Lesson 1C (Part 2) Flashcards Preview

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

Where do you commonly see bull eyes or target patterns?

With lung cancer

2

What is the sonographic appearance of a bull eyes or target pattern?

Hypoechoic peripheral halo
- hyperechoic centre

3

What are calcified metastases marked by? (2)

1. Echogenicity
2. Distal acoustic shadowing

4

What is shadowing in the liver caused by? (4)

1. Calcifications
- clean shadow
2. Air
- dirty shadow
3. Stones
4. Fat containing lesions

5

What are the most common causes of a calcified liver tumour?

Metastases

6

What are 3 examples of cystic mets?

1. Necrosis
- sarcomas
2. Cystadenocarcinoma of ovary & pancreas
3. Mucinous carcinoma of colon

7

What is the sonographic appearance of cystic metastases? (5)

1. Mural nodules
2. Thick walls
3. Fluid-fluid levels
4. Internal septations
5. Extensive necrosis

8

Where are infiltrative mets seen?

1. Breast
2. Lung
3. Malignant melanoma

9

What is the sonographic appearance of infiltrative metastatic disease? (2)

1. Diffuse disorganization of parenchyma
- may be confused with cirrhosis or fatty liver
2. Chemotherapy may make liver fatty

10

Kaposi sarcomas

Arise from connective tissue but can spread to liver
- rare

11

CEUS

Contrast enhancement ultrasound

12

What is the major role for contrast enhancement ultrasound? (2)

1. Diagnosis
2. Detection of mets

13

What does CEUS involve?

The use of microbubble contrast agents and specialized imaging techniques
- tiny bubbles in an injectable gas

14

What are benefits to CEUS? (6)

1. Shows sensitive blood flow and tissue perfusion
2. Are not nephrotoxic
3. No ionizing radiation
4. Similar results as CT and MRI
5. Determines vascularity in metastases
6. Biopsy establishes the primary tissue site

15

What is a normal variant for hepatomegaly?

Reidels lobe

16

What are 9 causes of hepatomegaly?

1. Liver Trauma ***
- alcohol abuse
2. Passive liver congestion
3. Fatty liver
4. Viral infections
- Hepatitis A, B and C
5. Mononucleosis
6. Hemochromatosis
7. Primary liver cancer
8. Leukemia
9. Lymphoma

17

Hepatomegaly

Enlargement of the liver
- can feel the liver edge below the rib cage

18

What is the normal range of the right lobe?

13-17cm

19

Where is Reidels lobe more common?

In women

20

Reidels lobe

Tongue shaped process of the liver
- gets mistaken for an enlarged liver

21

What are symptoms of hepatomegaly? (4)

1. Abdominal pain
2. Swelling
3. Feeling of fullness
4. Jaundice

22

What are diagnostic tests that can be taken for hepatomegaly? (5)

1. Ultrasound
2. X-ray
3. CT scan
4. Liver function blood tests
5. Biopsy

23

What can hepatic trauma cause?

Enlargement

24

What is the sonographic appearance of fresh hemorrhage?

Echogenic
- after 1 week its hypoechoic

25

What is passive liver congestion caused by?

Stasis of the blood within the liver parenchyma

26

What are some negative side effects of passive liver congestion? (2)

1. Hepatic venous drainage is compromised
2. Common complication of congestive heart failure

27

Why does the liver get enlarged with passive liver congestion?

Sinusoids dilate to accommodate back flow of the blood

28

Portal venous gas

Accumulation of gas in the peripheral portal venous system

29

What is portal venous gas caused by?

1. Ischemic, necrotic, ulcerated bowel
2. Colorectal carcinoma
3. Inflammatory bowel disease
4. Perforated peptic ulcer

- GI issues