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Abdo Pathology > Lesson 1.2 - Infectious Disease & Metabolic Disorders > Flashcards

Lesson 1.2 - Infectious Disease & Metabolic Disorders Flashcards

1
Q

Viral hepatitis may lead to (3)

A

Portal hypertension
Cirrhosis
HCC

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2
Q

Symptoms (7) and sign (1) of viral hepatitis

A 
Symp:
Fatigue
Headache
Anorexia
Fever 
Abdo pain
Nausea
Vomiting

Sign:
Jaundice

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3
Q

Recovery time implied for acute hepatitis

A

4 months

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4
Q

Acute hepatitis sono appearance

A

Liver parenchyma hypoechoic

Bright periportal walls

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5
Q

Starry night sign is characterized by

A

acute hepatitis

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6
Q

Chromic hepatitis is characterized by biochemical abnormalities that persist beyond __ months

A

6 months

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7
Q

Chronic hepatitis sono appearance

A

Hepatomegaly

Thickening of GB wall

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8
Q

T/F

Liver can appear normal in some cases of chronic hepatitis

A

true

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9
Q

Disorders of metabolism (4)

A
  1. Steatosis “Fatty liver”
  2. Glycogen storage disease-neonatal
  3. Cirrhosis
  4. NASH (non-alcoholic steatohepatitis)
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10
Q

T/F fatty liver is reversible

A

True

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11
Q

Causes of fatty liver/steatosis

A 
Severe hepatitis*
Hyperlipidemia*
Excessive alcohol*
Hyperalimentation
Excess corticosteroids
Diabetes
Obesity bypass surgery
Toxins
Pregnancy
Cystic fibrosis
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12
Q

T/F steatosis may lead to HCC in some pts

A

true

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13
Q

Mild steatosis characterized by

A

minimal diffuse increase in echogenecity

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14
Q

Moderate steatosis characterized by

A

moderate diffuse increase in echogenecity

slightly impaired visualization of intrahepatic vessels and diaphragm

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15
Q

Severe steatosis characterized by (4)

A

Marked increase in echogenicity
Poor penetration posterior liver
Poor/no visual hepatic vessels/diaphragm
Hepatomegaly

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16
Q

What is focal infiltration

A

Appearance of steatosis- regions of increased echogenicity within a background of normal liver - can mimic a mass

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17
Q

What is fatty sparing

A

Appearance of steatosis- Islands of normal liver parenchyma appear as hypoechoic masses within a dense fatty infiltrated liver - “no mass effect”

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18
Q

Focal fat characterized by

A

hyperechoic
No mass effect
May appear rounded, nodular or interspersed with normal tissue

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19
Q

Sono features of steatosis

A

Rapid change in time in both appearance and resolution (6 days)
No Mass Effect
No liver contour abnormality

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20
Q

What is the preferred site for focal fat

A

anterior to PV at porta hepatis

21
Q

What is the preferred site for focal fatty sparing or infiltration

A

anterior to PV at porta hepatis, GB fossa and liver margins

22
Q

When does glycogen storage disease occur?

A

In neonatal period where large amts of glycogen are deposited in liver and kidneys

23
Q

Do patients with glycogen storage disease live?

A

They survive to childhood or young adulthood with enzyme therapy

24
Q

What is glycogen storage disease indistinguishable from?

A

Its indistinguishable from diffuse fatty infiltration

25
Q

Cirrhosis sono appearance

A

Fibrosis
Nodular
Coarse hard texture
Increased echogenicity

26
Q

What three major pathological mechanisms combine to create cirrhosis

A

cell death
fibrosis
regeneration

27
Q

What is the most common cause of micronodular form cirrhosis. Whats the measurement?

A

alcohol consumption

<1 cm

28
Q

What is the most frequent cause of macronodular form cirrhosis. Whats the measurement?

A

chronic viral hepatitis

1-5 cm

29
Q

What is cirrhosis indistinguisable from?

A

Indistinguishable from end-stage liver disease

30
Q

Clinical presentation of cirrhosis (3)

A

Hepatomegaly
Jaundice
Ascites

31
Q

Causes of cirrhosis (4)

A

biliary cirrhosis
wilsons disease
primary sclerosing cholangitis
hemochromatosis

32
Q

What is the most common cause of portal hypertension?

A

Cirrhosis

33
Q

Other causes of portal hypertension

A

Ascites
Splenomegaly
Varices

34
Q

Early vs advanced stage of cirrhosis and liver size

A

early - liver may be enlarged

advanced - liver is small-shrinking, ascites

35
Q

Dysplastic nodule sono pattern

A

Adenomatous hyperplastic nodules

Larger than 10 mm (premalignant)

36
Q

What may be indicated if dysplastic nodules found

A

biopsy to rule out HCC

37
Q

What is NASH

A

Nonalcoholic steatohepatitis

38
Q

What does NASH resemble

A

alcoholic liver disease but occurs in those who drink little/no alcohol

39
Q

Major feature in NASH

A

fat in the liver
inflammation
damage

40
Q

T/F

NASH can lead to cirrhosis

A

True

41
Q

Signs and symptoms of NASH (3)

A

fatigue
weight loss
weakness

42
Q

T/F NASH causes decreased LFTs

A

False. NASH causes increased LFTs

43
Q

NASH sono appearance

A

Dense fatty infiltration Cirrhosis

44
Q

Acute liver failure

A

Rapid development of hepatocellular dysfunction
Coagulopathy
Encephalopathy
in pt without known prior liver disease

45
Q

T/F

chronic liver failure usually occurs in the context of cirrhosis

A

true

46
Q

Causes of chronic liver failure (4)

A

Excessive alcohol
Hep B or C
Non-alcoholic fatty liver disease

47
Q

T/F

Portal hypertension causes ascites

A

FALSE

Ascites usually occurs secondary to liver cell failure

48
Q

Death occurs if loss of hepatic parenchyma by necrosis is >___%

A

> 40%

49
Q

“Hepatic coma”

A

hepatic encephalopathy

Abdo Pathology (24 decks)

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