Flashcards in Lesson 1D (Part 1) Deck (29)
Loading flashcards...
1
What are the most common routes for pyogenic bacteria? (4)
1. Through the biliary tract in patients with suppurative (pus) cholangitis or cholecystitis
2. Goes through the portal venous system
- diverticulitis and appendicitis
3. Goes through the hepatic artery
- osteomyelitis and bacterial endocarditis
4. Occurs as a result of blunt or penetrating trauma to the liver
2
Cholangitis
Inflammation of the bile duct
3
Cholecystitis
Inflammation of the GB
4
Diverticulitis
Inflammation of the diverticulum
- impairing bowel function
5
Appendicitis
Inflammation of the appendix
6
Osteomyelitis
Inflammation of bone/bone marrow
7
Bacterial endocarditis
Inflammation of the endocardium
8
Hepatic abscess
Is a mass filled with pus inside the liver
9
Pyogenic bacteria
Things coming from the bowel and are going into the portal system
- bacteria passing through blood
10
What is hepatic abscesses mainly caused by?
Aanaeurobic (bacterial) infection
11
What are symptoms of pyogenic liver abscess? (6)
1. Fever
2. Malaise
3. Anorexia
4. RUQ pain
5. Jaundice
6. Leukocytosis
12
Is sonography helpful with detection of hepatic absesses?
Yes
13
What are some sonographic signs of liver abscesses? (5)
1. Frankly purulent
- cystic with fluid ranging from echo free to highly echogenic
2. Early supperation
- solid with altered echogenicity, usually hypoechoic due to necrotic hepatocytes
3. Gas producing organisms give rise to echogenic foci with posterior reverberation artifacts ***
4. Fluid/fluid interfaces, internal septations and debris
5. Walls can be thick, irregular or well defined
14
Fluid/filled
Clear fluid on the top and sludgy fluid on the bottom
15
What confirms diagnosis for liver abscesses? (2)
1. Presence of pus
2. Positive gram stain and culture
16
What kind of patients get fungal disease? (3)
1. Immunosuppressed ***
2. Females after pregnancy
3. People after hyperalimentation
17
What is an example of a fungal disease?
Candidiasis
18
How does candidiasis present?
With a persistent fever in a neutropenic patient (low white blood cell count) whose leukocyte count is returning to normal
19
Neoplasm
Any unidentified mass
20
What is the difference between a liver abscess and a hematoma?
A liver abscess needs to be drain, where as a hematoma can resolve on its own
21
What are 9 examples of patients that are immunosuppressed?
1. Transplant pre and post
2. Cancer
3. Chemotherapy/radiation therapy
4. AIDS/HIV
5. Inherited disease
- blood disorders
6. Underlying systemic infection
7. Poor nutrition
8. Shift workers
9. Pregnant
22
What are some sonographic features of candidiasis?
1. Wheel within a wheel
2. Central nidus
3. Hyperechoic foci
4. Bull's eye
5. Uniformly hypoechoic
6. Echogenic
23
Wheel within a wheel
Peripheral hypoechoic zone with an inner echogenic wheel and a central hypoechoic nidus
24
Central nidus
Focal necrosis where fungal elements are found
25
Hyperechoic foci
Multiple small abscesses with air
26
Bull's eye
Hyperechoic center with a hypoechoic rim
- echogenic center contains inflammatory cells
27
Uniformly hypoechoic
Due to progressive fibrosis
28
Echogenic feature of candidiasis
Variable calcification
- scarring
29
