URR 15 Flashcards
1
Q
without echoes, black
A
anechoic
2
Q
more echoes than the compared structure, brighter
A
hyperechoic
3
Q
less echoes than the compared structure, darker
A
hypoechoic
4
Q
same amount of echoes as the compared structure
A
isoechoic
5
Q
also known as steatosis
A
fatty liver
6
Q
Fatty liver is caused by _____ accumulation
A
triglyceride
7
Q
The most common cause of steatosis is:
A
obesity
8
Q
caused by chronic alcohol intake
A
alcoholic fatty liver disease
9
Q
_____ is a late-stage sequela of alcoholic fatty liver disease
A
alcoholic hepatitis
10
Q
In alcoholic fatty liver disease LFTs are ____
A
markedly increased
11
Q
AST:ALT ratio >___ in alcoholic fatty liver disease
A
2
12
Q
Most common chronic liver disease in Western countries
A
nonalcoholic fatty liver disease
13
Q
Causes of nonalcoholic fatty liver disease
A
diabetes
obesity
tuberculosis
starvation
cystic fibrosis
steroid use
14
Q
______ is a late-stage sequela of nonalcoholic fatty liver disease
A
nonalcoholic steatohepatitis
15
Q
With nonalcoholic fatty liver disease LFTs are:
A
mild to moderately increased
16
Q
Diffuse replacement
A
entire liver involved
17
Q
entire liver involved EXCEPT localized area (s)
A
focal fatty sparing
18
Q
only small portion of the liver experiences fatty infiltration
A
focal fatty replacement
19
Q
______ examination can help in differentiating focal sparing/infiltration from mass formation
A
contrast ultrasound
20
Q
Malignant tumor will demonstrate ____ at the tumor with contrast ultrasound
A
washout of contrast
21
Q
Primary finding on all imaging modalities of fatty liver
A
normal vessel course through the fatty deposits, NO displacement
22
Q
slight increase in fine echoes of liver, normal visualization of the diaphragm and vessel borders
A
mild diffuse infiltration
23
Q
moderate increase in fine echoes of liver, impaired visualization of the diaphragm and vessel borders
A
moderate diffuse infiltration
24
Q
marked increase in fine echoes of liver, poor or non-visualization of the diaphragm and vessel borders
A
severe diffuse infiltation
25
>15.5 cm superior - inferior length of liver measured in mid clavicular plane
hepatomegaly
26
Increased length with right lobe extending beyond the lower pole of right kidney
hepatomegaly
27
Hepatic veins affects with fatty liver changes
narrowed
decreased outflow
loss of pulsatility and respiratory phasicity
monophasic antegrade waveform
28
focal area of increased echogenicity, may have irregular borders, does NOT displace surrounding structures
focal infiltration of liver
29
Focal infiltration is usually adjacent to ____
portal structures
30
focal area of decreased echogenicity with remaining liver tissue diffusely increased in echogenicity, may have irregular borders. does NOT displace surrounding structures
focal sparing
31
Focal sparing is usually adjacent to:
gallbladder fossa
32
Reye syndrome is rare disorder that typically affects ____
children
33
Patient has a viral infection like the flu or chicken pox, during recovery, ____ develops
Reye syndrome
34
Reye syndrome is associated with ____ use during viral infection
aspirin
35
Reye syndrome causes excessive fat accumulation in the ____ and acute increase in _____
liver
cranial pressure
36
Symptoms of Reye syndrome
abnormal LFTs
excessive vomiting
confusion
delirium
loss of consciousiness
seizures
37
Reye syndrome can result in ____ and/or ___
lasting brain damage
death
38
Reye syndrome is diagnosed by:
liver biopsy
39
deposition of amyloid protein within the vessel walls of various organs which leads to organ failure
amyloid disease
40
Amyloid disease commonly involves the:
liver
41
Autosomal recessive disorders of glycogen metabolism
glycogen storage disease
42
Type 1 is most common glycogen storage disease
von Gierke disease
43
Glycogen storage disease usually affects the ___ or ____
liver
skeletal muscle
44
Lab testing for glycogen storage disease
hypoglycemia
may see abnormal LFTs
45
Glycogen storage disease is excessive storage of glycogen within:
hepatocytes
46
Glycogen storage disease is associated with ____ formation
adenoma
47
reduced storage of glycogen within the ____
hepatocytes
48
There will be a prominent appearance of ____
portal walls
49
abnormal iron deposition in a number of organs
hemochromotosis
50
can be inherited or due to hemolytic anemia
hemochromatosis
51
Hemochromatosis is best evaluated with:
MRI
52
Wilson disease is an _____ disorder
autosomal recessive
53
Disorder of copper metabolism that is characterized by excessive deposition of copper in the liver, brain, and other tissues
Wilson Disease
54
Wilson Disease leads to ____, ___, ____, and/or _____
hepatic dysfunction
hepatitis
cirrhosis
liver failure
55
Symptoms of Wilson disease
jaundice
hematemesis
portal hypertension
ascites
56
Rusty or brown-colored ring around the iris of the eye is associated with
Wilson Disease
57
rusty or brown-colored ring around the iris of the eye is called:
Kayer-Fleischer rings
58
Wilson disease shows a _____ in AST and ALT, biliruin, PT
increased
59
Wilson disease shows ____ albumin
decreased
59
If a younger patient presents with cirrhosis, ____ should be considered
Wilson disease
59
Wilson disease shows ____ serum and urine copper levels
elevated
59
Sonographic appearance of Wilson disease
echogenic fatty liver
fibrotic periportal thickening
nodular cirrhostic changes
59
Diffuse, irreversible liver disease
cirrhosis
59
Symptoms of cirrhosis
increased abdominal girth from ascites
jaundice
liver atrophy
splenomegaly
weight loss
59
Cirrhosis shows ____ AST, ALT, alkaline phosphatase, bilirubin, GGTP, LDH
increased
59
Cirrhosis shows ____ albumin levels and albumin/globulin ratio
reduced
59
If cirrhosis is caused by alcoholism:
severe increase in AST
59
If cirrhosis is caused by viral hepatitis:
severe increase in ALT
59
Anemia is seen in advanced cirrhosis typically due to associated ____
GI bleeds
59
Most common causes of cirrhosis are
alcoholism
hepatitis C
60
_____ is the most common cause for micronodular cirrhosis
alcoholism
60
Causes of cirrhosis
alcoholism
hepatitis C
chronic liver disease
biliary obstruction
viral hepatitis B
glycogen storage disease
hemochromatosis
Wilson disease
Budd Chiari Syndrome
60
_____ is the most common cause for macronodular cirrhosis
chronic viral hepatitis
61
Cirrhosis leads to:
necrosis of hepatocytes
fibrosis
regeneration of abnormal nodules
62
Cirrhosis is associated with _____ carcinoma
hepatocellular
63
Patients with cirrhosis have a significantly increased risk of developing _____, _____, ____, ____, and ____
cavernous transformation
dilated coronary and umbilical veins
HCC
ascites
portal thrombosis
64
Patients with cirrhosis should have their liver vasculature evaluated regularly due to an increased risk of _____ and ____
portal thrombosis
tumor invasion from hepatocellular carcinoma
65
Cirrhoses commonly leads to ascites which may require intermittent ____ t
paracentesis treatments
66
Sonographic appearance of early stage cirrhosis:
hepatomegaly
diffuse increase in echogenicity
mild heterogeneity
67
Sonographic appearance of later stage cirrhosis:
decrease liver size
coarse echotexture
ascites and periperal edema
gallbladder and bowel wall thickening
formation of nodules within the liver
68
Most definitive sonographic sign on cirrhosis
decreased liver size with coarse texture and nodule formation
69
Ascites and peripheral edema are caused by:
reduced albumin levels
70
Gallbladder and bowel wall thickening are associated findings with _____
hypoalbuminemia
71
Micronodular cirrhosis
multiple nodules <1 cm in size
usually associated with alcoholism
72
Macronodular cirrhosis
multiple nodules usually 1-5 cm in size
usually associated with chronic viral hepatitis
73
When liver atrophy occurs, the _____ is spared in most cases
caudate lobe
74
causes an abnormal ratio of right lobe length to caudate lobe length
liver atrophy
75
Caudate lobe / Right lobe ratio >___ indicates cirrhosis
0.65
76
Normally the right lobe length is an average of ___X the length of the caudate lobe
4-6
77
causes volume overload in the portal veins and inspiration will have little effect on the portal vein diameter in these patients
portal hypertension/thrombosis
78
With portal hypertension/thrombosis, portal venous flow will demonstrate:
reduced velocity and pulsatility
79
Flow reversal of the portal vein occurs in:
advanced cirrhosis
80
Dilated coronary vein and patent umbilical vein are signs of:
significant portal hypertension
81
Hepatic veins can also be narrowed due to cirrhotic liver changes with decreased outflow, loss of pulsatility and respiratory phasicity=
monophasic antegrade waveform
82
Hepatic vein changes due to cirrhotic liver changes are called:
portalization of the hepatic vein
83
As portal venous inflow decreases, ____ occurs as arterial inflow blood volume increases and dilates the vessel
hepatic artery hypertrophy
84
Post-prandially, the normal hepatic artery will demonstrate:
increased resistive index
85
A patient with cirrhosis will demonstrate a ______ in the hepatic artery after eating
diminished change in RI
86
The most common causes of hepatic fibrosis
hepatitis B and C
nonalcoholic steatohepatitis
alcohol abuse
87
Can be used to assess the parenchymal stiffness/liver fibrosis
ultrasound shear wave elastography
