Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI 2 > Liver Lesions > Flashcards

Liver Lesions Flashcards

1
Q

What are 3 primary, benign liver lesions?

A

Hemangioma

Focal nodular Hyperplasia (FNH)

Adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are 2 maligant liver lesions?

A 
o Hepatocellular Carcinoma (HCC)
o Cholangiocarcinoma (CCA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  • Oral contraceptives increase chance of:
  • A history of extrahepatic malignancy increase chance of:
A

 Hepatic adenoma

 Metastatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pt with Underlying liver disease is more at risk for:

• History of primary sclerosing cholangitis (PSC) puts you at risk for:

A

 Hepatocellular carcinoma (except Hep B can go right to this)

 Cholangiocarcinoma (CCA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pt with Non-cirrhotic liver has liver cancer, most likely caused by what?

What if they did have cirrhotic liver?

A

most likley mets from :GI, LUng, UG, breast

IF cirrhotic liver and cancer 77% its liver cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

• The most common benign liver lesion
(1% of all autopsies)
• FOUND IN NON-CIRRHOTIC LIVER

NO maligant potential

A

Hemangioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When do we see pts with hemangiomas?

A
  • Majority diagnosed in third to fifth decade
  • Can range from 1-20 cm (> 10 cm = giant hemangiomas)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Congenital vascular malformations (blood-filled cavities lined by endothelium)

A

Hemangioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

You see a central stellate scar on a liver, Dx?

A

Focal nodular hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

• Second most common benign liver lesion
(Found in 0.3 to 0.6% of all autopsies)
• FOUND IN NON-CIRRHOTIC LIVER
• A reaction to intrahepatic anomolous artery leading to
hyperperfusion

A

Focal nodular hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who do we see focal nodular hyperplaisa in and where is it located?

A
  • Women between ages of 20 and 50
  • Majority < 5cm (rarely exceeds 10 cm)
  • Can be multiple in 10%-20% of cases
  • NO MALIGNANT POTENTIAL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do hemangiomas and focal nodular hyperplasia have in common?

A

both benign with no malignant hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  • Third most common benign liver lesion
  • FOUND IN NON-CIRRHOTIC LIVER
  • Benign proliferation of hepatocytes
A

Hepatic Adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is hepatic adenoma different and simular to focal nodular hyperplasia and hemangioma?

A

All three are benign and non-malignant while hepatic andenoma has ability for malignant transformation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What proliferates in hepatic adenoma?

A

hepatocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
  • Majority in women of childbearing age
  • Associated with contraceptives use
  • Usually asymptomatic
A

Hepatic adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

• Unlike hemangiomas and FNH, there is a risk
of HEMORRHAGE and MALIGNANT TRANSFORMATION
 Growth and rupture of adenoma can occur during
pregnancy

A

Hepatic adenoma

19
Q

Treatement for hepatic adenoma

A

• Treatment
 Contraceptives should be discontinued
 Avoid pregnancy
 Surgical resection is recommended to avoid the risk of cancer and tumor rupture.

20
Q

What trends are we seeing with HCC?

A

Fastest growthing death rate in the US, survival rates are better then they used to be but still pretty bad with survial of 12%; Dt HIV and HCV in the 70/80s are now getting maligant tranformaiton

21
Q

RAtes of Viral hepatits in the US

A

HCV and HBV are big cuase of HCC

  • HBV most frequent in Asians
  • HCV most frequent in nonAsians
22
Q

What happens to the blood flow pattern in HCC? How can we use this knowledge to Dx HCC?

A

See decreaesed portal flow and increased arterial flow from hepatic artery

this allows us to target the cancer

Can see HCC in the “Washout” during venous phase

23
Q

• Produced by fetal liver and placenta
• Elevated in 60%-70% of patients with HCC
 can be elevated with hepatic inflammation in the absence of HCC
 can be elevated in cirrhosis in the absence of HCC

A

Alpha Fetoprotein (AFP)

24
Q

Can AFP levels give us dx of HCC?

A

NO! can be elevated with hepatic inflammation in abscence of HCC like in cirrhosis

25
Q

Values greater than 200 ng/ml in conjunction
with liver lesion on imaging is consistent with

A

HCC

26
Q

How to prevent HCC

A
  • HBV vaccination
  • Treatment of viral hepatitis
  • ? Coffee
27
Q

During pregancy, hematocrit, serum urea, uric acid,
albumin, total protein will:

A

all decrease, substances become diluted

28
Q

Spiders, plamar erythema, decreased GB contractility (increase stone risk) is seen in:

A

Pregancy and liver disease

29
Q

What happens to ALK Phos levels when you are pregnant?

A

They will increase (from placenta)

30
Q

Pt is in 1st trimester of pregancy and your pt have continous vomitting adn is severely dehydrated. Her ALT is 3x normal. what could be cause?

A

HYPEREMESIS GRAVIDARUM

rare; tx symtpoms with fluids and antiemetics

31
Q

Pt is 7 months along with her 2nd child and has horrible itching that keeps her up at night. Your preceptor suspcects somehting is going on with her liver, what would your Dx be?

A

Intrahepatic cholestatis of pregancy (IHCP)

uncommon overall

more in 3rd trimester

increase risk for prematurity or perinatal death

32
Q

You have a pt with Intrahepatic Cholestatis of Pregancy, what would you suspect her labs to be

bilirubin

AST/ALT

serum bile acids

A

jaundice in 25%, up to 4-fold AST/ALT
increase, serum bile acids increased 30 to 100- fold

33
Q

Have a pregant pt with the following labs:

jaundice in 25%, up to 4-fold AST/ALT
increase, serum bile acids increased 30 to 100-
fold

A

IHCP

34
Q

How do you tx pt with IHCP

A

 cholestyramine-binds bile acids
 ursodeoxycholic acid which modifies bile acid
pool, inhibits absorption of more hydrophobic bile
acids

35
Q

How does cholestyramine work?

Ursodeoxycholic acid:

A

binds bile acids

modifies bile acid pool, inhibits absorption of more hydrophobic bile acids

36
Q

PREECLAMPSIA
• Usually occur after ___weeks
• Preeclampsia:
 5-7% of pregnancies
 AST and ALT elevation ___%

A

20

hypertension, proteinuria,edema

25-50%

37
Q

• Eclampsia: preeclampsia + seizures
 0.1-0.2% of pregnancies
 AST and ALT elevations in____

A

80-90%

***• Delivery if near term

38
Q

What is a common overlap between Pre-eclampsia and AFLP?

A

HELLP

39
Q

ACUTE FATTY LIVER OF PREGNANCY
(AFLP)
•____ trimester, 1 in 7000-15,000 pregnancies
• Preeclampsia occurs in _____

A

Third

20-40% of AFLP

40
Q

• Etiology of Acute fatty liver pregancy:

fatty acid oxidation defects in____
_____: long-chain 3-hydroxyacyl coenzyme
dehydrogenase deficiency in a fetus with a heterozygous mother
 Leads to fatty liver in mother

A

fetus

LCHAD

41
Q

How can you tell if mom has mild or severe AFLD?

A
  • Mild: liver test abnormalities
  • Severe: jaundice, coagulopathy and encephalopathy
  • Urgent delivery indicated
42
Q

What does HELLP syndrome stand for?

A

• Hemolytic anemia

  • *E**levated Liver tests
    • L**ow Platelets
43
Q

Cause or associatesions of HELLP syndrome

A

• Unclear etiology
• 0.2-0.6 of pregnancies
 4-12% of women with preeclampsia/eclampsia
• Urgent delivery indicated

GI 2 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions