Rotation: Ultrasound (Liver And Gallbladder)

Front 1

If the liver has increase in fat then it will have what texture

Back 1

increased echogenicity, sometimes you wont be able to see all the way through the liver

Front 2

Do you have to measure the length width and depth of each lobe of the thyroid
What is the format of writting directions?
What slice do yo measure the length and height?
What slice do you measures the width?

Back 2

yes
L x W x H
Length and height are measured on sagital and width is measured on transverse.

Front 3

When describing the liver what should be included

Back 3

size and if parenchyma is normal

Front 4

When describing the gallbladder what should be included

Back 4

the wall, gallstones, pericholicystic fluid, murphys sign

Front 5

What is the sequence for the abdominal us?

Back 5

transverse pancrease
sagital aorta (prox, mid, dist)
sagital left liver lobe
transverse left liver lobe
transverse right liver lobe
sagital right liver lobe
right kidney
gallbladder
CBD
spleen
left kidney

Front 6

What are the landmarks for the sagital left liver

Back 6

left lateral section
mid section (contains hepatics and left portal)
caudate with IVC underneath

Front 7

Transverse right liver landmarks are

Back 7

dome, hepatics and then portal vein

Front 8

What are the landmarks for the sagital right liver lobe

Back 8

hepatics, mid section, and then the measurement section "liver-kidney interface".

Front 9

What is the Sensitivity and specificity of Us for cholecystitis

Back 9

80 and 80%

Front 10

What is the differential for homogenous hyperechoic liver

Back 10

fatty liver, hemochromatosis, fibrosis, cirhhosis, glycogen storage disease

Front 11

What is the differential for homogenous hypoechoic liver

Back 11

acute liver congestion, amyloidosis, acute hepatitis.

Front 12

What is the ddx for an enlarged liver

Back 12

congested liver, fatty liver, fatty liver hepatitis, fatty liver cirrhosis, diffuse infiltration.

Front 13

What is the ddx for anechoic masses

Back 13

cyst, polycystic kidney disease, hemorrhhage/hematoma, bilioma, abscess, hydatid cyst, hepatitic pelliosis, lipoma, lymphoma, mets, vessels.

Front 14

What is the ddx for hyperechoic liver masses

Back 14

hemangioma, biliary duct hamartomas, regenerative nodules, porphyria, hcc, fnh, mets, abscess, necrosis, focal fat.

Front 15

What is the upper limit of normal for gb size

Back 15

longitudinal 10cm
transverse 4cm

Front 16

What is posterior acoustic enhancement

Back 16

an artifact seen in ultrasound examination. There is an area of increased brightness underneath fluid resulting from the lack of impedance when sound waves pass through fluid and increased echoes from underlying structures.

Front 17

When meauring the CBD do you include the wall

Back 17

no, the lumen only

Front 18

What is a pitfall of comparing the other organs of the abdomen to the liver

Back 18

the liver may be unhealthy and mislead

Front 19

How do you tell if the liver is normal looking

Back 19

there should be echogenic areas surrounding the portal triads

Front 20

What is the ddx for echogenic lesions of liver
7

Back 20

focal fat, hemangioma, adenoma, primary neoplasm, metasistasis, FNH, lipoma

Front 21

When describing the common bile duct what should be included

Back 21

the size

Front 22

Where do you check if you suspect ascites

Back 22

morrisons pouch

Front 23

what size polps come out

Back 23

>1cm

Front 24

When the kidney is a lot darker than the liver what should you suspect

Back 24

fatty liver

Front 25

If you suspect something to be a gallbladder stone what should you check

Back 25

shadow

Front 26

What are the landmarks for left transverse liver

Back 26

dome, hepatic veins and then portal vein.

Front 27

What is the normal gallbladder wall thickness

Back 27

3 mm or less

Front 28

What is the ddx for hypoechoic masses

Back 28

mets, lymphoma, abscess, hematoma, complicated cyst, adenoma, fnh, hcc, lipoma, atypical hemangioma, focal fatty change.blood vessel and bile ducts,

Front 29

how do you tell if a object in the gallbladder is a stone

Back 29

look for a shadow

Front 30

How do you determine if there is hepatomegaly besides increased measured size

Back 30

if there liver goes below the lower pole of the left kidney.

Front 31

What are some findings of a pt with a fatty liver

Back 31

Increased echogenicity, with liver significantly more echogenic than kidney
Increase in size of liver and change in shape as volume of infiltration increases
Posterior acoustic attenuation due to fatty infiltration
Margins of hepatic veins are blurred due to increased refraction and scattering of sound
With increasing infiltration, vessels are pushed apart and hepatic veins take a more curved course

Front 32

More peripheral what runs along with the portal veins

Back 32

the ducts. They are much smaller and if the branches of the portal veins are seen en foss then you will see a much smaller duct adjacent to it

Front 33

What should always be done before stating a patient has nodular surface

Back 33

look at a designated liver edge

Front 34

What is the measurement for portal wedge pressure for portal htn

Back 34

>10mm Hg

Front 35

How do you interpret doppler

Back 35

Red: toward transducer
Blue: away from transducer
Green: high-velocity flow
Color saturation indicates speed
Deep shades: slow flow
Light shades: fast flow

Front 36

What is red

Back 36

towards the transducer

Front 37

What is blue

Back 37

away from transducer

Front 38

What is green

Back 38

high velocity

Front 39

What is dark shades

Back 39

slow flow

Front 40

What is light shade

Back 40

fast speed