Part 2 Liver Boards

Front 1

Autosomal Dominant Polycystic Kidney Disease has two types, which one is more common?

Which have longer life expectancy?

What decade of life does it show itself?

Back 1

ADPKD (1) more common.

ADPKD(1)- short arm of chromosome 16, 85-90% of pt’s.

ADPKD(2) - chromosome 4, 10-15%; slower, chronic.

-ADPKD(2) has longer life expectancy than APKD(1).

-4th decade of life

Front 2

ADPK affects the liver by cysts but has no association with?

What part of the liver does it affect when APKD involved?

Most common cause of death for APKD?

Back 2

Portal HTN or liver fibrosis.

Right lobe liver.

Renal failure; both fail at same time.

Front 3

Which is dominant and recessive: APKD and IPKD.

What is the most common cause of liver cell necrosis?

Back 3

-ADPKD- dominant, large cyst.

-IPKD- recessive.

-Viral Hepatitis.

Front 4

What is the incubation time of Hepatitis A, B, C, D, E?

Back 4

Hep A & D: 2-6 weeks

Hep B & C: 2-6 months

Hep E: 2- 9 weeks

Front 5

Which hepatitis is more prevalent in Africa, South America, Asia?

Back 5

Hepatitis E

Front 6

Will Hep A transition to chronic?

Back 6

No.

Front 7

-What hepatitis virus are of the U.S?

-Through needles?

Back 7

Hep A,B,C

Needles: Hep B, C, D

Front 8

This hepatitis is associated with poor socioeconomic conditions, which can lead to epidemics. Can occur in majority of children before 5 years.

Back 8

Hep A

Front 9

This hepatitis is associated with poor socioeconomic conditions, which can lead to epidemics. Can occur in majority of children before 5 years.

Back 9

Hep A

Front 10

Homosexuals, clotting disorders and individuals working with primates increase chance to get which Hepatitis?

Back 10

Hepatitis A

Front 11

Hepatitis A affects children and adults the same?

Back 11

Adults- more signs and symptom problems.

Kids can bounce back

Front 12

This virus most common mode is through sex in U.S and in Asia most common mode is mother to child. Which virus is this?

Back 12

Hepatitis B

Front 13

Acute hepatitis B versus chronic hepatitis B?

Back 13

Acute hepatitis B- serum sickness like syndrome with rash, arthralgia, fatigue, anorexia.

Chronic- lasts more than 6 mo. ongoing anorexia. Elevation of AST,ALT, bilirubin. Can be asymptomatic, considered “healthy carriers.”

Front 14

What is the most common chronic infection in the U.S?

Back 14

Hepatitis C

Front 15

This hepatitis is an RNA that has most common transmission fecal-oral route and similiar to Hep A. Which one?

Back 15

Hepatitis E

Front 16

What is the most common type of liver abscess is caused by?

Back 16

Bacteria. It is called Pyogenic Abscess

Front 17

What causes Pyogenic abscess?

Back 17

Cholangitis, appendicitis, endocarditis, diverticulitis cholecystitis.

Front 18

What causes Pyogenic abscess?

Back 18

Cholangitis, appendicitis, endocarditis, diverticulitis cholecystitis.

Front 19

This finding is usually in hospitalized patients, elderly. Located in right lobe livers associated with bright echogenic focus and distal, dirty shadowing. In newborns or infants relatable to umbilical cord infections.

Back 19

Pyogenic abscess

Front 20

This finding is in the liver. It’s a cyst with a cyst appearance. Pt has been around a lot of livestock recently. Finding?

Back 20

Ecchinococcus

Front 21

This finding is in the liver. It’s a cyst with a cyst appearance. Pt has been around a lot of livestock recently. Finding?

Back 21

Ecchinococcus

Front 22

What strains of echinococcus?

Back 22

E. Granulosa, E. Vogeli, E, multilocularis.

Front 23

This finding is in the liver. It’s a cyst with a cyst appearance. Pt has been around a lot of livestock recently. Finding?

Back 23

Ecchinococcus

Front 24

What strains of echinococcus?

Back 24

E. Granulosus, E. Vogeli, E, multilocularis.

Front 25

Tapeworm that is locally invasive are found in Canada, U.S, Asia. Known of mice and other rodents for this type.

Back 25

E. Multilocularis

Front 26

This finding is found in places of Central America, South America. This host is dogs.

Back 26

E. Vogeli

Front 27

This finding is found in places of Central America, South America. This host is dogs.

Back 27

E. Vogeli

Front 28

This cyst develops from host of sheep, cattle, and horses. Association with dogs. Finding?

Back 28

E. Granulosus

Front 29

This is a watery cyst that has echoes inside- Sandlike appearance.

Back 29

Hydatid cyst

Front 30

Echinococcus is involved in what most common sites?

Back 30

Liver and lung

Front 31

Echinococcus have sx?

Back 31

Asymptomatic, several years later the cyst enlarges. This is when Sx can occur. Abdominal pain, palpable mass in RUQ.

Front 32

Hepatic echinococcus can mimic?

Back 32

Bile duct compressed, cyst fluid in the biliary tree, may mimic recurrent cholelithiasis, biliary obstruction can result in jaundice.

Front 33

Echinococcus increases chances of? (What organ)

Back 33

Cancer (echinoccocus in the liver)

Front 34

This patient has been around a lot of livestock. Scanning the liver and this is the finding. Patient has been experiencing jaundice and epigastric pain.

Back 34

Multiple daughter cyst

Front 35

This patient has been around a lot of livestock. Scanning the liver and this is the finding. Patient has been experiencing jaundice and epigastric pain.

Back 35

Multiple daughter cyst

Front 36

Cyst within a cyst is what sono appearance of what finding?

Back 36

(Echinococcus)

Front 37

Moving membrane in the liver within a large cyst surrounded by fluid. Septations separate. Sono sign?

Back 37

Water lily sign

Front 38

The cantlies line is the landmark for?

Back 38

Main lobar fissure

Front 39

The cantlies line is the landmark for?

Back 39

Main lobar fissure

Front 40

List liver function tests?

Back 40

ALP, bilirubin, AST, ALT, Albumin, Prothrombin time, AFP, Lactic dehydrogenase, Glutamyl transpeptidase

Front 41

The cantlies line is the landmark for?

Back 41

Main lobar fissure

Front 42

List liver function tests?

Back 42

ALP, bilirubin, AST, ALT, Albumin, Prothrombin time, AFP, Lactic dehydrogenase, Glutamyl transpeptidase

Front 43

Large amounts of ALT in the liver, monitor for?

Back 43

Cirrhosis and Hepatitis

Front 44

The cantlies line is the landmark for?

Back 44

Main lobar fissure

Front 45

List liver function tests?

Back 45

ALP, bilirubin, AST, ALT, Albumin, Prothrombin time, AFP, Lactic dehydrogenase, Glutamyl transpeptidase

Front 46

Large amounts of ALT in the liver, monitor for?

Back 46

Cirrhosis and Hepatitis

Front 47

What is the specific indicator for hepatocellular damage??

Back 47

Alanine aminotransferase (ALT)

Front 48

The cantlies line is the landmark for?

Back 48

Main lobar fissure

Front 49

List liver function tests?

Back 49

ALP, bilirubin, AST, ALT, Albumin, Prothrombin time, AFP, Lactic dehydrogenase, Glutamyl transpeptidase

Front 50

Large amounts of ALT in the liver, monitor for?

Back 50

Cirrhosis and Hepatitis

Front 51

What is the specific indicator for hepatocellular damage??

Back 51

Alanine aminotransferase (ALT)

Front 52

This lab is to identify biliary obstruction. It generally excretes with bile. What lab should be evaluated?

Back 52

Alkaline phosphatase (ALP)

Front 53

Bilirubin can be associated with direct or indirect. How to differentiate?

Back 53

direct- liver just needs to be excrete by the kidneys.

Indirect- elevated bilirubin because liver can’t process it or it can’t get into the liver / excessive form.

Front 54

What’s the most sensitive indicator for LFT for alcohol abuse?

Back 54

Glutamyl transpeptidase (GTT or GGTP)

Front 55

What’s the most sensitive indicator for LFT for alcohol abuse?

Back 55

Glutamyl transpeptidase (GTT or GGTP)

Front 56

What is albumin?

Back 56

Protein- controls oncotic pressure in the tissue.

Front 57

This is a branch of the celiac axis that supplies the liver and divides into the GDA and Proper hepatic artery=

Back 57

Common hepatic artery

Front 58

This is a branch of the celiac axis that supplies the liver and divides into the GDA and Proper hepatic artery=

Back 58

Common hepatic artery

Front 59

Branch of the main portal vein that marks the anterior border of the caudate lobe and carries blood from the GI tract to the left lobe.

Back 59

Left portal vein

Front 60

This is a small sac posterior to the stomach and anterior to the pancreas and part of the transverse colon.

Back 60

Lesser sac

Front 61

This is a small sac posterior to the stomach and anterior to the pancreas and part of the transverse colon.

Back 61

Lesser sac

Front 62

This vessel in the liver drains blood from Gi tract to the liver to be processed.

Back 62

Main portal vein

Front 63

Splenic, superior and inferior mesenteric vein unite near head of pancreas.

Back 63

Portal confluence

Front 64

“Fourth” lobe of the liver- medial portion of the left lobe.

Back 64

Quadrate lobe

Front 65

Branch of the main portal vein that carries blood from the GI tract to the right lobe of liver=

Back 65

Right portal vein

Front 66

What’s the terminal end of the falciform ligament?

Back 66

Ligamentum Teres (Round ligament)

Front 67

What spaces form part of the morison pouch?

Back 67

Subhepatic space and subphrenic space.

Front 68

Another name for Morrison pouch?

Back 68

Hepatorenal recess, right subhepatic space.

Front 69

Another name for Morrison pouch?

Back 69

Hepatorenal recess, right subhepatic space.

Front 70

Liver size measurement?

Back 70

12-15 cm length

Front 71

What structure encloses most of the abdominal organs; enclose organs of intraperitoneal.

Back 71

Greater sac

Front 72

This ligament connects the posterior superior surface of the liver to diaphragm.

This ligament connects the liver to the anterior abdominal wall and to the diaphragm.

Back 72

Coronary ligament.

Falciform ligament.

Front 73

The transverse fissure for the ligamentum venosum contains which ligament?

Back 73

Gastrohepatic ligament

Front 74

Portal veins drain which structures?

Back 74

Digestive tract, pancreas, spleen.