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Abdo Pathology > Spleen & portal venous > Flashcards

Spleen & portal venous Flashcards

1
Q

t/f if spleen enlarges so does its splenule

A

true

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2
Q

with splenic rupture, what do you expect to see? (4)

A

fluid LUQ
decreased hematocrit
morisons pouch and pelvis
intraperitoneal hematoma

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3
Q

what do you expect to see with a hematoma?

A

anechoic initially, then echogenicity resembles normal spleen after 24-28 hr

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4
Q

what MIMICS splenomegaly?

A

hematoma

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5
Q

what do you suspect if you see a wedge-shaped mass in the periphery?

A

splenic infarction

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6
Q

splenomegaly considered

A

> 18cm

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7
Q

indications for splenomegaly (8)

A

mononucleosis (infectious reason)
congestion (portal hypertension, portal/spelenic thrombosis)
inflammatory/rheumatologic (sarcoidosis)
neoplasia (hemangioma/met)
infiltrative (lymphoma, gaucher’s disease)
hematologic (leukemia, lymphoma)
Gaucher’s disease

NOT HEMATOMA (mimics)

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8
Q

focal abnormality sizes

A

<1 cm - micronodular
1-3 cm - nodular
>3 cm - focal

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9
Q

non-hodgkins sono app

A

hypoechoic, hypovascular

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10
Q

what is the most common primary malignant nonlymphoid tumour of the spleen

A

hemangiosarcoma

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11
Q

most common cancer that metastises to spleen

A

melanoma

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12
Q

most common primary benign neoplasm

A

hemangioma

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13
Q

hemangioma sono app

A

well defined, focal, solid, echogenic

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14
Q

true splenic cysts (3)

A

congenital
hydatid
peliosis

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15
Q

not true splenic cysts (3)

A

abscesses
hematoma
pseudocyst

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16
Q

MPV should be less than

A

<13mm

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17
Q

left PV size and location

A

longer/smaller

medial/lateral

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18
Q

right PV size and location

A

shorter/wider

anterior/posterior

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19
Q

normal flow is

A

hepatopedal flow

20
Q

if hepatofugal flow is seen, what is most likely?

A

portal hypertension (prob cirrhosis)

21
Q

complications of liver failure (2)

A

hepatic encephalpathy

impaired protein synthesis

22
Q

most important portosystemic anastomoses are (2)

A

gastroesophageal collaterals

esophagel varices

23
Q

main cause of collaterals

A

high portal pressure

24
Q

portal vein hypertension associated with (2)

A

ascites and varices

25
Q

recanalized umbilical vein occures in the presence of (2)

A

cirrhosis

portal hypertension

26
Q

what condition is associated with recanalized umbilical vein?

A

caput medusae

27
Q

what ligament is recanalized umbilical vein assoc with

A

round/lig teres

28
Q

splenomegaly is considered (and severe)

A

> 13 cm, 18cm is severe

29
Q

what does portal vein thrombosis lead to

A

cavernous transformation

30
Q

complications of portal vein thrombosis (3)

A

GI bleed
Ascites
Encephalopathy

31
Q

what does transgular intrahepatic portosystemic shuunt (TIPS connect

A

portal vein with hepatic vein

relieves pressure on abnormal veins

32
Q

what does distal splenorenal shunt connect (DSRS)

A

splenic vein to lt. kidney vein

33
Q

elevation of erythrocytes associated with (2)

A

polycythemia vera

severe diarrhea

34
Q

decrease in erythrocyte associated with (4)

A

internal bleed
hemolytic anemia
hodgkin’s disease
hemangiosarcomas

35
Q

low hemoglobin assoc with (4)

A

cancer
lymphoma
cirrhosis
internal bleed

36
Q

leukocytes elevation assoc with (4)

A

Hemmorrhage
Infection
Malignancy
Leukemia

37
Q

leukocytes decrease assoc with (5)

A 
viral infection
Hypersplenia
Diabetes mellitus
Leukemia
Lymphoma
38
Q

complications splenomegaly (2)

A

hypersplenism

spontaneous rupture

39
Q

gaucher’s disease (5)

A

rare inherited disorder
causes splenomegaly
multiple splenic nodules, fibrosis/infarction

40
Q

SMV runs ____ to SMA and IMV

A

Rt lateral

41
Q

which vessel is blue on US

A

posterior right portal vein because away from transducer

42
Q

sonographic applications for portal system (3)

A

portal vein hypertension
detect tumour invasion
detect thrombosis

43
Q

what is the usual cause of portal hypertension

A

cirrhosis

44
Q

portal pressure above what causes complications (what complications? what is the main complication)

A

> 12 mmHg, varices and ascites (esophageal varices)

45
Q

arterialization of hepatic blood supply

A

with PH, the hepatic arteries will enlarge and become tortuous - aliasing
as portal venous flow to liver decreases, arterial flow increases

46
Q

t/f most causes of portal hypertension cannot be treated

A

true - treatment focuses on preventing/managing complications

Abdo Pathology (24 decks)

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