a. Hepatocellular disease
b. Ascites
c. Jaundice
d. Hemolysis

A

ANS: C
Elevation of serum bilirubin results in jaundice. Jaundice is a nonspecific finding seen in massive blood breakdown, hepatocellular disease, or biliary obstruction.

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16
Q

Which one of the following actions should be done to image the near field of the liver?

a. Increase transducer frequency.
b. Change from a sector to a linear transducer.
c. Use a curved array transducer.
d. Increase the near gain.

A

ANS: C
Generally, a wider “pie” sector or curved linear array transducer is most appropriate to image the near field of the abdomen optimally.

17
Q

Typical symptoms a patient may have with an abscess formation include all of the following except:

a. Fever
b. Decreased white blood count
c. Pain
d. Increased white blood count

A

ANS: B

Clinical symptoms of an abscess include fever, abdominal pain, and an increase in white blood count.

18
Q

Jim MacDonald, a sheep farmer, arrives at the hospital with right upper quadrant pain, fever, and an elevated white blood cell count. He states that 3 months earlier, he was kicked in the ribs. An irregular mass showing low-level echoes is found on the sonogram. What is your differential diagnosis?

a. Amebic abscess
b. Hematoma
c. Echinococcal cyst

A

ANS: C
The best diagnosis is an echinococcal cyst. An abscess is a possibility, although with a history of being a sheep herder, echinococcal cyst is more likely. A hematoma does not cause a fever.

19
Q

Which one of the following tumors consists of large blood-filled spaces?

a. Adenoma
b. Hamartoma
c. Ewing angioma
d. Cavernous hemangioma

A

ANS: D
A hemangioma is a benign tumor consisting of large blood-filled (cystic) spaces. Their sonographic appearance may vary from small to large and hyperechoic to complex

20
Q

Dilated intrahepatic bile ducts may be seen with all of the following except:

a. Intrahepatic mass in the area of the porta hepatis
b. Gallstones in the fundus of the gallbladder
c. Obstructive stone in the cystic duct
d. Lymphadenopathy in the porta hepatis

A

ANS: B
Dilated intrahepatic ducts may be seen with gallstones in the neck of the gallbladder, with an intrahepatic mass in the area of the porta hepatis; with an obstructive stone in the cystic duct; and with lymphadenopathy in the porta hepatis

21
Q

Hepatocellular disease can be defined as a process that affects the:

a. Spherocytes and interferes with liver function
b. Phagocytes and does not interfere with liver function
c. Phagocytes and interferes with liver function
d. Hepatocytes and interferes with liver function

A

ANS: D

Hepatocellular disease can be defined as a process that affects the hepatocytes and interferes with liver function.

22
Q

In glycogen storage disease, type I is the most common and is also known as __________ disease

a. von Gierke
b. von Gussel
c. von Gerpe
d. von Slurpie

A

ANS: A
The most common type of glycogen storage disease is type I, von Gierke disease in which abnormal amounts of glycogen are deposited in the liver and kidneys.

23
Q

All of the following describe normal portal venous flow except:

a. Low-flow velocity
b. Hepatofugal flow
c. Spontaneous flow
d. Phasic flow

A

ANS: B

The portal venous system demonstrates spontaneous, phasic, hepatopetal flow with a low-flow velocity.

24
Q

Which one of the following is noted in type I glycogen storage disease?

a. Small liver and hypoechoic parenchyma
b. Hyperechoic liver and hepatomegaly
c. Normal texture and hepatomegaly
d. Normal texture and prominent intrahepatic biliary ducts

A

ANS: B
Patients with type I glycogen storage disease demonstrate hepatomegaly, increased echogenicity, and attenuation of the liver parenchyma.

25
Q

All of the following statements are true about the features most often observed in an extrahepatic mass except:

a. Internal invagination of the liver capsule
b. Formation of a triangular fat wedge
c. Discontinuity of the liver capsule
d. Anteromedial shift of the IVC

A

All answers are observed in an extrahepatic mass
Extrahepatic mass or masses demonstrate discontinuity of the liver capsule, formation of a triangular fat wedge, and anteromedial shift of the IVC or anterior displacement of the right kidney.

26
Q

All of the following statements are true about the features most often observed in an intrahepatic mass except:

a. Anterior displacement of the right kidney
b. Displacement of the hepatic vascular radicles
c. External bulging of the liver capsule
d. Posterior shift of the IVC

A

ANS: A
Intrahepatic mass or masses demonstrate displacement of the hepatic vascular radicles, external bulging of the liver capsule, or a posterior shift of the IVC.

27
Q

The most common site for echinococcal virus growth is in the:

a. Lungs
b. Bones
c. Liver
d. Brain

A

ANS: C
After entering the proximal portion of the small intestines in humans, the larvae burrow through the mucosa, entering the portal circulation and traveling to the liver

28
Q

The amebic abscess may reach the liver through the:

a. Hepatic artery
b. Gastroduodenal artery
c. Hepatorectal artery
d. Portal vein

A

ANS: D

The infection is primarily a disease of the colon; therefore the parasites reach the liver via the portal vein.

29
Q

What benign liver tumor is located near the free edge of the liver, solitary, well-circumscribed, and a nonencapsulated multinodular mass?

a. Adenoma
b. Cavernous hemangioma
c. Focal nodular hyperplasia (FHN)
d. Lipoma

A

ANS: C
FHN generally demonstrates a solitary, well-circumscribed lesion located along the subcapsular area of the liver. Lesions may be multiple and are typically found in women under the age 40 years.

30
Q

. Common malignancies affecting the pediatric population include all of the following except:

a. Neuroblastoma
b. Wilms tumor
c. Leukemia
d. Hepatoblastoma

A

ANS: D
Common malignancies affecting the pediatric population include the neuroblastoma, Wilms tumor, and leukemia. Hepatoblastoma is a rare hepatic malignant tumor seen in infancy and childhood.

Chapter 9 Vascular (16 decks)

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