Lesson 1A (Part 3) Flashcards
Bilirubin
A product from the breakdown of hemoglobin in old red blood cells
What can cause abnormal levels of bilirubin?
A disruption in the process
What causes the skin to look yellow?
A leakage of bilirubin into the tissues
What does bilirubin reflect the balance between? (2)
- Production of bile
2. Excretion of bile
What are elevated levels of direct or conjugated bilirubin associated with? (4)
- Obstruction
- Hepatitis
- Cirrhosis
- Liver metastases
What are decreased levels of indirect of unconjugated bilirubin associated with?
Non-obstructive conditions
- eg. steatosis
What are indications for an US of the liver? (5)
- Abnormal LFT’s
- Hepatocellular disease
- Biliary disease
- Abdominal /postprandial pain
- Palpable liver or spleen
pancreatitis
What are 2 types of congenital abnormalities for development in the liver?
- Agenesis
2. Partial agenesis
Agenesis
No liver
- cant liver without it (but can live with a partial liver)
Partial agenesis
Part of the liver
- typically have a larger right lobe if you don’t have a left lobe (one lobe compensatory)
What are 2 types of congenital abnormalities for position in the liver?
- Situs inversus totalis
2. Congenital (fetal US) diaphragmatic hernia or omphalocele
Situs inversus totalis
Liver is found in the left hypochondrium
- opposite side
Congenital (fetal US) diaphragmatic hernia or omphalocele
Liver may herniate into the thorax or outside the abdominal cavity
- break through the diaphragm
What is a common appearance for granulomas?
Calcifications in parenchyma
What is granulomas related to? (2)
- Scarring
2. Infection
What is the common appearance for hamaromas? (4)
- Small
- Focal
- Solid
- Hypoechoic
What is the common appearance for cysts? (3)
- Fluid filled
- Epithelial lining
- Posterior acoustic enhancement
What are cysts related to?
Abnormal LFTs
- tumours
- infection
- biliary obstruction
What is the common appearance for abscess forming from cysts? (4)
- Internal echoes
- Septations
- Thick walls
- Solid
What is the common appearance for cavernous hemangioma? (4)
- Homogenous
- Hyperechoic
- Tiny blood vessels but avascular on doppler
- Well circumscribed
What is the most common benign tumour?
Cavernous hemangioma
What is the common appearance for focal nodular hyperplasia? (5)
- Central scar
- vascular malformation - Isoechoic
- Well circumscribed
- Contour abnormality to liver
- Hypervascular/stellate pattern
- spoke wheel appearance
What is the second most common benign tumour?
Focal nodular hyperplasia
- FNH
What is FNH related to? (3)
- Hormones
- Oral contraceptives
- Child bearing years
