Lesson 1B (Part 2) Flashcards Preview

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Flashcards in Lesson 1B (Part 2) Deck (29)
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1

What are the 3 characterizations of steatosis?

1. Mild
2. Moderate
3. Severe

2

Mild steatosis

Minimal diffuse increase in hepatic echogenicity

3

Moderate steatosis (2)

1. Moderate diffuse increase in hepatic echogenicity
2. Slightly impaired visualization of intrahepatic vessels and diaphragm

4

Severe steatosis (4)

1. Marked increase in echogenicity
2. Poor penetration of posterior liver
3. Poor or no visualization of hepatic vessels and diaphragm
4. Hepatomegaly often present

5

What are some sonographic appearances of fatty liver? (3)

1. Focal Fatty Infilitration
2. Fatty Sparing
3. Focal Fat

6

Focal fallt infiltration

Regions of increased echogenicity are present within a background of normal liver
- can mimic a MASS

7

Fatty sparing

Islands of normal liver parenchyma appear as hypoechoic masses within a dense fatty infiltrated liver “no mass effect”
- most of the liver is fat with little bits of normal liver

8

What are the sonographic features of steatosis? (4)

1. Rapid change in time in both appearance and resolution
- 6 days
2. NO Mass Effect
3. No liver contour abnormality
4. Focal fat may appear rounded, nodular, or interspersed with normal tissue

9

What is the preferred site for focal fat in steatosis?

Anterior to the portal vein at the porta hepatis

10

Where is the preferred site for focal fatty sparing or infiltration?

Anterior to the portal vein at the porta hepatis, gallbladder fossa, and liver margins

11

When does glycogen storage disease occur?

During neonatal period
- large amounts of glycogen are deposited in the liver and kidneys

12

How do glycogen storage diseases appear?

Indistinguishable from diffuse fatty infiltration
- need to remember different age group

13

Cirrhosis

Diffuse process characterized by fibrosis and the conversion of normal liver architecture into structurally abnormal nodules
- coarse texture

14

What are 3 major pathological mechanisms that combine to create cirrhosis?

1. Cell death
2. Fibrosis
3. Regeneration

15

What is the most common cause of micronodular form?

Alcohol consumption

16

What is the most frequent cause of macronodular?

Chronic viral hepatitis

17

Is cirrhosis usually acute or chronic?

Chronic

18

What is the most common cause of portal hypertension?

Cirrhosis

19

What are 3 clinical presentations of cirrhosis?

1. Hepatomegaly
2. Jaundice
3. Ascites

20

What are 4 other causes of cirrhosis?

1. Biliary cirrhosis
2. Wilsons disease
3. Primary sclerosing cholangitis
4. Hemochromatosis

21

What is the sonographic appearance of cirrhosis? (5)

1. Volume redistribution
- enlarged/irregular contour (early)
- small (advanced)
2. Coarse echotexture
3. Nodular surface
- ascites
4. Nodules (colour doppler)
- regenerative and dysplastic
5. Portal hypertension
- ascites, splenomegaly and varices

22

NASH

Nonalcoholic steatohepatitis

23

What is nonalcoholic steatohepatitis commonly known as?

Silent liver disease
- resembles alcoholic liver disease, but occurs in people who drink little or no alcohol

24

What is the major feature of NASH? (3)

1. Fat in the liver
2. Inflammation
3. Damage

25

What can NASH lead to?

Cirrhosis

26

What is NASH related to?

Obesity
- can lead to diabetes and high blood cholesterol, which can further complicate the health of someone with NASH

27

What are signs and symptoms of NASH? (4)

1. Fatigue
2. Weight loss
3. Weakness
- may begin once the disease is advanced or cirrhosis is present
4. Increased LFTs

28

What is the treatment for NASH? (2)

1. Reduce weight
- eat a balanced diet
- engage in physical activity
- avoid alcohol and unnecessary medications
2. Liver transplant may be necessary if cirrhosis ensues

29

What is the sonographic appearance of NASH? (2)

1. Dense fatty infiltration
2. Cirrhosis