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Flashcards in GB Abnormal Deck (138)
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1

What is the term for calcification of the GB wall?

porcelain GB

2

What is the cause of porcelain GB?

it is unknown

3

Porcelain GB occurs in association with _____ and may represent some form of _____.

gallstone disease
chronic cholecystitis

4

What determines the sonographic appearance of porcelain GB?

the degree and pattern of calcification

5

When the entire GB wall is thickly calcified, a _____ _____ line with dense posterior _____ _____ is noted.

hyperechoic semilunar
acoustic shadowing

6

Mild calcification of the GB wall appears as a(n) _____ line with variable degrees of _____.

echogenic
posterior acoustic shadowing

7

With calcification of the GB wall, the luminal contents may be _____ (visible/not visible), interrupted clumps of _____ appear as _____ foci with posterior shadowing.

visible
calcium
echogenic

8

Why is the WES sign absent with a porcelain GB?

Because the GB wall is calcified

9

What is another term for adenomyomatosis?

Rokitansky-Aschoff Sinuses

10

Adenomyomatosis can be either focal or _____. Is it benign or malignant?

diffuse
benign

11

What happens to the GB physiologically to cause adenomyomatosis?

The diverticula in the GB wall become clogged with stones or sludge

12

What is the most common U/S appearance of adenomyomatosis?

tiny echogenic foci in the GB wall that create comet-tail artifacts

13

What is the most common appearance of adenomymatosis with doppler U/S?

echogenic foci with ringdown or twinkling artifact

14

What is another term for ringdown artifact?

twinkling artifact

15

The comet-tail artifact with ringdown or twinkling from adenomyomatosis is located where in the GB?

in the Rokitansky-Aschoff sinuses

16

If you don't see twinkling artifact within the comet-tail artifact in the GB, what should be done?

Further study to rule out neoplasm.

17

Does not move, does not shadow =

polyps

18

Why is it important to distinguish between benign and malignant polyps?

Because benign are very common and malignant require early intervention to improve outcome.

19

What are the two most frequently used criteria to identify a polyp as benign?

multiplicity
size below 10mm

20

Malignancy of polyps has been documented in 37-88% of resected polyps that were

larger than 10mm

21

Other malignancy risk factors for a person with polyps are (6)

1) older than 60
2) single lesion
3) gallstone disease
4) rapid change in size
5) sessile morphology
6) doppler velocity of more than 20cm/sec and resistive index of less than 0.65

22

Approximately half of all polyps are _____ polyps.

cholesterol

23

This kind of polyp represents the focal form of GB cholesterolosis.

cholesterol polyp

24

Cholesterolosis results in the accumulation of _____ (such as _____ and _____) in the GB wall. It is a common _____ condition of the GB.

lipids
triglycerides
cholesterol
non-neoplastic

25

T or F? Polyps DO NOT roll and DO NOT produce posterior shadowing.

True

26

The diffuse form of cholesterolosis is called

strawberry GB

27

Where does strawberry GB get its name?

golden yellow lipid deposits agains the red GB mucosa

28

Cholesterolosis is usually asymptomatic but if there are symptoms, it is usually in the form of

colicky abdominal pain

29

Although cholesterolosis and adenomyomatosis appear similar, the main difference is that cholesterolosis doesn't have

comet tail reverberation artifact (ring down or twinkling)

30

The 2 most common lesions that cause biliary obstruction are

gallstones
carcinoma of the pancreas head