Liver Part 2 P2

Question 1

4 disorders of liver metabolism

Answer 1

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

Question 2

Glycogen storage disease occurs in ________ period

Answer 2

Neonatal

Question 3

In Glycogen storage disease large amounts of __________ are deposited in ____ and _____

Answer 3

Glycogen

Deposited in liver and kidneys

Question 4

Glycogen storage disease patients survive to yound adulthood with

Answer 4

Enzyme therapy

Question 5

Glycogen storage disease may develop (2)

Answer 5

Benign adenomas or hepatocellular carcinomas

Question 6

Glycogen storage disease appaers indistinguishable from

Answer 6

Diffuse fatty infiltration

But there is a different age group

Question 7

Cirrhosis diffuse process characterized by (2)

Answer 7

Fibrosis and the conversion of normal liver architecture into structural abnormal nodules

Question 8

3 major pathological mechanisms of Cirrhosis

Answer 8

Cell death
Fibrosis
Regeneration

Question 9

Most common cause of micronodular form of Cirrhosis

Answer 9

Alcohol consumption

Question 10

Most freq cause of macronodular form of Cirrhosis

Answer 10

Chronic viral hepatitis

Question 11

Patients who continue to abuse alcohol after cirrhosis may end up with

Answer 11

End stage liver disease

Question 12

End stage liver diseaase clinical presentation is

Answer 12

Hepatomegally
Jaundice
Ascites

Question 13

4 Other causes of Cirrhosis

Answer 13

Biliary Cirrhosis
Wilsons disease
Primary sclerosing cholangitis
Hemochromatosis

Question 14

Most common cause of Cirrhosis is

Answer 14

Portal hypertension

Question 15

Sonographic appearance of Cirrhosis

Answer 15

Volume redistribution
Coarse echotexture
Nodular surface
Regenerative and dysplastic nodules

Question 16

Portal hypertension sonographic appearance of Cirrhosis

Answer 16

Ascites, splenomegally and varices

Question 17

Sonographic pattern in early stages of Cirrhosis (3)

Answer 17

Liver may be enlarged
May be difficult to distinguish from fatty liver
Look for irregular contour (higher freq)

Question 18

Sonographic pattern in advanced stages of Cirrhosis

Answer 18

Liver is often shrinking with ascites

Question 19

Sonographic pattern in coarse stages of Cirrhosis

Answer 19

Increased echogenicity

Loss of smooth texture

Question 20

Sonographic patterns of nodular surface with cirrhosis (3)

Answer 20

Irregularity of liver surface due to regenerating nodules and fibrosis
Ascites helps outline edges
Linear probe delineates the contour well

Question 21

Sonographic appearnace of regenerating nodules (2)

Answer 21

Hepatocytes surrounded by fibrotic septae

May be isoechoic or hypoechoic with a thin echogenic border

Question 22

Dysplastic nodules are larger than ____mm

Answer 22

10 mm

Question 23

Dysplastic nodules have well differentiated (3)

Answer 23

Hepatocytes
Portal venous blood supply
Malignant cells

Question 24

With Dysplastic nodules a _____ is indicated to rule out HCC

Answer 24

Biopsy

Question 25

nonalcoholic steatohepatitis (NASH) is a _______ and _____ liver diease

Answer 25

Commmon and silent

Question 26

nonalcoholic steatohepatitis (NASH) resembles

Answer 26

Alcoholic liver disease but they dont drink

Question 27

nonalcoholic steatohepatitis (NASH) major feature is

Answer 27

Fat in the liver, along with inflammation and damage

Question 28

nonalcoholic steatohepatitis (NASH) can lead to

Answer 28

Cirrhosis

Question 29

nonalcoholic steatohepatitis (NASH) is related to

Answer 29

Obesity

Question 30

Signs and symptoms of nonalcoholic steatohepatitis (NASH)

Answer 30

Fatigue, weight loss and weakness

Question 31

nonalcoholic steatohepatitis (NASH) diagnosed by

Answer 31

Biopsy with increased LFTs

Question 32

Treatment for nonalcoholic steatohepatitis (NASH)

Answer 32

Reduce weight, eat balance diet, due activity, avoid alcohol

Question 33

nonalcoholic steatohepatitis (NASH) sonographically appears as

Answer 33

Dense fatty infiltration of cirrhosis

Question 34

Acute liver failur defined as

Answer 34

s "the rapid development of hepatocellular dysfunction, specifically coagulopathy and mental status changes (encephalopathy) in a patient without known prior liver disease”

Question 35

Chronic liver failure usually occurs in context of

Answer 35

Cirrhosis

Question 36

Chronic liver failure result of (6)

Answer 36

Excessive alcohol HEP B or C Autoimmune, hereditary and metabolic causes Steatohepatitis or nonalcoholic fatty liver disease

Question 37

Does uncomplocicated portal hypertension cause ascites

Answer 37

No

Question 38

Ascites usually occurs ________ to licer cell failure

Answer 38

Secondary

Question 39

Coagulopathy is

Answer 39

Bloods ability to clot is impaired

Question 40

Coagulopathy may occur (2)

Answer 40

Spontaneously or following a medical condition

Question 41

Hepatic encephalopathy is result of

Answer 41

Liver failure

Question 42

With hepatic encephalopathy patient exhibits

Answer 42

Confusion, altered level of consciousness and coma

Question 43

Drug account for __ to ___ % of hepatic failure

Answer 43

20-40%

Question 44

Outcome of drug toxicity is _____ or _____

Answer 44

Liver transplant or death