Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Abdomen > Liver Disease > Flashcards

Liver Disease Flashcards

(91 cards)

Start Studying
0
Q

What is fatty infiltration?

A

Acquired, reversible disorder of metabolism. An accumulation of triglycerides within hepatocytes. No harmful effect on liver function.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What is hepatocellular disease?

A

Defined as a disease process that affects the hepatocytes and interferes with liver function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Causes of fatty liver

A
  1. Obesity
  2. Alcoholism
  3. Diabetes mellitus- hyperglycemia
  4. Pregnancy- rapid weight gain
  5. Severe hepatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Diffuse fatty infiltration

A

Will cause increased liver echogenicity and increased attenuation of the ultrasound beam.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Focal fatty infiltration

A

May mimic neoplastic involvement. Regions of increased echogenicity are present within background of normal liver parenchyma. Will have a lack of mass effect. Fatty infiltration may resolve as early as within 6 days. The extent of fatty infiltration is variable but commonly seen at the ports hepatis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Focal fatty sparing

A

Entire liver is fatty except one spot of normal tissue. Small focal areas of normal liver surrounded by fatty tissue. Appear as hypoechoic masses within a dense fatty infiltrated liver. Commonly seen adjacent to gb fossa.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cavernous malformation

A

Multiple serpinginous channels at the porta hepatis as a result of recanalization of the thrombosed vein. Usually happens with portal vein thrombosis. Hepatic artery tries to work harder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Clinical presentation of cavernous malformation

A

Abdominal pain, hematemesis (blood in stomach acids), encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the sonographic appearance of cavernous malformation?

A

Non visualization of portal vein.

Multiple serpinginous channels within a distorted porta hepatis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Budd Chiari Syndrome?

A

It is an obstruction of the hepatic venous outflow tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Budd Chiari Syndrome etiology?

A

Intrinsic thrombus of hepatic vein
Rumors, Extrinsic compression by HCC or RCC
IVC thrombus
Membrane or Webb is present in the IVC or atrium
Hematologist disorders such as polycythemia rubes Vera, and coagulopathies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Signs and symptoms of Budd Chiari Syndrome

A 
Abdominal pain
Jaundice associated with hepatocellular disease
Ascites 
Hepatomegaly 
Splenomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the sonographic features of Budd Chiari?

A

Depending on degree from of obstruction
Enlarged hepatic veins (prox to obstruction)
Non visualization of hepatic veins dist to obstruction
Abnormal flow pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What may cause a cyst?

A

They may be congenital, traumatic, parasitic or inflammatory in origin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Single or Policystic disease of the liver

A

A gradual dilation of interlobar bile duct

Commonly associated with polycystic disease of the kidneys, spleen, ovaries and lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Characteristics of simple cysts

A 
Anechoic 
Thin walled 
Round well-defined borders
Posterior acoustic enhancement 
Smooth margin
No internal echoes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If only one organ is affected with multiple cysts what is it called?

A

Multicystic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

If multiple organs are involved with multiple cysts what is it called?

A

Polycystic

*1:1000 incidence. Affects females more than males 4:1 ratio. Usually through 5th and 6th decade of life.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a hematoma

A

Localized collection of blood caused by trauma to the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Ultrasound appearance of hematoma

A

Day 1-2: blood is an school or hypoechoic
Day 3-5: more echoes due to clotting
Day 6: hypoechoic to anechoic due to resolving clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the names of cystic structures found in or around liver?

A

Perivascular: near or around vessels
Subcapsular: between glissons capsule and liver
Perihepatic : outside or surrounding the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Clinical manifestation of hematoma

A 
RUQ pain
Hepatomegaly 
And distention
Decreased hematocrit
Increased leukocytes 
Hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is another name for Hydatid Cyst?

A

Echinococcal Cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Etiology of Echinococcus

A

Tapeworm larvae ingestion from contaminated vegetables.
Human becomes intermediate host
The eggs invade the intestinal wall and travel through the portal system where they develop into cystic mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
What are the clinical signs of Hydatid cyst?
RUQ pain Nausea Vomiting Positive serological testing
25
Sonographic appearance of Hydatid cyst?
1 stage: simple cyst Later stages: May develop a daughter cyst (cyst within a cyst) Cysts with thick septa between the fluid collections Has a "honeycomb" appearance
26
Calcified cysts
When Hydatid cyst is healing. Surgery removal may be necessary
27
What is the water lily sign?
When echinococcal cyst germinal layer has either collapsed or become detached
28
What is an amoebic cyst caused by?
The amoeba named entamoeba hystolytica
29
What is the route of transmission of entamoeba hystolytica?
Fecal/oral route Contaminated water Lives in GI tract Travels through portal system
30
Clinical signs and symptoms of amoebic cyst
``` Abdominal pain Dysentery (blood and mucus in diarrhea) Vomiting Fever/chills Black stools ```
31
Lab values of amoebic cyst?
Increased wbc and lft
32
What is the ultrasound appearance of an amoebic cyst?
Variable appearance Largest cyst of liver Internal echoes May look like abscess- complex cyst (amoebic abcess)
33
What is schistosomiasis?
Parasitic infection acquired from contaminated water where worms can penetrate the skin or enter GI tract and travel through portal system into liver and causing periportal fibrosis
34
Clinical signs and symptoms of schistosomiasis
Portal hypertension | Cirrhosis is possible
35
What is the ultrasound appearance of schistosomiasis?
Increased echogenicity of periportal region | PV dilation and thickened portal walls
36
What causes an abscess in the liver?
Bacterial infection, | Commonly from biliary infection
37
What is the ultrasound appearance of an abscess?
``` Thick walls Round or oval shaped Irregular, poorly defined borders Multiple septations Internal echoes Size is variable 80% located in Rt lobe Comet tail artifact from micro bubbles ```
38
What is cavernous hemangioma?
Most common benign tumor of the liver Not a true neoplasm but more of a vascular abnormality Arterio-venous malformation Lined with endothelial tissue filled with wbc More common in women Typically < 5cm
39
What are the complications of cavernous hemangioma?
Enlargement can occur during pregnancy and hormone therapy
40
Clinical signs and symptoms of cavernous hemangioma
Usually asymptomatic | Large hemangioma can cause abdominal distention and pain
41
What are the lab values of cavernous hemangioma?
Normal
42
What is the ultrasound appearance of cavernous hemangioma?
``` Hyperechoic Round Homogenous Well circumscribed mass Usually in art lobe May be multiple As the mass degenerates the center will become anechoic Post enhancement seen within >2.5 cm Extremely low flow, may or may not be visualized w Doppler ```
43
What is focal modular hyperplasia (FNH)?
Second most common benign tumor Excess growth and accumulation of liver lobule components Occurring most commonly in women of reproductive age Linked to birth control Usually <8cm
44
What is the ultrasound appearance of FNH?
``` Variable Typically <5 cm Hypo-hyperechoic Even isle choice to the liver Frequently identified by mass effect Non capsulated ```
45
What is liver cell adenoma (LCA)?
A true encapsulated neoplasm consisting of atypical cells Less common than FNH more common in women and associated with birth control Women/men ratio incidence 4:1 Variable sonographic appearance
46
What are the clinical signs and symptoms of LCA?
Palpable abdominal mass RUQ pain Abdominal pressure Normal labs
47
What is the most common primary liver malignancy?
Hepatocellular carcinoma HCC - adult | Hepatoblastoma, germ cell tumor - pediatric under 3 yrs of age
48
Etiology of HCC
``` Alcohol abuse Hep B & C Toxins - hepatocarcinoges in food Metabolic disorders More common in men ```
49
Clinical signs and symptoms of HCC
RUQ pain Palpable mass, rapid liver enlargement Fever of unknown origin Rapid weight loss
50
Sonographic appearance of HCC
Single or multiple tumor Variable in echogenicity, usually hypoechoic w irregular borders Hyper vascular A distinct tendency to destroy the portal venous wall with invasion into the vessel lumen Hepatoma gay if mass is large
51
Related findings of HCC
Ascites in advanced stages Portal HTN jaundice Splenomegaly
52
What are the lab values of HCC?
Increased AFP | Most accurate 70%
53
Complications of HCC
Hepatomegaly Invasion of hepatic vein producing Budd Chiari syndrome Thrombosis or tumor invasion of portal system occurs in 68% of HCC
54
What is Metastatic disease in liver?
Cancer that spreads to liver causing ,ultisols tumor invasion Can be from lungs, breast, colon, panc
55
Ultrasound appearance of METS
Non specific. Depends on primary target lesions Mets from lung or breast cancer- echogenic w hyperechoic rim Mets from lymphoma- multiple hypoechoic lesions Mets from GI tract- echogenic lesions Mets from mucinous or serous cyst or adenocarcinoma of the ovary- cystic
56
What is Bouveret's syndrome?
Gastric outlet obstruction caused duodenal impaction of large gallstone that has migrated
57
What is double barrel shot gut sign?
Dilated bile ducts are caused by obstructed gall stones. | It can also result from neoplasm
58
What is another name for double barrel shot gun sign?
Parallel channel sign
59
Sizes do dilated ducts
Extrahepatic >5 mm | Intrahepatic >2 mm
60
Complications of gall stones
``` Cholecystitis Cholangitis Jaundice Gangrene Ulcer Perforation Fistula Pancreatitis Peritonitis Paralytic ileus (obstruction of small intestine) Sepsis ```
61
Bouveret's Syndrome
Gastric outlet obstruction caused by duodenal impaction of a large gallstone that has migrated through a cholecystoduodenal fistula
62
What kind of treatments for gall stones are there?
ESWL Laproscopic cholecystectomy Sphincterotomy and extraction of stones Oral dilution therapy
63
What is ESWL?
Stands for extracorporal shock-wave lithotripsy | The shock wave shatters the small stones into smaller pieces. Limited success
64
What is porcelain GB?
Porcelain GB is complete or patchy calcification of the GB wall. Rare. More common in female 5:1
65
What is the sonographic appearance of porcelain GB?
Biconvex, curvilinear, hyperechoic structure with variable acoustic shadowing May simulate stone-filled GB devoid of bile, but lacks WES sign Low level echoes with the GB wall are not identifiable due to calcification infiltration
66
What is courvoisier gallbladder?
``` An enlarged, hydropic gallbladder Painless distention of the GB Patients may have palpable mass in RUQ Usually due to obstruction of cbd Pancreatic head mass may obstruct cbd Clinical Obstructive jaundice, increased DB, increased ALP ```
67
GB polyp?
``` Benign growth within GB Projects into GB lumen on a stalk which is rarely visible Soft tissue mass Non-mobile, non-shadowing Less echogenic compared to stone ```
68
What is cholesterolosis?
Cholesterol deposit in the GB wall.
69
Another name for cholesterolosis
Strawberry GB
70
What is adenomyomatosis?
Hyperplastic cholecystosis or diverticulosis of GB Diffuse type involves all mucosal walls of the GB It is characterized by epithelial proliferation, muscle hypertrophy, intramural diverticula (rokitansky aschoff sinuses) which may be segmental or diffuse Benign condition that requires no specific treatment, found as an accidental finding in up to 9% of cholecystectomy specimen
71
Other names for adenomyomatosis
Hyperplastic cholecystosis | Diverticulosis of GB
72
Sonographic appearance of adenomyomatosis?
Mural thickening with calcification and comet tail reverberation artifact due to small cholesterol crystals within rokitansky aschoff sinuses
73
What is Rokitansky Aschoff Sinuses?
Diverticula within the wall of GB The pathology associated with them is adenomyomatosis Sludge and stones accumulate within the sinuses and present as focal wall thickening. Echogenic foci are visible within the thickened wall. The accumulation causes a characteristic V-shaped or comet tail reverberation artifact
74
What imaging modality can differentiate adenomyomatosis from GB carcinoma?
MRI, by depicting Rokitansky aschoff sinuses. | MRI is the modality of choice.
75
What is Adenoma?
Rare, bening epithelial tumor, representing as an overgrowth of the epithelial lining of GB. Protrudes into the GB lumen. Non mobile, adhere to GB wall.
76
What is the sonographic appearance of adenoma?
``` Solitary, homogenously hyperechoic mass which becomes heterogenous with increasing size. Single or multiple Usually larger than polyps No shadow, no movement to dependent part Usually less than 1 cm ```
77
What is emphysematous GB?
An infection associated with gas-forming bacteria within the wall of the GB. Differs from the usual type of acute cholecystitis as cholelithiasis is absent Incidence: male>female Men >60 yo
78
What is the predisposing factor of emphysematous GB?
Diabetes mellitus Vascular compromise of cystic area may play role in etiology Gas may occur in the wall and/or lumen of GB Gas may spread to peri-cholecystitis tissue Gas rarely escapes into bile ducts because usually occluded by cholelithiasis
79
Sonographic features of emphysematous GB
Indistinct shadowing emanating from the wall or lumen of GB | Ring Down artifact or comet tail artifact from shadowing from air in GB lumen
80
What is pneumobilia?
Air in biliary tract Most commonly seen after ERCP And can also occur due to surgically created biliary-enteric anastomosis, incompetence of the sphincter of oddi, wall erosion by the gallstone or ulcer into cbd.
81
Where is pneumobilia most commonly seen?
In the hilum of liver.
82
What is Mirizzi's Syndrome?
Extrinsic biliary obstruction caused by compression of the stone within the cystic duct. The stone causes extrinsic mechanical compression of the cbd
83
Sonographic features of Mirizzi's Syndrome
Intrinsic hepatic bile dilation, a normal size cbd. | A large stone in the cystic duct of GB
84
What is Caroli's Desease?
Congenital communicating cavernous ectasis of the intrahepatic bile ducts. It is a segmental, non-obstructive, saccular dilation of intrahepatic bile ducts
85
What is choledochal cyst
Congenital cyst in the bile duct
86
Sonographic appearance of choledochal cyst
A presence of cyst-like mass in the porta hepatis area | Dilated intrahepatic biliary tree
87
Biliary carcinoma clinical and lab
``` More common in women 60-70% white women Stones will be present in almost 95% of cases May be asymptomatic Increased direct bilirubin, WBC and ALP CEA- carceno embrionic antigen ```
88
Etiology of biliary carcinoma
70-80% of cases the neoplasm is adenocarcinoma | 15% is papillary carcinoma
89
What 3 other areas should be investigated to confirm the diagnosis of GB carcinoma?
Liver METS Periaortic lymphadenopathy Bile duct dilation
90
What is Klatskin Tumor?
Is a specific type of cholangiocarcinoma Causes intrahepatic biliary dilation without extrahepatic dilation. Located at the hepatic hilum, at the junction of the right and left hepatic ducts. Signs and symptoms are weight loss, jaundice, RUQ pain, digestive disturbances

Abdomen (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions