Liver Part 2

Question 1

Viral hepatitis can lead to (3)

Answer 1

Portal hypertension
Cirrhosis
Hepatocellular carcinoma

Question 2

How is Hep a spread

Answer 2

Fecal oral route

Question 3

Hep a is epidemic in developing countries affecting

Answer 3

THE YOUth

Question 4

Hep a is a _____ infection

Answer 4

Acute

Question 5

Hep a causes death by

Answer 5

ACUTE LIVER FAILURE

Question 6

Hep B is transmitted

Answer 6

Parenterally but also from blood

Question 7

Where is hep c a major health problem

Answer 7

Italy and mediterranean

Question 8

Hep c spreads throug h

Answer 8

Blood

Question 9

Hep C is detected in lab tests by

Answer 9

Presence of antibodies

Question 10

Hep D is dependent on

Answer 10

Having Hep B first

Question 11

Geographically hep D is where

Answer 11

Same as hep B

uncommon in NA

Question 12

Hep D is common in what type of people

Answer 12

IV drug users

Question 13

Sign of viral hepatitis

Answer 13

Jaundice

Question 14

7 symptoms of viral hep

Answer 14

Fatigue, headache, anorexia, fever, abdominal pain, nausea and vomiting

Question 15

Acute hepatitis implies recovery within ____ months

Answer 15

4

Question 16

Acute hepatitis shows the parenchyma as more _______ leading to the appearance of _____________ ______ Walls

Answer 16

Hypoechoic

Bright periportal

Question 17

Sonographic appearance of Acute hepatitis is

Answer 17

Starry night sign

Question 18

Chronic hep biochemical abnormalities persist beyond

Answer 18

6 months

Question 19

Chronic hep will show have ________ present in tests

Answer 19

Antibodies

Question 20

On sonogaphy we will see _____ and ______ with Chronic hep

Answer 20

Hepatomegaly & thickening of GB wall

Question 21

Can Liver appear normal with Chronic hep

Answer 21

Yup

Question 22

Chemicals that are harmful to liver (2)

Answer 22

Alcohol

Presecription meds

Question 23

4 disorders of liver metabolism

Answer 23

Steatosis (fatty liver)
Glycogen storage disease- neonatal
Cirrhosis- chronic liver disease
NASH- non-alcoholic steatohepatitis

Question 24

Steatosis (fatty liver) is a ______ and _____ disorder of metabolism

Answer 24

Acquired and reversible

Question 25

Steatosis (fatty liver) is most common cause of _____ recent increase

Answer 25

Obesity

Question 26

Steatosis (fatty liver) affects the _____ in the hepatocytes

Answer 26

Triglycerides (fat)

Question 27

10 causes of Steatosis (fatty liver)

Answer 27

``` Excessive alcohol —> causes lipolysis Severe hepatitis Hyperlipidemia (cholesterol) Diabetes Excess corticosteroids Pregnancy Hyperalimentation Obesity bypass surgery Cystic fibrosis Toxins ```

Question 28

Steatosis (fatty liver) is the precursor for

Answer 28

Significant chronic disease

Question 29

Steatosis (fatty liver) may lead to ____ in some patients

Answer 29

Hepatocellular carcinoma (HCC)

Question 30

Steatosis (fatty liver) deposits may be ____ or _____

Answer 30

Focal or diffuse

Question 31

Mild Steatosis (fatty liver) has

Answer 31

Minimal diffuse increase in hepatic echogenicity

Question 32

Moderate Steatosis (fatty liver) has (2)

Answer 32

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

Question 33

Severe Steatosis (fatty liver) has (4)

Answer 33

Increase in echogenicity Poor penetraion of posterior liver Poor to no visualization of hepatic vessels and diaphragm Hepatomegally often present

Question 34

3 other sonographic appearances of fatty liver

Answer 34

Focal fatty infiltration Fatty sparing Focal fat

Question 35

What do we see with focal fatty infiltration

Answer 35

Regions of increase echogenicity in background of normal liver Can mimic a mass

Question 36

Fatty sparing appears as

Answer 36

Islands of normal liver parenchyma appear as hypoechoic masses within a dense fatty infiltrated liver

Question 37

Sonographic appearance of Steatosis (fatty liver) (4)

Answer 37

Rapid change in appearance and resolution over 6 days No mass effect No liver contour abnormality Focal fat appear rounded, nodular or interspersed

Question 38

4 other tests for testing Steatosis (fatty liver)

Answer 38

CT for low attenuation areas Contrast enhanced to differentiate fatty from neoplasia MRI - distinguish diffuse from focal fatty infiltration Nuclear medicine scintigraphy