URR 16 Flashcards by Billie Harney

Ultrasound shear wave elastography <___ kPa (1.3m/s) is suggestive of normal liver tissue

How well did you know this?

Not at all

Perfectly

Ultrasound shear wave elastography __-__ kPa (2.1-2.4 m/s) is highly suggestive of advanced chronic liver disease

13
17

How well did you know this?

Not at all

Perfectly

Ultrasound shear wave elastography >__ kPa (2.4 m/s) is highly suggestive of clinically significant portal hypertension.

How well did you know this?

Not at all

Perfectly

transmission of an initial ultrasonic pulse is used as a baseline signal for later comparison

a short-duration high-intensity pushing pulse is then transmitted by the same transducer

a series of diagnostic intensity pulses are transmitted, which are used to track the displacement of the tissue caused by the pushing pulse

acoustic radiation forced impulse

How well did you know this?

Not at all

Perfectly

The response of the tissue to radiation force is displayed as the _____ of tissue displacement

quantitative shear-wave velocity (m/s)

How well did you know this?

Not at all

Perfectly

The stiffer a region of tissue, the ____ the shear-wave velocty

greater

How well did you know this?

Not at all

Perfectly

The ROI for AFRI should be __-__ cm below the liver capsule

2
3

How well did you know this?

Not at all

Perfectly

inflammation of the liver

hepatitis

How well did you know this?

Not at all

Perfectly

Liver changes are reversible with treatment of _____

viral hepatitis

How well did you know this?

Not at all

Perfectly

Lifestyle changes can reverse _______ steatohepatitis

alcoholic and nonalcoholic

How well did you know this?

Not at all

Perfectly

Symptoms of hepatitis

jaundice
hepatomegaly
nausea
fever/chills
malaise
dark urine
pale stool

How well did you know this?

Not at all

Perfectly

Significantly impaired liver function can cause ______ as the brain is exposed to high levels of toxic substances normally filtered by the liver

hepatic encephalopathy

How well did you know this?

Not at all

Perfectly

most common cause of intrahepatic cholestasis

hepatitis

How well did you know this?

Not at all

Perfectly

Symptoms of intrahepatic cholestasis

jaundice
dark urine
pale stool

How well did you know this?

Not at all

Perfectly

most common reason for spread of hepatitis

IV drug users

How well did you know this?

Not at all

Perfectly

Lab tests with hepatitis

increased AST, ALT, alkaline phosphatase

How well did you know this?

Not at all

Perfectly

If hepatitis is caused by _____, there is a greater increase in AST

alcoholism

How well did you know this?

Not at all

Perfectly

If hepatitis is caused by ____, greater increase in ALT

viral hepatitis

How well did you know this?

Not at all

Perfectly

There will be elevated _____ because the liver cells product extra bile

direct bilirubin

How well did you know this?

Not at all

Perfectly

Hepatitis shows ____ prothrombin time

prolonged

How well did you know this?

Not at all

Perfectly

____ increases with liver damage due to cirrhosis and chronic viral hepatitis

LDH

How well did you know this?

Not at all

Perfectly

Infectious causes of hepatitis

viral
bacterial
fungal
parasitic

How well did you know this?

Not at all

Perfectly

Viral hepatitis includes:

A, B, C, D, E, G

How well did you know this?

Not at all

Perfectly

Hepatitis A is passed:

fecal-oral route

How well did you know this?

Not at all

Perfectly

Hepatitis has a ____ incubation time

2-6 week

Hepatitis B is passed:

through blood, bloodborne

Hepatitis B has a ___ incubation time

2-6 month

Hepatitis B can cause:

hepatic failure

Hepatitis C is passed:

through blood; bloodborne

Most common chronic bloodborne infection in the US

Hepatitis B

acute liver inflammation caused by prolonged heavy alcohol use

alcoholic hepatitis

Late-stage sequela for nonalcoholic fatty liver disease

nonalcoholic steatohepatitis

Nonalcoholic steatohepatitis becomes irreversible if:

fibrotic and cirrhotic changes have begun

most cases caused by acetominephin overdose

fulminant hepatitis

leads to acute liver failure and requires a liver transplant

Fuliminant hepatitis

Other noninfectious causes of hepatitis:

toxins autoimmune disorders medications such as anabolic steroids, erythromycin, and methotrexate

persistence of the hepatitis infection for more than 6 months

chronic hepatitis

Most common causes of hepatic fibrosis

hepatitis B and C nonalcoholic steatohepatitis alcohol abuse

_____ can be used to stage the degree of fibrosis present

elastography

In acute viral hepatitis, the liver demonstrates an increase in size with overall decrease in echogenicity due to _____

fluid accumulation

Acute viral hepatitis shows an increase in echogenicity of fat in the ____, _____, and _____

ligamentum venosum falciform ligament periportal tissues

In acute viral hepatitis, fluid also causes increased reflections from the portal vasculature =

periportal cuffing

In acute viral hepatitis the liver tissue is described as having a "____" appearance

starry sky

_____ is a commonly associated finding with acute viral hepatitis

cholecystitis

Chronic viral hepatitis shows a ____ size of liver

decreased

Chronic viral hepatitis shows ____ echogenicity of portal vein walls

decreased

Chronic viral hepatitis can lead to multiple granuloma formation that present as:

punctate calcifications that may or may not cause acoustic shadowing

Chronic viral hepatitis has ____ liver parenchyma with fibrosis

hyperechoic

Acute alcoholic hepatitis presents as:

hepatomegaly with diffusely echogenic liver parenchyma

Acute alcoholic hepatitis shows an elevated hepatic arterial velocity <___ cm/s

100

Acute alcoholic hepatitis presents with a dilated _____

hepatic artery

Chronic alcoholic hepatitis appears as:

atrophied liver with micronodular cirrhosis

Nonalcoholic steatohepatitis appears as:

significant fatty changes and development of fibrosis

Fulminant hepatitis is also:

acute liver failure

In Fulminant hepatitis the liver may initially be normal in appearance and then will rapidly shrink in size due to _____

hepatic necrosis

In fulminant hepatitis, the _____ will have markedly elevated resistive indices.

hepatic artery

Hydatid disease

echincoccal cyst

found in feces of infected animals and human, raw pork

echinococcal cyst

Cysts formed by tapeworms

echinococcal cyst

In hydatid disease, embryos are freed and absorbed in digestion, they are sent to the liver via the ____

portal system

In hydatid disease, LFTs are usually normal, but can lead to ____

jaundice

Hydatid disease will show increased ______ if the biliary tree is obstructed by cyst formation

alkaline phosphatase

Symptoms of hydatid disease

low grade fever nausea leukocytosis

Hydatid disease can be tested by blood using the ____ test and the ____

indirect hemagglutination enzyme-linked immunosorbent assay (ELISA)

can be used to diagnose hydatid disease; small amount of sterilized hydatid cells is injected under the skin, if a red bump appears with 20-30 minutes, the patient is infected

Casoni Skin Test

Rupture of a large hydatid cyst can cause the patient to:

go into anaphylactic shock

Sonographic appearance of hydatid cyst (early stage)

simple cyst with debris that was produced with development (hydatid sand)

Large cyst with "daughter cysts" within

Echinococcal cyst

fluid collection with septa; associated with echinococcal cyst

Honeycomb sign

fluid collection with split wall; associated with echinococcal cyst

Water Lily Sign

Echinococcal cysts are most commonly found in the ___ lobe of the liver

right

Chronic infestation of a hydatid disease results in a:

calcified mass

fluke parasite; found in polluted waters and infested shellfish, snails

schistomiasis

In schistomiasis, the ____ carries the worm ova to the liver

portal vein

Schistomiasis can cause narrowing and occlusion of smaller portal vessels called:

periportal fibrosis

Most common parasitic infection in humans

schistomiasis

Schistomiasis causes:

portal hypertension

Schistomiasis most commonly affect the:

urinary tract

thick, echogenic portal vein walls; primary finding of schistomiasis

periportal fibrosis

anechoic lumen surrounded by fibrotic areas

Bull's eye sign with portal veins in cross section

The Bull's eye sign is associated with:

schistosomiasis

In schistomiasis, there is debris/occlusion within _____ portal venous system

intrahepatic

In schistosomiasis, the liver size ____ as the infection progresses

decreases

_____ occurs later in schistosomiasis as the parasites occlude intrahepatic portal veins

portal hypertension

Schisotosomiasis can also lead to:

cystitis with diffuse bladder wall calcification

also known as pneumocystitis carinii

pneumocystitis jirovecci

caused by a yeast-like fungus

pneumocystitis Jirovecci

Pneumocystits Jirovecci most commonly affects:

AIDS patients and others with suppressed immune systems

Pneumocystis jirovecci causes _____ which is life threatening in AIDS atients

pneumocystis pneumonia

Pneumocystic jirovecci presents as:

diffuse echogenic foci formation within the liver, no shadowing

Multiple non-shadowing echogenic foci within the liver parenchyma, diffuse micro- and/or macrocalcifications within the tissue, posterior shadowing may be seen with larger calcifications

pneumocystis jirovecci

A systemic fungal respiratory disease caused by bird, bat, and other animal droppings

granulomatous infections

most common causes of granulomatous infections

histoplasmosis tuberculosis

formation of multiple echogenic foci (granulomas) in the spleen and liver

granulomatous infections

3 types of hepatic abscesses

pyogenic ameobic fungal

symptoms of hepatic abscesses

fever nausea diarrhea RUQ pain hepatomegaly

Hepatic abscess labs

increased LFTs abnormal WBC count

most common type of hepatic abscess

pyogenic abscess

Pyogenic abscesses are caused by:

bacteria

Pyogenic abscesses are most commonly caused by:

biliary disease (cholangitis, cholecystitis)