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IMG1037 (Vascular) > WEEK 2- PORTAL HYPERTENSION > Flashcards

WEEK 2- PORTAL HYPERTENSION Flashcards

1
Q

walls of the portal veins are __ and ___ compared to the hepatics

A

thick & hyperechoic

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2
Q

wall diameter of the portal veins is ___ compared to the hapatics

A

wider

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3
Q

blood flow in the portal veins is

A

hepatopedal

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4
Q

hepatopedal

A

blood flow TOWARDS the liver

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5
Q

hepatofugal

A

blood flow AWAY from the liver

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6
Q

location of the portal veins is __-segmental and in the ___ portion of the liver

A

INTRAsegmental

inferior

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7
Q

flow in the portal veins is ALWAYS

A

antegrade (towards the transducer)

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8
Q

flow velocity in the portal veins

A

relatively low (16-40)

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9
Q

MPV spectral doppler

  • ___ the base line
  • ___ resistance
  • ____-phasic
  • ____ velocity
A
  • below
  • low
  • mono
  • continuous, low
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10
Q

MPV feeds approx ___% of the oxygenated blood to the liver from the ___

A

70%

intestines

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11
Q

an increase in portal venous pressure greater than 10mmHg or hepatic venous gradient greater than 5mmHg

A

portal hypertension

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12
Q

portal hypertension results in ___ veins (large and swollen)

A

varicose

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13
Q

varicose veins commonly form in these 4 areas

A
  1. esophagus
  2. stomach
  3. rectum
  4. umbilical area
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14
Q

varices are very fragile and can ___ easily when the pressure becomes high

A

rupture

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15
Q

increased resistance in portal hypertension causes ___ vessels to develop

A

collateral

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16
Q

___ channels open for blood to flow away from the liver and through the collateral vessels

A

embryologic

17
Q

etiology of portal hypertension

A

result from pathologic condition that increases vascular resistance to portal blood flow

18
Q

primary cause of portal hypertension

A

cirrhosis

19
Q

portal hypertension can develop from an increase in ___ blood flow or an increased ___ to blood flow

A

portal

resistance

20
Q

PREhepatic causes of portal hypertension (obstruction to blood flow at level of the portal vein)

A

-thrombosis in portal or splenic vein

21
Q

INTRAhepatic causes of portal hypertension

A
  • TB
  • Cirrhosis, METS
  • Obstruction
22
Q

POSThepatic causes of portal hypertension (obstruction of blood flow at level of the hepatic vein)

A
  • Hepatic vein thrombosis (Budd-Chiari syndrome)
  • IVC obstruction
  • Cardiac diseases
23
Q

complications of portal hypertension

A
  • Encephalopathy (confusion)
  • Ascites (fluid in abdo)
  • Splenomegaly
  • Varices
  • GI bleed
24
Q

diagnosis of portal hypertension is based on symptoms such as

A

-ascites & varices

25
Q

lab test results suggest increase liver enzymes, decreased platelets, decreased WBC suggest

A

portal hypertension

26
Q

portal vein diameter >__mm is associated with portal hypertension

A

13

27
Q

as shunts develop, portal vein diameter ____

A

decreases

28
Q

what is the best method to detect varices

A

endoscopy

29
Q 
portal hypertension presents if: 
portal venous pressure >\_\_mmHg
Heptaic venous gradient >\_\_mmHg
Splenic vein pressure >\_\_\_mmHg
Portal vein pressure >\_\_cm
A
  • 10
  • 5
  • 15
  • 30
30
Q

name 3 differential diagnosis for portal hypertension

A
  • Budd Chiara syndrome
  • Occlusion of vessels
  • Cirrhosis
  • Sarcoidosis
  • Wilson Disease
31
Q

decompression procedure for portal hypertension

A

TIPS

transjugular intrahepatic portosystemic shunt

32
Q

metallic shunt is places in the liver

A

TIPS

33
Q

TIPS connect the ___ vein and ___ vein

A

portal & hepatic

34
Q

purpose of TIPS

A

decrease pressure in portal vein `

35
Q

ultrasound findings of portal hypertension

A
  • PV dilation
  • reverse doppler flow in MPV (hepatofugal)
  • recanalized paraumbillical vein
  • Varices
  • Splenomegaly
36
Q

main points to remmeber about Portal hypertension:

PORTAL

A
  • Pressure >10mmHg
  • Esophageal varices
  • Reverse (hepatofugal) flow
  • Tuberculosis (is a non cirrhosis cause)
  • AST & ALT are high
  • Low sodium diet is important treatment

IMG1037 (Vascular) (4 decks)

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