LIVER 3

Question 1

3 hepatic liver diseases

Answer 1

fatty liver
cirrhosis
hepatic fibrosis

Question 2

Fatty Infiltration caused by and results from

Answer 2

Caused by chronic hepatic injury and results from an accumulation of abnormal triglycerides and lipids

Question 3

why has fatty infiltration become a concern

Answer 3

increasing childhood obesity rates

Question 4

is fatty infiltration permanent

Answer 4

can be reversible

Question 5

Diffuse Fatty Infiltration sono appearance

Answer 5

Large and echogenic liver with decreased vis of the hepatic veins

Question 6

focal fatty infiltration appearance

Answer 6

Distinct areas of increase echogenicity

does not change contour of liver but appearas like mass

Question 7

Cirrhosis cause

Answer 7

Parenchymal destruction, scarring, fibrosis and nodular regeneration

Question 8

Cirrhosis clinical presentation (3)

Answer 8

Hepatomegaly (in early stages)
Jaundice
Ascites

Question 9

cirrhosis lab tests

Answer 9

↗ AST, ALT, LDH

↗ Direct & indirect bilirubin

Question 10

cirrhosis signs on ultrasound

Answer 10

Small liver (late stage)
Surface nodularity
Coarse/heterogenous echo
Increased echo
Signs of ascites, splenomegaly, portal hypertension

Question 11

hepatic fibrosis is associated with

Answer 11

ARPKD

Question 12

what is hepatic fibrosis

Answer 12

Excessive connective tissue build up due to chronic injury

Question 13

clinical presentation of hepatic fibrosis (2)

Answer 13

Hepatomegaly

Portal hypertension

Question 14

sono features of hepatic fibrosis (2)

Answer 14

increased echogenicity of liver

-biliary dilatation

Question 15

4 hepatic vascular disorders

Answer 15

Portal Hypertension
Portal Vein Thrombosis
Budd-Chiari*
Hepatic Infarction

Question 16

what is portal hypertension

Answer 16

Increased resistance to normal portal flow

Question 17

clinical presentation of portal hypertension (5)

Answer 17

Splenomegaly
Ascites
Caput medusa
In severe cases:
Hematemesis
Hepatic encephalopathy

Question 18

3 types of obstruction leading to portal hypertension

Answer 18

Prehepatic (PV or spl. vein thrombosis)
Intrahepatic (cirrhosis)
Posthepatic (heart conditions)

Question 19

sono features of portal hypertension (5)

Answer 19

Hepatofugal portal flow
Varices
Splenomegaly
Ascities
Cirrhosis

Question 20

What two things can cause portal vein thrombosis

Answer 20

Can be caused by thrombosis due to dehydration, catheterization, shock or portal hypertension
or
tumor invasion from HCC or hepatoblastoma

Question 21

clinical presentations of portal vein thombosis

Answer 21

• Acute abdo pain

- splenomegaly

Question 22

sono features of portal vein thrombosis (6)

Answer 22

Enlarged, echogenic portal veins
Absent doppler
Vis tumor invasion
Cavernous transformation (in chronic PVT)
Acute PVT can mimic normal portal vein on grey scale ..why?
Collaterals

Question 23

Budd-Chiari syndrome is clinical features of

Answer 23

features of hepatic venous outflow obstruction

Question 24

causes of budd-chiari syndrome (3)

Answer 24

Idiopathic occlusion
Neoplastic invasion (Hepatoblastoma, HCC, Wilms tumor)
Thrombosis

Question 25

sono findings of Budd-Chiari syndrome (6)

Answer 25

Primary findings Hepatomegaly Echogenic clot in HVs Absence of flow in HVs Secondary findings Ascites Pleural effusion GB wall edema

Question 26

Hepatic Infarction due to

Answer 26

hepatic blood supply, rare tho becuase of dual supply | can occur with hepatic artery occlusion

Question 27

sono features of hepatic infarction

Answer 27

Wedge-shaped, round or oval area of decreased echogenicity Good margins Changes from hypo to hyper to calcification over time

Question 28

most commonly injured abdominal organ in blunt abdominal trauma in children

Answer 28

liver lol

Question 29

hepatic cysts associated with

Answer 29

multicystic kidney disease and Von Hippel Lindau disease | Can be acquired via trauma

Question 30

Hydatid echinococcal cysts

Answer 30

Parasitic (tapeworm) | Echinococcus

Question 31

Hydatid echinococcal cysts caused from

Answer 31

Exposure to livestock, farming, dogs | Parasite reaches liver from intestines through PV

Question 32

Hydatid echinococcal cysts sono appearance

Answer 32

``` Simple cyst Complex cyst (daughter cysts, septa, debris, floating membranes) ```

Question 33

Hydatid echinococcal cysts clinical signs (5)

Answer 33

``` Urticaria RUQ pain Hepatomegaly Lungs, brain, kidneys can be affected Rupture of cyst to peritoneum – anaphylactic shock ```