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DMST ABD 3 > Metabolic Disease: Liver > Flashcards

Metabolic Disease: Liver Flashcards

(62 cards)

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1
Q

What kind of process is hepatocellular disease?

A

Diffuse process

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2
Q

Hepatocellular disease is a dysfunction of what?

A

Hepatocytes

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3
Q

With hepatocellular disease normal liver is replaced with what?

A

Fat or fibrosis

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4
Q

With hepatocelluar disease, simple fatty changes into what disease?

A

Cirrhosis

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5
Q

Hepatocellular disease impacts LFT how? And how does it affect the liver? 2

A
  1. Abnormal LFTs
  2. Often affects liver size
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6
Q

Is fatty infiltration (Steatosis) uniform?

A

Not always, it can be diffuse or focal

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7
Q

How is fatty infiltration (steatosis) obtained? And is it reversible?

A
  1. Acquired
  2. Reversible
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8
Q

How does someone get fatty infiltration (steatosis)?

A

Alcohol abuse and obesity

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9
Q

Fatty infiltration (steatosis) is the precursor to what?

A

Chronic disease

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10
Q

What do we look for when evaluating for fatty infiltration? 4

A
  1. Echogenicity changes
  2. Echo texture changes
  3. Attenuation characteristics
  4. Ability to visualize vessels
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11
Q

What is the sonographic appearance of fatty infiltrates? 3

A
  1. Liver difficult to penetrate
  2. Paucity of vessels
  3. Echogenicity change
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12
Q

What is mild (grade 1) fatty infiltration? 2

A
  1. Slight increase in liver echogenicity
  2. Diaphragm and vessels clearly defined
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13
Q

What is Moderate (grade 2) fatty infiltrates? 2

A
  1. Increased in liver echogenicity
  2. Vessels and diaphragm not sharply defined
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14
Q

What is severe (grade 3) fatty infiltrates? 2

A
  1. Liver echogenicity increased markedly
  2. Extremely difficult to define diaphragm and vessel walls
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15
Q

What are focal fatty changes in the liver in terms of Infiltration?

A

Focal areas of increased echogenicity (fatty deposits) within mostly normal liver parenchyma

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16
Q

What is focal fatty changes in the liver in terms of sparing?

A

Focal hypoechoic areas (normal liver tissue) within a mostly fatty liver

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17
Q

Focal fatty changes both commonly involve what areas of the liver?

A

Periportal areas of medial LL and GB

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18
Q

Does focal fatty changes affect mass?

A

No mass effect

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19
Q

What is the rate of change for focal fatty changes?

A

Can rapidly change with time

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20
Q

Focal fatty changes has what type of boundaries?

A

Map like boundaries

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21
Q

What is cirrhosis?

A

A diffuse process that destroys the liver cells

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22
Q

What does cirrhosis results in?

A

Fibrosis with nodular changes

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23
Q

Cirrhosis is commonly secondary to what?

A

Alcohol abuse

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24
Q

What are some causes of cirrhosis other than alcohol abuse? 2

A
  1. Chronic viral hepatitis
  2. Primary scleroising cholangitis
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25
What is the progressive changes with cirrhosis?
Cell death > Fibrosis > regeneration
26
Is cirrhosis reversible?
No its irreversible
27
What are lab values with fatty infiltration? 3
1. ALT 2. AST 3. Possible GGT
28
Acute cirrhosis appears as what?
Severe fatty infiltration
29
The lab values of Cirrhosis depend on what?
Stage of disease
30
What are some lab values that are increased with Cirrhosis? 5
1. AST 2. ALT 3. LDH 4. Bilirubin (conjugated) 5. Gamma globulin
31
What lab values are decreased with cirrhosis?
Serum albumin
32
What are clinical presentations of cirrhosis? 6 (a/s)
1. Hepatomegaly 2. Jaundice 3. Ascites 4. Diarrhea 5. Feeling of fullness 6. Weight loss
33
Cirrhosis leads to what eventually? (Condition) 2
Portal hypertension and liver failure
34
What is Glycogen storage disease?
Autosomal recessive disorder which causes excess glycogen deposits in hepatocytes
35
What is an example of glycogen storage disease?
Von Gierke’s disease
36
When does Glycogen storage disease begin?
Neonatally
37
How does benign adenomas and HCC appear in Glycogen storage disease?
Benign adenomas and HCC can be secondary
38
What is the GSD sonographic appearance? 2
1. Diffuse fatty infiltration 2. Adenomas - solid masses with variable echogenicity
39
What is diffuse fatty infiltration look like for GSD?
Indistinguishable from other causes of diffuse focal fatty disease
40
Von Gierkes disease is a deficiency of what?
G6P enzymes
41
What are ascites?
Free serous fluid in the abdominal cavity
42
What does transudate contain?
Little protein/cells
43
What does transudate suggest? 2
Non inflammatory process in terms of 1. Cirrhosis 2. Congestive heart failure
44
What does this image demonstrate?
Ascites in the bowel
45
What does this image represent?
Glucose storage disease
46
What does this image represent?
Chronic Cirrhosis, you can tell by the 1. Small liver 2. CL/RL >0.65 3. Coarse echo texture 4. Nodular surface 5. Paucity of vessels
47
What does this image represent?
Acute cirrhosis, you can tell by the 1. Enlarged liver 2. Textural changes
48
What does these images represent?
1. Fatty infiltration on the left 2. Fatty sparing on the right
49
What does this image represent?
Severe (Grade 3) fatty infiltration 1. Liver echogenicity increased 2. Extremely difficult to define diaphragm and vessel walls
50
What does this image represent?
Moderate (grade 2) Fatty infiltrate 1. Increase in Liver echogenicity 2. Vessels and diaphragm not sharply defined
51
What does this image represent?
Mild (grade 1) fatty infiltrate
52
What does transudate look like sonographically?
Anechoic
53
What does exudate consist of? 2
1. High protein content 2. Blood, pus, chylous
54
What does exudate ascites causes?
Inflammation or malignant causes
55
What does exudate ascites look like sonographically? 3
1. Internal echoes 2. Echogenic 3. Loculations
56
Free fluid changes with what?
Patient position
57
Free fluid conforms to what?
Surrounding organs
58
Free fluid has acute anlges with what?
Organ contact
59
Does Lobulated fluid change with movement?
No
60
What are the margins for Loculated fluid?
Rounded margins
61
Loculated fluid has what kind of effect?
Mass effect
62
What is the most dependent spaces in the abdomen? 3
1. Morison’s pouch (RT lobe and RT kidney) 2. Paracolic gutters 3. Pouch of Douglas

DMST ABD 3 (11 decks)

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