Liver Pathology Flashcards by Rexlin Sebastin

Which abnormal lab of cirrhosis is nonspecific?

LDH

AST

GGT

conjugated bilirubin

ALT

LDH

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A patient comes in after a recent trip to Haiti, and they have an elevated WBC and are running a fever. You see a complex appearing mass within the liver. Of the options below, what would you guess it most likely to be?

Fatty infiltration

Echinococcal Cyst

Liver cyst

Abscess

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The sonographic appearance of “Starry Night” is a description of which pathology?

Cirrhosis

Chronic Hepatitis
Granulomas

Acute Hepatitis

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Alpha-fetoprotein is significantly elevated in which disease?

Hepatocellular carcinoma

Cirrhosis

Hepatitis

Fungal Abscess

Hepatocellular carcinoma

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Your patient has been out of the country. They present with these symptoms: RUQ pain, diarrhea, Fever, Elev. WBC, Elev. LFT’s. You see a rounded, complex mass in the dome of the liver near the capsule. What is the most likely pathology?

Pyogenic Abscess

Amebic Abscess

HCC

Fungal Abscess

Amebic Abscess

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You are scanning a patient who takes birth control and the hepatic veins appear to be obstructed. There is ascites, and splenomegaly also noted. What is the probable pathology?

Budd-Chiari Syndrome

Portal Vein Thrombosis

Mets

Cholangiocarcinoma

Budd-Chiari Syndrome

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Candidiasis is also known as….

Hepatitis

Echinococcal Cyst

Amebic Abscess

Fungal Abscess

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Which part of the liver is least affected by Budd-Chiari?

Right Anterior

Right Posterior

Left Medial

Left Lateral

Caudate

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The Central Fibrous Scar and Stellate Vascularity is Sonographically related to?

Cavernous Hemangiomas

Hepatic Adenoma

Focal Nodular Hyperplasia

HCC

Focal Nodular Hyperplasia

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What is the most common malignant liver tumor in early childhood?

Neuroblastoma

Wilm’s Tumor

HCC
Hepatoblastoma

Hepatoblastoma

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Which pathology am I describing? Small shrunken liver, Hyperechoic liver parenchyma, decreased echogenicity of the portal vein walls.

Chronic Hepatitis

Acute Hepatitis

Echinococcal Disease

HCC

Chronic Hepatitis

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______is the most common cause of portal HTN.

Cirrhosis

Schistosomiasis

Hepatitis

Fungal Abscess

Cirrhosis

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Cystic Lesions within the liver include all except:

Hydatid cysts

Polycystic Liver disease

Hemangiomas

Echinococcal disease

Hemangiomas

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A 40 year old male comes in for a scan. He had some mildly elevated LFT’s. What is the probable pathology?
FNH

Focal Fatty Sparing

Hemangiomas

Focal Fatty Sparing

HCC

Focal Fatty Sparing

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The pathologies that create gas and/or air produce the same artifact. What is it?

Posterior Acoustic Enhancement
Reverberation

Shadowing

WES sign

Reverberation

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You are scanning a patient and you notice a few small calcifications within the liver. The patient has NO symptoms. The patient tell you that he is a chicken farmer. What probably is the pathology?

Cirrhosis

Histoplasmosis

Granulomas

Hepatitis

Granulomas

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Hepatic Adenomas are associated with Glycogen Storage Disease. T or F

True

False

True

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With hepatitis which lab will not be elevated?

Unconjugated bilirubin

ALT

AST

Conjugated Bilirubin

Unconjugated bilirubin

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If you see liver mets that are hyperechoic, which primary cancer is it most likely associated with?

Sarcoma

Gastrointestinal

Lung

Lymphoma

Gastrointestinal

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The most common benign tumor of the liver is….

Hepatic Adenoma

HCC

Echinococcal Cyst

Cavernous Hemangioma

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What is a hepatic lipoma?

Cancer

Cyst

Fatty Tumor

Hydatid Disease

Fatty Tumor

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This parasitic infection is a major cause of Portal Hypertension worldwide.

Amebic Abscess

Hydatid Disease

Hepatitis

Schistosomiasis

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______is the most common organism causing infection in AIDS patients.

Pneumocystic Carinii

Candidiasis

cholangitis

Kaposi’s Sarcoma

Pneumocystic Carinii

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The speed propagation artifact is associated with which pathology?

HCC

FNH

Fatty infiltration

Hepatic Lipoma

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Splenomegaly can be a result of _______. Hydatid Disease Liver cysts Fatty liver Portal HTN

Portal HTN

You have a patient that presents with splenomegaly, a portal vein with a diameter >13 mm, Ascites, and portal systemic collaterals. They have all of these findings because they are exhibiting signs of _____? HCC Portal HTN Portal Vein Thrombosis Budd-Chiari Syndrome

Portal HTN

Hepatocellular Carcinoma is the least common primary malignancy of the liver. T or F True False

False

The "wheel within a wheel" lesion is a sonographic appearance of which of the following? A. Pyogenic Abscess B. Fungal Abscess C. Candidiasis D. Amebic Abscess A & C B & C C & D

B & C

A patient you are scanning has histoplasmosis. What pathology does this cause? HCC Granulomas Hepatitis Focal Nodular Hyperplasia

Granulomas

Your patient is running a fever and has elevated WBC. They have NOT been out of the country. You find a complex mass with reverberation and the radiologist suggests a fine needle aspiration to confirm the etiology. What pathology would this most likely demonstrate? Cavernous Hemangioma Hepatic Adenoma Pyogenic Abscess Amebic Abscess

Pyogenic Abscess

What is the most common cause of micronodular cirrhosis? Chronic Hepatitis Acute Hepatitis Alcoholism Tuberculosis

Alcoholism

A cyst with a detached endocyst describes which pathology? Echinococcal cyst Polycystic liver Disease Simple liver cyst Hemorrhagic Cyst

Echinococcal cyst

Which of the following can lead to fatty liver? Pregnancy FNH Obesity Diabetes

Obesity

_____ is a parasitic infection that can cause portal HTN. FNH Schistosomiasis Pyogenic Abscess Hydatid Disease

Schistosomiasis

______is the most common organism causing infection in AIDS patients. Pneumocystic Carinii Candidiasis Pyogenic Abscess Fungal Abscess

Pneumocystic Carinii

Cirrhosis is a liver disease that can possibly lead to.... Mets Hepatocellular Carcinoma (HCC) Hydatid Disease Hepatitis

Hepatocellular Carcinoma (HCC)

Your patient went to Vietnam for an agricultural trip. They were in a very poor part of the country they tell you and the facilities were terrible. Since he came back he has been having some RUQ pain. While scanning you find this: What is it? Echinococcal Cyst: Detached Endocyst Liver Mets HCC pyogenic abscess Echinococcal Cyst: Daughter Cysts

Echinococcal Cyst: Daughter Cysts

This patient has Von Gierks Glycogen Storage Disease. You have found this in their liver, when you go back and read the report the Dr. feels that it should be surgically removed. What do you think it is? Hepatic Adenoma Hemangioma FNH

Hepatic Adenoma

What is a hepatic lipoma? Cancer Cyst Fatty Tumor Hydatid Disease

Fatty Tumor

If you see liver mets that is hyperechoic, which primary is it most likely associated with? Lung Gastrointestinal Sarcoma Lymphoma

Gastrointestinal

You are scanning a patient who takes birth control and the hepatic veins appear to be obstructed. There is ascites, and splenomegaly also noted. What is the probable pathology? Budd-Chiari Syndrome Portal Vein Thrombosis Mets Cholangiocarcinoma

Budd-Chiari Syndrome

An amebic abscess occurs because the parasite has traveled to the liver via the ____. Hepatic Veins Hepatic Artery Portal Vein Bile Ducts

Portal Vein

You see a small non-shadowing calcification in the liver. What is it more than likely? Budd-chiari Syndrome HCC Portal Vein Gas Granuloma

Granuloma

The portal triad consists of the: main portal vein, common bile duct, and hepatic artery main portal vein, hepatic duct, and common bile duct main portal vein, hepatic artery, and hepatic vein main portal vein, hepatic artery, and hepatic duct

main portal vein, common bile duct, and hepatic artery

A 20-year-old asymptomatic woman presents for an abdominal ultrasound. A round hyperechoic, subcapsular mass is identified in the right lobe of the liver. What is the most likely diagnosis? solitary metastatic lesion echinococcal cyst hepatoblastoma cavernous hemangioma

cavernous hemangioma

You have a patient with AIDS. They present with diffuse, non-shadowing echogenic foci. What is it? Portal Vein Gas Pneumocystis Carinii Kaposi's Sarcoma Fatty liver infiltration Pneumocystis Carinii

Pneumocystis Carinii

This patient has a history of cirrhosis. Lately his lab work was a little different than his normal. Along with the elevated liver enzymes he also has elevated alpha-feto protein. What do you think this is in the image below? FNH Amebic Abscess HCC Hepatitis

HCC

The sonographic appearance of "Starry Night" is a description of which pathology? Cirrhosis Chronic Hepatitis Granulomas Acute Hepatitis

Acute Hepatitis

Micronodular Cirrhosis is most commonly caused by acute hepatitis chronic hepatitis alcoholism

alcoholism

What is the normal pressure of the portal vein? 5-10 mmhg 10-15 mmhg 15-20 mmhg 30 mmhg

5-10 mmhg

A 50-year-old diabetic patient presents with abdominal pain and slightly elevated liver function tests. Hepatomegaly and diffuse increase in the liver parenchymal echogenicity are present. This is characteristic of: cirrhosis hepatocellular carcinoma pyogenic infection fatty infiltration

fatty infiltration

Sonographic findings of Portal HTN are: 1. Reversal of flow in the portal vein 2. Collaterals 3. Hepatomegaly 4. Ascites 1, 2, 4 1, 3, 4 1, 2, 4

1, 2, 4

Which of the following is a differential of a liver cyst? Hydatid Disease Cavernous hemangioma FNH Adenoma

Hydatid Disease

A 40 year old male comes in for a scan. He had some mildly elevated LFT's, but otherwise does not complain of any symptoms. What is the probable pathology? See the white arrow. image.png HCC Focal Fatty Sparing FNH Hemangiomas

Focal Fatty Sparing

What are the 3 mechanisms of Cirrhosis? fibrosis regeneration cell birth cell death dissolution

fibrosis regeneration cell death

A cyst within a cyst or daughter cyst is a characteristic of: hepatoma polycystic liver disease echinococcal cyst pseudocyst

echinococcal cyst

Which pathology am I describing? Small shrunken liver, Hyperechoic liver parenchyma, Decreased echogenicity of the portal vein walls. Chronic Hepatitis Acute Hepatitis Echinococcal Disease HCC

Chronic Hepatitis

A patient presents with weight loss, increased alpha fetal protein (AFP), and abdominal enlargement. This is most characteristic of: focal nodular hyperplasia (FNH) liver adenoma hepatoma lymphoma

hepatoma

An inpatient exam is ordered and you find this image. They are running a fever and their chart states immunocompromised. What is this? Echinococcal Disease Fungal Abscess Amebic Abscess Pyogenic Abscess

Fungal Abscess

Which lists the correct criteria for a simple cyst? thick walled, posterior shadowing, hyperechoic thin smooth walls, posterior acoustic enhancement, anechoic irregular border, solid, no posterior artifact

thin smooth walls, posterior acoustic enhancement, anechoic

This patient has a history of IV drug use. They have not been feeling well and they had lab work done which revealed elevated AST/ALT and total bilirubin. The Dr has sent them for a scan of the liver. You start scanning and notice the liver looks as below: Which of the following pathologies have you most likely found? Liver Agenesis Schistosomiasis HCC Hepatitis

Hepatitis

Macrocellular Cirrhosis is most commonly caused by: acute hepatitis chronic hepatitis alcoholism

chronic hepatitis

The most common benign tumor of the liver is.... Hepatic Adenoma HCC Echinococcal Cyst Cavernous Hemangioma

Cavernous Hemangioma

Which pathology presents with a hypoechoic halo? HCC FNH Adenoma Lipoma

HCC

Which part of the liver is least affected by Budd-Chiari? Right Anterior Right Posterior Left Medial Left Lateral Caudate

Caudate

Which of the following is a characteristic of Budd-Chiari syndrome? thrombus of the hepatic and portal vein thrombus in the hepatic artery and vein thrombus in the hepatic vein and the inferior vena cava thrombus in the hepatic artery and aorta

thrombus in the hepatic vein and the inferior vena cava

Your patient has a history of lymphoma. You are scanning their liver and find the following. Which do you most likely think it is? image.png Bulls-eye mets Hypoechoic mets Diffuse mets Echogenic mets

Hypoechoic mets

Which vessels increase in size as they course superiorly toward the diaphragm? Think of how each appears on ultrasound exams. patent umbilical veins hepatic veins portal veins hepatic arteries

hepatic veins

Abnormal labs of cirrhosis are? GGTP AST conjugated bilirubin ALT All listed LDH

All listed

The speed propagation artifact is associated with which pathology? HCC FNH Fatty infiltration Hepatic Lipoma

Hepatic Lipoma

Alpha-fetoprotein is most significantly elevated in which disease? Hepatitis Cirrhosis Hepatocellular carcinoma Fungal Abscess

Hepatocellular carcinoma

Sonographic finding with acute hepatitis can include all of the following except: decreased echogenicity of portal vein walls liver enlargement starry night decreased liver parenchymal echogenicity

decreased echogenicity of portal vein walls

What is the name of the porto-systemic collaterals that occur around the umbilicus? Recanulized umbilical vein Caput Medusa Spleno-renal varices Gastrointestinal varices

Caput Medusa

The fissure of the ligamentum venosum divides the liver into: right and left lobes left lobe and caudate lobe left medial and lateral segments right lobe and caudate lobe

left lobe and caudate lobe

The liver function laboratory test which is most specific to hepatocellular disease is: CEA hematocrit ALT HCG

ALT

The Pathologies that create gas and/or air seem to produce the same artifact. What is it? Posterior Acoustic Enhancement Comet tail/reverberation Speed Propagation artifact Mirror image artifact

Comet tail/reverberation

Candidiasis is the cause of which of the following? Hepatitis Echinococcal Cyst Amebic Abscess Fungal Abscess

Fungal Abscess

You are scanning a patient and you notice a few small calcifications within the liver. The patient has NO symptoms. The patient tells you that he is a chicken farmer. What probably is the pathology? Cirrhosis Histoplasmosis Granulomas Hepatitis

Granulomas

Your patient came in for a routine gallbladder scan. They have been complaining of RUQ pain, nausea, and vomiting. You start scanning their liver and find this, what do you think it is and should you look at any other organ? CHOOSE 2 ANSWERS. Adult Polycystic Disease Simple Liver Cyst Hemangioma FNH Look at pancreas Look at kidneys Look at spleen

Look at kidneys Adult Polycystic Disease

A small hyperechoic nodular liver best describes: acute viral hepatitis early staged cirrhosis chronic viral hepatitis normal pediatric liver

chronic viral hepatitis

Which pathology am I describing? Round, hypoechoic complex mass. Typically occurs in the dome of the liver. Contiguous with the liver capsule. HCC Focal Nodular Hyperplasia Amebic Abscess Hemorrhagic Cyst

Amebic Abscess

Which of the following carries the majority of the oxygen and nutrients to the liver? hepatic artery portal vein common duct celiac axis

portal vein

Which of the following is NOT a sonographic appearance of Mets in the liver? cyst with detached endocyst bulls eye mets calcified mets echogenic mets

cyst with detached endocyst

The Central Fibrous Scar and Stellate Vascularity is Sonographically related to? Cavernous Hemangiomas Hepatic Adenoma Focal Nodular Hyperplasia HCC

Focal Nodular Hyperplasia

Caudate lobe may appear enlarged due to: hypertension cirrhosis hepatitis fatty infiltration cirrhosis

cirrhosis

This pathology is fluid filled with an epithelial lining. Cyst Hydatid disease Cavernous hemangioma Hepatic Adenoma

Cyst

This patient has Chrohn's Disease. What do you think that this is? Portal HTN Portal Vein Thrombosis Granulomas Portal Vein Gas

Portal Vein Gas

You have an order to evaluate this patients liver post-surgery. What do you see?

TIPS shunt

Focal Fatty Sparing usually occurs where? adjacent to the GB porta hepatis caudate lobe at the liver margins All listed

All listed

what is the normal liver size? 12.5 cm 15.5 mm 1.55 cm 15.5 cm

15.5 cm

The hepatoblastoma ranks where among childhood abdominal tumors? First Second Third Fourth

Third

The patient preparation necessary to examine the liver is: drink 16 ounces of water NPO for 6 hours clear liquids no specific preparation is needed

NPO for 6 hours

If a cyst becomes hemorrhagic and infected which of the following signs/symptoms might occur? Mark all that apply. Elevated WBC Elevated RBC Decreases hematocrit Pain

Elevated WBC Pain

Hepatofugual portal vein blood flow may be seen in patients with: portal hypertension biliary disease fatty infiltration cavernous hemangioma

portal hypertension

How can a cavernous hemangioma appear sonographically? select all that apply echogenic well defined irregular margins cystic

well defined echogenic

A patient you are scanning has histoplasmosis. What pathology does this cause? HCC Granulomas Hepatitis Focal Nodular Hyperplasia

Granulomas

What is the term for a malignant lesion of the liver?: hepatoma focal nodular hyperplasia cavernous hemangioma fibroma

hepatoma

When the liver is congenitally absent this is known as: Adult Polycystic Disease Agenesis Schistosomiasis Pyogenic Abscess

Agenesis

This patient has presented with portal hypertension after coming back from a trip to a third world country. You notice that the portal tracts are wider than normal and appear to be somewhat occluded. What is this possible pathology? Hydatid Disease Pyogenic Abscess Fungal Abscess Schistosomiasis

Schistosomiasis

Splenomegaly can be a result of _______. Hydatid disease Liver cysts Fatty liver Portal HTN

Portal HTN

A 30-year-old patient presents with abdominal pain and abnormal liver function tests. The abdominal ultrasound reveals a dilated portal and superior mesenteric vein with hepatofugal blood flow. This is most characteristic of: portal aneurysm portal atresia portal fistula portal hypertension

portal hypertension

The "wheel with in a wheel" lesion is a sonographic appearance of which pathology? A. Pyogenic Abscess B. Fungal Abscess C. Candidiasis D. Amebic Abscess A & C B & C C & D

B & C

Your patient has a history of HCC. They come in because they have had sudden onset of severe abdominal pain. You place the probe down and start scanning their liver and see the portal vein. When you put color on it there is no color showing up. What is this? Budd-Chiari Syndrome Schistosomiasis Portal Thrombosis Normal Portal Vein

Portal Thrombosis

Which of the following cancers is the most common primary cancer of the liver that affects adults? HCC-Hepatocellular Carcinoma Echogenic Liver Mets Hypoechoic Liver Mets Hepatoblastoma

HCC-Hepatocellular Carcinoma

Liver Pathology Flashcards

(104 cards)