Flashcards in Lesson 1A (Part 3) Deck (29)
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1
Bilirubin
A product from the breakdown of hemoglobin in old red blood cells
2
What can cause abnormal levels of bilirubin?
A disruption in the process
3
What causes the skin to look yellow?
A leakage of bilirubin into the tissues
4
What does bilirubin reflect the balance between? (2)
1. Production of bile
2. Excretion of bile
5
What are elevated levels of direct or conjugated bilirubin associated with? (4)
1. Obstruction
2. Hepatitis
3. Cirrhosis
4. Liver metastases
6
What are decreased levels of indirect of unconjugated bilirubin associated with?
Non-obstructive conditions
- eg. steatosis
7
What are indications for an US of the liver? (5)
1. Abnormal LFT’s
2. Hepatocellular disease
3. Biliary disease
4. Abdominal /postprandial pain
5. Palpable liver or spleen
pancreatitis
8
What are 2 types of congenital abnormalities for development in the liver?
1. Agenesis
2. Partial agenesis
9
Agenesis
No liver
- cant liver without it (but can live with a partial liver)
10
Partial agenesis
Part of the liver
- typically have a larger right lobe if you don't have a left lobe (one lobe compensatory)
11
What are 2 types of congenital abnormalities for position in the liver?
1. Situs inversus totalis
2. Congenital (fetal US) diaphragmatic hernia or omphalocele
12
Situs inversus totalis
Liver is found in the left hypochondrium
- opposite side
13
Congenital (fetal US) diaphragmatic hernia or omphalocele
Liver may herniate into the thorax or outside the abdominal cavity
- break through the diaphragm
14
What is a common appearance for granulomas?
Calcifications in parenchyma
15
What is granulomas related to? (2)
1. Scarring
2. Infection
16
What is the common appearance for hamaromas? (4)
1. Small
2. Focal
3. Solid
4. Hypoechoic
17
What is the common appearance for cysts? (3)
1. Fluid filled
2. Epithelial lining
3. Posterior acoustic enhancement
18
What are cysts related to?
Abnormal LFTs
- tumours
- infection
- biliary obstruction
19
What is the common appearance for abscess forming from cysts? (4)
1. Internal echoes
2. Septations
3. Thick walls
4. Solid
20
What is the common appearance for cavernous hemangioma? (4)
1. Homogenous
2. Hyperechoic
3. Tiny blood vessels but avascular on doppler
4. Well circumscribed
21
What is the most common benign tumour?
Cavernous hemangioma
22
What is the common appearance for focal nodular hyperplasia? (5)
1. Central scar
- vascular malformation
2. Isoechoic
3. Well circumscribed
4. Contour abnormality to liver
5. Hypervascular/stellate pattern
- spoke wheel appearance
23
What is the second most common benign tumour?
Focal nodular hyperplasia
- FNH
24
What is FNH related to? (3)
1. Hormones
2. Oral contraceptives
3. Child bearing years
25
What is the common appearance for hepatic adenomas? (5)
1. Hyper vascular
- periphery
2. Heterogenous
- presence of fat, glycogen hemorrhagic products
3. Multiple feeding arteries
4. Shows central hepatic artery
5. Capsule in 1/3 of cases**
26
What is a symptom of hepatic adenomas (2)
1. Pain
- RUQ
2. Palpable mass if large enough
27
What are hepatic adenomas related to?
Hormones
28
What is the common appearance for fatty tumours? (2)
1. Broken diaphragm
2. Echogenic mass
- well defined
29
