REVIEW - Liver

Question 1

most common cause of hydatid disease

Answer 1

parasite - sheep cattle

Question 2

sono appearance hydatid liver disease

Answer 2

cystic mass with smaller daughter cysts, lily-pad

Question 3

most common benign tumour of liver

Answer 3

cavernous hemangioma

Question 4

sono appearance hemangioma

Answer 4

homogenous, hyperechoic <3cm, hypovascular

Question 5

what causes increased echogenicity of hemangioma?

Answer 5

numerous interfaces between walls of cavernous sinuses and blood within

Question 6

is colour dop useful for hemangioma?

Answer 6

no, flow too slow

Question 7

D/D when hemangioma is seen (2)

Answer 7

mets from colon/GI

HCC

Question 8

if you’re differentiating between colon mets or HCC what would lab values or history indicate for either?

Answer 8

HCC- cirrhosis/hepatatis

colon mets - LFT increased

Question 9

what lesion associated with bleeding/hemorrhage

Answer 9

adenomas

Question 10

sono appearance adenoma

Answer 10

solitary, encapsulated, LARGE, hypo/iso/hyper

Complex due to hemorrhage; sono changes with duration of bleeding. at first echogenic –> after 1 week more hypo

Question 11

why is resection of adenomas rec.?

Answer 11

hemorrhage risks and malignant degeneration

Question 12

second most common benign tumour

Answer 12

FNH

Question 13

sono app FNH

Answer 13

iso/hyper/hypo
stellate vascular pattern/spoke of wheel
central scar

Question 14

assoc with OC (2)

Answer 14

adenomas

FNH

Question 15

causes of fatty liver disease (you may not think)

Answer 15

pregnancy
cystic fibrosis
chemo
toxins

Question 16

t/f fatty liver is not reversible

Answer 16

false

Question 17

what changes from mild to severe fatty liver disease?

Answer 17

minimal diffuse increase in hepatic echogenicity to marked increase in echogenicity. poor penetration to posterior liver

Question 18

important to image right kidney/liver interface

Answer 18

to compare echogenicity

Question 19

3 mechanisms that combine to create cirrhosis

Answer 19

cell death
fibrosis
regeneration

Question 20

most common cause of micronodular form of cirrhosis

Answer 20

alcohol consumption

Question 21

most common cause of macronodular form of cirrhosis

Answer 21

chronic viral hepatitis

Question 22

classic clinical presentation of cirrhosis (3)

Answer 22

hepatomegaly
jaundice
ascites

Question 23

sono features of ascites (5)

Answer 23

volume redistribution (early-large, advanced - small)
coarse echotexture
nodular surface
portal hypertension

Question 24

portal hypertension assoc with (3)

Answer 24

ascites
varices
splenomegaly

Question 25

most common malignant liver tumour

Answer 25

HCC

Question 26

two most common predisposing causes of HCC

Answer 26

alcoholism | hepatitis

Question 27

what does HCC invade (2)

Answer 27

portal vein | hepatic vein

Question 28

most common primary tumours that result in liver mets (6)

Answer 28

``` GB colon stomach panc breast lung ```

Question 29

what structures aid in the spread of disease

Answer 29

blood born- HA or PV | lymphatics - stomach, panc, ovary, uterus

Question 30

D/D for hyperechoic lesions in the liver other than mets?

Answer 30

hemangiomas (mets from colon hyperechoic)

Question 31

echogenic mets tend to arise from

Answer 31

GI tract/colon | HCC

Question 32

Hypoechoic mets arise from

Answer 32

Breast, lung, gastric, panc, esophageal

Question 33

Bulls eye mets

Answer 33

Lung

Question 34

8 causes hepatomegaly

Answer 34

``` alcohol abuse hepatitis fatty infiltration mononucleosis hemochromatosis primary liver cancer leukemia lymphoma ```

Question 35

3 stages of hematoma sono app

Answer 35

<24 hr echogenic within 1st week hypo 2-3 wk indistinct, tissue granulation

Question 36

what am I: not on medication, single avascular hyperechoic lesion

Answer 36

hemangiomas

Question 37

what am I: incidental lesion, colour doppler indicated spoke wheel pattern Hx OC use

Answer 37

FNH

Question 38

what am I: OC, hypervascular, palpable

Answer 38

adenoma

Question 39

what am I: 50 yr old man, underdeveloped country, increased LFTs

Answer 39

hydatid disease

Question 40

what am I: fever, abdo pain, nausea, vomit, jaundice, leukocytosis, starry night sign

Answer 40

Hepatitis

Question 41

chronic hep can lead to

Answer 41

Cirrhosis portal hypertension HCC

Question 42

Fecal-oral route - which hepatitis?

Answer 42

A

Question 43

What am I: recent cholecystectomy following a bout of cholecystitis. presented with fever, malaise, anorexia, RUQ pain. Leukocytosis.

Answer 43

abscess

Question 44

what may be present with abscess?

Answer 44

gas - echogenic foci with artifact

Question 45

what am I: pt c/o distended abdo S/S hepatomegaly, jaundice. denies alcohol abuse. increased LFTs

Answer 45

cirrhosis

Question 46

causes of cirrhosis

Answer 46

alcohol primary, then Hep C

Question 47

w/a | immunosuppressed

Answer 47

candidiasis - multiple small abscesses

Question 48

w/a | bright periportal walls

Answer 48

hepatitis

Question 49

w/a | dilated portal tracts

Answer 49

schistosomiasis

Question 50

w/a | 2nd most commonly benign liver lesion

Answer 50

FNH

Question 51

w/a | reversible metabolic disease

Answer 51

steatosis

Question 52

w/a | broken diaphragm sign

Answer 52

fatty tumour

Question 53

w/a | aurora sign

Answer 53

lung parenchymal disease

Question 54

w/a | collection of blood following trauma

Answer 54

hematoma

Question 55

w/a | gas producing bacteria in a collection

Answer 55

abscess

Question 56

w/a | focal mass on cirrhotic liver

Answer 56

HCC

Question 57

w/a | most common parasitic disease

Answer 57

schistosomiasis

Question 58

w/a | most common benign liver mass

Answer 58

hemangioma

Question 59

w/a | periportal hypoarea on fatty liver

Answer 59

focal sparing

Question 60

w/a | brightly echogenic enlarged liver

Answer 60

diffuse fatty infiltration

Question 61

w/a | anatomic variant seen in women

Answer 61

reidels lobe

Question 62

w/a | nodular liver with irregular contour

Answer 62

cirrhosis

Question 63

w/a | anechoic, smooth walls, posterior enhancement

Answer 63

simple cyst

Question 64

w/a | daughter cyst

Answer 64

hydatid disease