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ABD URR > Pathology: Liver > Flashcards

Pathology: Liver Flashcards

1
Q

While scanning the liver in a patient with chronic cirrhosis, you notice a tubular vessel connecting to the splenic vein just prior to its confluence with the SMV. Flow within the vessel is very low velocity, continuous and moving in a cephalic direction. What explains this finding

A

a dilated coronary vein is present which is a common complication of cirrhosis

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2
Q

The most common parasitic infection in humans is

A

schistosomiasis

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3
Q

_______ is the most common malignancy of the liver seen in a patient with AIDS. ______ is the most common infection of the liver seen in a patient with AIDS

A

kaposi sarcoma, pneumocystis carinii

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4
Q

What describes the expected waveform from the hepatic vein in a patient with cirrhosis

A

monophasic, continuous antegrade flow

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5
Q

A patient presents with a history of AIDS and recent pneumocystis carinii infection. What changes to the liver do you expect to see on the ultrasound exam

A

diffuse echogenic foci throughout the liver tissue

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6
Q

Fulminant hepatitis is most commonly caused by

A

acetaminophen abuse

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7
Q

Steatosis refers to

A

fatty liver disease

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8
Q

Hepatic artery hypertrophy is a common finding with

A

cirrhosis

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9
Q

Periportal cuffing is a sign of

A

acute viral hepatitis

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10
Q

What correctly describes peliosis hepatis

A

blood filled cavities of varied size form in the liver tissue

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11
Q

The Ultrasound Liver Imaging Reporting and Data System (US LI-RADS) is used to assess patients at risk for

A

hepatocellular carcinoma

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12
Q

What vessels will be abnormally dilated with significant portal HTN

A

main portal vein and left gastric vein

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13
Q

A resistive index over 0.8 in the common hepatic artery would be an expected finding in patients with

A

portal htn and transplant rejection

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14
Q

Reduced glycogen storage in the liver usually causes the liver parenchyma to have a sonographic appearance similar to

A

acute viral hepatitis

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15
Q

_________ should be suspected in an infant with a large hepatic hemangioma and unexplained thrombocytopenia

A

kasabach-merritt syndrome

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16
Q

Compensatory enlargement of the caudate lobe occurs with which of the following

A

cirrhosis and budd chiari syndrome

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17
Q

What liver tumor is usually treated by surgical resection due to risk of hemorrhage and malignant transformation

A

adenoma

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18
Q

Hypoalbuminemia associated with cirrhosis leads to

A

gallbladder and bowel wall thickening

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19
Q

About 50% of all primary tumors that metastasize to the liver are drained through the

A

portal vein

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20
Q

The hormone changes with pregnancy have been associated with the enlargement of what type of liver mass

A

hemangioma

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21
Q

A patient is referred for a RUQ scan due to the possibility of a fungal infection of the liver. They have a 4yr history of treatment for AIDS. The liver demonstrates diffuse presentation of multiple calcifications of different sizes, with and without shadowing. These findings are most consistent with

A

pneumocystis carinii

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22
Q

What type of liver abscess presents as a mass with internal septations similar to the spokes of a wheel

A

fungal

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23
Q

Portalization of the hepatic veins is a common finding in which of the following

A

advanced cirrhosis

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24
Q

If a liver transplant has a piggyback anastomosis, how does this affect your evaluation

A

there will be a single anastomosis site in the IVC that must be evaluated

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25
Q

If a liver transplant has a piggyback anastomosis, how does this affect your evaluation

A

there will be a single anastomosis site in the IVC that must be evaluated

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26
Q

What is caput medusa

A

tortuous vessels around the umbilicus caused by portal HTN

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27
Q

A liver mass with a hypoechoic rim should create a strong suspicion of

A

malignancy

28
Q

What condition is associated with prominent portal walls

A

acute viral hepatitis

29
Q

What is commonly associated with contaminated water and causes debris/occlusion within intrahepatic portal venous system

A

schistosomiasis

30
Q

_______ usually presents as multiple target lesions in the liver

A

metastasis

31
Q

A 6 month old female is referred for an abdominal ultrasound due to suspected kasabach-merritt syndrome. What are you looking for on the exam

A

liver or spleen hemangioma formation

32
Q

What would cause an increase in serum AST levels with normal serum ALT levels

A

congestive heart failure

33
Q

Placement of a Linton or Warren shunt is a method used to

A

reduce portal hypertension

34
Q

What is a potential collateral pathway formed in patients with cirrhosis

A

blood moves fom the coronary and short gastric veins into the esophageal veins

35
Q

You are scanning through the liver and note the caudate lobe is nearly the same size as the right lobe. The surface of the liver appears lobulated or nodular. What is most likely the diagnosis of these findings

A

cirrhosis

36
Q

A patient presents with an isolated slight increase in liver function tests. You identify two hyperechoic, homogeneous masses in the area of the prota hepatis. These findings are most consistent with

A

focal fatty infiltration

37
Q

A vascular condition of the liver seen in women who take oral contraceptives is

A

budd chiari syndrome

38
Q

WHat is a potentially life threatening complication of portal HTN

A

ruptured gastroesophageal varices

39
Q

What liver complication is associated with cholangitis, diverticulitis and osteomyelitis

A

pyogenic abscess

40
Q

What is most likely to demonstrate a simple cyst with gravity dependent debris in the right lobe of the liver

A

early echinococcal infection

41
Q

What is true regarding a transjugular intraheptic shunt

A

air is retained within the shunt after placement which limits the US evaluation for the first 3-5 days

42
Q

The diamter of the __________ will be relatively unaffected by hepatic congestion

A

heaptic artery

43
Q

What is the most common cause of a hepatic abscess in the US

A

cholangitis and cholecystitis

44
Q

If tardus parvus waveforms are identified in the intrahepatic artery waveforms of a transplant, this finding is ________. If biphasic waveforms are identified in the right and left hepatic arteries, the finding is _______.

A

suspicious for hepatic artery stenosis, suspicious for organ rejection

45
Q

A patient presents with abdominal pain for 3 months following a missionary trip to India. Lab values demonstrate normal LFTs. The US exam demonstrates a 3cm cyst with septations in the right lobe of the liver. These findings are most consistent with

A

hydatid cyst

46
Q

What liver disorder leads to the sonographic appearance of hepatomegaly with decreased echogenicity and scattered bright portal reflections within the parenchyma

A

acute viral hepatitis

47
Q

What describes the Doppler appearnce of liver transplant rejection

A

high resistance flow in the hepatic artery

48
Q

A patient presents with a history of hep c and you identify a solid liver mass with a hypoechoic halo. This finding is most consistent with

A

hepatocellular carcinoma

49
Q

How can a hepatic adenoma be differentiated from focal nodular hyperplasia on contrast enhanced ultrasound

A

FNH lesions usually demonstrate centrifugal enhancement while adenomas demonstrate centripetal enhancement

50
Q

The most common finding with congestive hepatomegaly is

A

IVC dilatation

51
Q

What finding indicates a failed transjugular intrahepatic shunt

A

hepatofugal flow in the main portal vein

52
Q

Triglyceride accumulation in the liver leads to ______, while copper accumulation in the liver leads to ______

A

steatosis, wilson disease

53
Q

___________ is the most common cause for micronodular cirrhosis and ____________ is the most common cause of macronodular cirrhosis

A

alcohol consumption, chronic viral hepatitis

54
Q

A mass that presents with a bull’s eye appearance within the liver tissue is most likely

A

metastasis

55
Q

The primary finding that differentiates liver mass formation from steatosis is

A

steatosis will demonstrate normal vessel course through affected areas, while mass formation displaces vasculature

56
Q

High-intensity transient signals (HITS) are seen on the doppler evaluation of a patient with

A

portal venous gas

57
Q

What is the most common primary ccancer to metastasize to the liver

A

GI tract

58
Q

What abnormality causes focal development lesions of the liver and is associated with congenital hepatic fibrosis, autosomal dominant polycystic disease and cholangiocarcinoma

A

biliary hamartomas

59
Q

A TIPS shunt is placed into the liver circulation to alleviate portal HTN. What two vessels are usually connected

A

right portal vein connects to the right hepatic vein

60
Q

________ is the most common liver malignancy, while ________ is the most common primary liver malignancy

A

metastasis, hepatocellular carcinoma

61
Q

What is the most common cause for intrahepatic cholestasis

A

hepatitis

62
Q

Liver hemangiomas are a sommon benign neoplasm that will usually appear on an US of a normal liver as

A

well defined, hyperechoic liver mass

63
Q

A cyst within a cyst (daughter cyst) is a classic sign of

A

hydatid cyst or echinococcal cyst

64
Q

Alcoholic cirrhosis demonstrates a severe increase in ______, while viral hepatitis demonstrates a severe increase in _______

A

AST, ALT

65
Q

What metabolic infiltrative disorder is associated with hepatic adenoma formation

A

von gierke disease

ABD URR (8 decks)

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