abdomen 2 Flashcards by Dalila Juarez

a major cause of portal hypertenstion worldwide, the intrahepatic portal veins become occluded resulting in portal hypertension
has periportal fibrosis

schistosomiasis

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Benign solid liver mass that is believed to be a developmental hyperplastic lesion, rather than a true neoplasm

Focal Nodular Hyperplasia

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extremely rare fatty tumors

Hepatic lipomas

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what is the most common mass invading the IVC

Renal cell carcinoma

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what are causes for GB wall thickening

cholecystitis
hypoalbuminemia
ascites
hepatitis
congestive heart failure
pancreatitis

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calcium bilirubinjate granules and cholesterol crystals

nonshadowing, echogenic material which layers and shifts with pt postion

sludge

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gas found in the wall of gb , due to ischemia and infection

emphysematous cholecystitis

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what causes gas in the biliary system

ERCP
sphincter of Oddi papilotomy
Cholendochojejunostomy
gallbladder (biliary) fistula
emphysematous cholecystitis

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purulent materisl within the gb due to bacteria containing bile associated with acute cholecystitis

empyema of the gb

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complication of acute cholecystitis, localized fluid collection in the gb fossa

Gallbladder perforation

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sludge like material with a high concentration of calcium, associated with chronic cholecystitis and gb obstruction
with distal acoustic shadowing

Milk of calcium bile ( Limy bile)

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less than 10mm are unlikely to be cancerous, if greater than 10mm and demonstrate growth could be malignant

Gallbladder polyps

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Lipids are deposited in the gb wall

cholestorolosis

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intraluminal mass, asymmetric wall thickening or mass that fills the gb lumen(most common)

gallbladder carcinoma

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what are the two most common lesions to cause biliary obstruction

gallstones

carcinoma of the head of the pancreas

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name the causes of biliary obstruction

choledocholithiasis
Mirizze syndrome
cholangiocarcinoma
cholangitis
biliary atresia
choledochal cyst
Caroli's disease
pancreatic adenocarcinoma
gallbladder carcinoma

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suspected when jaundice (hyperbilirubinemia) persists beyond 14 days of age
absence of CHD and CBD

Biliary atresia

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air in the biliary tract, associated with Endoscopic retrograde cholangiopancreatogram (ERCP)

pneumobilia

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congenital bile duct anomalies consisting of cystic dilatation of the intra or extrahepatic bile ducts

cholecochal cysts

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type 5 choledochal cyst,

congenital anomaly of the biliary tree characterized by multifocal segmental dilatation of the intrahepatic bile ducts

caroli’s disease

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inflammation and fibrosis of the intrahepatic and extrahepatic bile ducts

Primary sclerosing cholangitis

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chronic and progressive cholestasis due to destruction of the small intrahepatic bile ducts leading to end stage liver disease

Primary biliary cirrhosis

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what structures are in contact with the pancreatic head

IVC
CBD
Ampulla of Vater (terminal end of CBD)
GDA
Duodenal C loop (2nd portion)

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an inflammatory mass formed by edema and leakage of pancreatic enzymes, forms as a complication of acute pancreatitis

Pancreatic phlegmon

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a spreading inflammatory reaction to an infection which forms a suppurative lesion

Phlegmon

exocrine gland disorder resulting in viscous secretion causing pancreatic dysfunction

cystic fibrosis

accumulation of pancreatid fluid and necrotic debris confined to the retroperitoneum

pancreatic pseudocyst

Failure of the dorsal and ventral pancreatic ductal systems to fuse during embryonic development resultig in the smaller Sanrorini's duct draining the pancreas

Pancreas DIvisum

Congenital anomaly where the ventral pancreas encircles the second part of the dueodenum

annular pancreas

90% of the pts with this present with lymphatic and metastatic spread of the tumor typically arises in the head

Pancreatic adenocarcinoma

benign, associted with von Hippel lindau disease , Cluster of grape like cysts

Pancreatic serous cystadenoma | Microcystic cystadenoma

Uncommon, Malignant or malignant potential, multicystic pancreatic mass

Mucinous cystic neoplasms | macrocystic cystadenoma

Tumors of the pancreatic islet cell uncommon Insulinoma- most common usually benign gastrinoma-malignant potential, Zolliger ellison syndrome

Islet cell Tumors (endrocrine Tumors)

although not characteristic of insulinomas and gasrinomas where are most of the pancreatic islet cell tumors found

Pancreatic body and tail

an inherited endocrine disorder

Multipel Endocrine Neoplasia

what are the most common sites of involvement for Multiple Endocrine Neoplasia (MEN)

``` Parathyroids ( hyperparathyroidism) Pancreatic Islet cell (gastrinomas, insulinomas) Pituitary glands (Prolactinomas)\ Adrenal glands (pheochromocytomas) thyroid ( medullary thyroid carcinoma) ```

what are the organ relations to the right kidney

Adrenal gland- Superomedial Liver- superiolateral Right colic flexure- inferior 2nd part of duodenum- medial

what are the organ relations to the left kidney

Adrenal gland and spleen are superior Pancreatic tail is anterior to the upper pole left colic flexure is inferior

Results from failure of the kidneys to ascend into the abdomen

ectopic kidney (pelvic kidney)

Most common fusion anomaly in which the lower poles typically connect across the midline anterior to the aorta

Horseshoe kidney

Developing kidneys fuse in the pelvis and one kidney ascends to its normal position carrying the other one with it across the midline

Crossed fused renal ectopia

kidneys may fuse to form a round mass in the pelvis known as discoid or pancake kidney

Fuse pelvic kidney

common variant of cortical thickening on the lateral aspect of the left kidney

Dromedary hump

seen as a triangular hyperechoic area on the anterior aspect of the upper pole of the right kidney

Junctional parenchymal defect

Duplication of the collection system which occurs in approximately 15% of the population

Duplex kidney

Complete duplex kidney

two ureters | i

Incomplete duplex kidney

one ureter

Normal variation of prominent renal cortical parenchyma located between two medullary pyramids, may give the appearance of a mass effect

Column of Bertin (septal cortex)

associated with oligohydramnios and pulmonary hypoplasia, incompatible with life

Bilateral renal agenesis

associated with bicornuate uterus in females | and seminal vesicle agenesis in males

unilateral renal agenesis

lies outside the renal sinus sonographycally appearing as a cystic collection medial to the renal hilum

Extrarenal pelvis

Obstruction due to a flap of mucusa that has a slit like opening in the area of the prostatic urethra

Posterior urethral valves

calyceal diverticula that sonographically appear as a simple cyst

pylogenic cyst

cortical cysts that bulge into the central sinus of the kidney

Parapelvic cysts

lymphatic cysts in the central sinus

peripelvic cysts

cysts with multiple or thick septations thick calcifications, mural nodule; solid component suggest malignancy

atypical renal cysts

bilateral renal enlargement due to the development of numerous cysts of varying sizes, demonstrates in adults

Autosomal Dominant (adult) Polycystic Kidney disease

may be detected in utero with oligohydramnios | bilateral renal enlargement, multiple microscopic cysts, hyperechoic parenchyma, loss of cortical medullary distinction

Autosoma recessive (infantile) polycystic kidney disease

Multiple noncommunicating cysts with the absence of renal parenchyma, typically unilateral but may be bilateral

Multicystic dysplastic kidney

what urinary malformations are associated with MDK

contralateral ureteropelviec junction obstruction contralateral renal agenesis of hypoplasia crossed fused ectopia horseshoe kidney patent urachus ureterocele vesicoureteral reflux

what is congenital ureteropelvic junction (UPJ) obstruction caused by

ureteral hypoplasia high insertion of the ureter into renal pelvis compression by segmental artery

What is UPJ obstruction associated with

``` MDK renal agenesis (contralateral) Duplicated collection system Horseshoe kidney Ectopic kidney ```

inherited disease which usually presents in the second or third decade of life with serious visual impairment

Von Hippel lindau disease

name the related tumors that can be found with Von Hippel lindau syndrome

Renal cell carcinoma pheochromocytoma islet cell tumors Renal and pancreatic cysts

hyperechoic benign renal tumor. causes a propagation speed artifact 80% in rt kidney

Angiomyolipoma

a multi system genetic disease seizures, mental retardation and facial angiofibromas

Tuberous sclerosis

with tuberous sclerosis there is and increased incidence of

renal cysts and angiomyolipomas (typically bilateral)

Most common solid renal mass in the adult | typically unilateral

renal cell carcinoma

renal parenchyma may be the site of secondary tumors that have metastasized from other primary organs lung breast colon, etc

renal metastases

the most common childhood renal tumor | mean age diagnosis is 3-5 yrs

Wilms tumor (nephroblastoma)

how can you differentiate a wilms tumor from an adrenal neuroblastoma?

Wilm's tumor destroys the renal contour if the normal renal contour is maintained bilaterally, and abdominal mass is most likely an adrenal neuroblastoma

renal infection, most occur via ascending route from the bladder.

Acute pyelonephritis

a bacterial infection associated with renal ischemia

emphysematous pyelonephritis

renal injury induced by recurrent renal infection due to anatomic anomalies obstructive lesions ureteral reflux

chronic pyelonephritis

type of chronic pheonephritis resulting from chronic infections due to a long term obstruction

Xanthogranulomatous pyelonephritis (XGPN)

what are findings associated with XGPN

``` renal enlargement parenchymal abscesses Staghorn calculus papillary necrosis hydronephrosis pyonephrosis loss of cortical medullary boundry cortical thinning ```

Failure to depict a normal kidney associated with staghorn calculus suggests the diagnosis of

XGPN

Purulent material in the collection system of the kidney associated with an infection secondary to obstruction

Pyonephrosis

fungus ball | candidiasis is the most common renal fungus disease

Mycetoma

name the hyperechoic renal masses

``` mycetoma angiomyolipomas blood clots pyogenic debris sloughed papilla renal stones ```

abrupt decline in renal function

acute renal injury | formally acute renal failure

``` blood clot in renal vein associated with: extrinsic compression nephrotic syndrome renal tumors renal transplants trauma ```

renal vein thrombosis

a sudden cause of prerenal failure that presents as: acute flank pain hematuria sudden rise in blood pressure

renal artery thrombosis

the most common cause of acute kidney injury, medical renal disease/ intrinsic renal failure

acute tubular necrosis

inflammatory response resulting in glomerular damage caused by infectious and noninfectious causes

Acute glomerulonephritis (GN)

Ischemia of the medullary pyramids

Papillary Necrosis

increased renal sinus fat that replaces normal renal parenchyma

renal sinus lipomatosis

a herniation of the bladder mucusa through the bladder wall musculature

bladder diverticula

a cystic dilatation of the fetal urachus

urachal cyst

the most common bladder neoplasm

Transitional cell carcinoma

symptoms include sudden onset of hypertension uncontrollable hypertension decreased renal size

renal artery stenosis

abdomen 2 Flashcards

(91 cards)