Abdominal Ultrasound- Liver

Front 1

Where is the bare area of the liver located?

Back 1

Posterior aspect of right lobe

Front 2

The adult liver weighs?

Back 2

1200-1600 grams

Front 3

Using the mid-clavicular measurement the normal liver should not exceed?

Back 3

16cm

Front 4

What is Glisson's capsule?

Back 4

Layer of connective tissue surrounding the liver

Front 5

Hepatic veins are (interlobar or intersegmental)?

Back 5

Intersegmental

Front 6

Sagitally, the right hepatic artery lies where in relation to the common bile duct and main portal vein?

Back 6

Circular structure between the CBD and MPV

Front 7

An ALT-SGPT increase can indicate?

Back 7

Hepatocellular Dz., Biliary obstruction

Front 8

An AST-SGOT increase can indicate?

Back 8

Hepatocellular Dz, muscular or skeletal damage

Front 9

Direct Bilirubin increase can indicate?

Back 9

Hepatocellular Dz., biliary tract obstruction

Front 10

Indirect Bilirubin increase can indicate?

Back 10

Hepatocellular Dz, or disorders causing increased in red blood cell hemolysis

Front 11

What is the most specific indicator for biliary obstruction?

Back 11

ALP (alkaline phosphatase)

Front 12

An increase in AFP is present in 50% of patients with?

Back 12

Hepatomas or hepatoblastomas

Front 13

What is diffuse hepatocellular disease?

Back 13

Disease which affects the hepatocytes of the liver and interferes with liver function

Front 14

What are some types of Diffuse Liver Dz.?

Back 14

Fatty Liver, Hepatitis, Glycogen's Storage Dz, Cirrhosis

Front 15

Describe Fatty Liver Infiltration

Back 15

Required, reversible dz. which results in excess accumulation of triglycerides in the liver cells

Front 16

Focal fatty sparring is commonly seen where anatomically?

Back 16

Anterior to the gallbladder

Front 17

Describe Glycogen Storage Dz.

Back 17

Autosomal recessive disorder causing excess glycogen accumulation

Front 18

Glycogen storage dz is commonly associated with what liver mass?

Back 18

Adenomas

Front 19

Describe Hepatitis

Back 19

Inflammation of the liver due to alcohol abuse, medication or viral infection

Front 20

How is Hepatitis A spread?

Back 20

Oral-fecal route

Front 21

How does Hep B & C spread?

Back 21

Via blood pathways or exposure to body fluids containing blood

Front 22

Describe the AST-SGOT and ALT-SGPT lab values with Hepatitis

Back 22

Marked increase in values which fall rapidly over several days

Front 23

The "starry sky" appearance is commonly seen with acute or chronic hepatitis? WHy?

Back 23

Acute. Due to the fact that the liver echogenicity decreases so the portal triads stand out more

Front 24

Describe the sonographic findings of chronic hepatitis

Back 24

Increased liver echogenicity, coarse texture, decreased echogenicity of portal triads, portal HTN

Front 25

Describe liver Cirrhosis

Back 25

Fibrosis, scarring and parenchymal necrosis of liver tissue with disorganized nodular regeneration

Front 26

Which liver lobe enlarges with Cirrhosis?

Back 26

Caudate

Front 27

What are some predisposing factors for hepatocellular carcinoma?

Back 27

Liver Cirrhosis and Hepatitis B

Front 28

What is the most common cause of portal HTN?

Back 28

Cirrhosis

Front 29

What is Budd Chiari Syndrome

Back 29

Thrombotic dz of the IVC and hepatic veins

Front 30

The main portal vein should not exceed __ in diameter?

Back 30

13mm

Front 31

What does TIPS stand for?

Back 31

Transjugular intrahepatic portosystemic shunt

Front 32

What is the the function of TIPS?

Back 32

Allows blood to flow from portal system directly into the hepatic vein

Front 33

What is cavernous transformation?

Back 33

Multiple small vessels at the porta hepatis as a result of recannalization of the thrombosed portal vein

Front 34

What makes a true liver cyst?

Back 34

True liver cysts are congenital and contain an epithelial lining

Front 35

What is a pyogenic abscess?

Back 35

Localized collection of pus and/or debri due to bacterial infection

Front 36

What is the most common bacteria that causes a pyogenic abscess?

Back 36

E. coli

Front 37

What are some lab values that would indicate a pyogenic abscess?

Back 37

Elevated WBC count, elevated LFT, Anemia

Front 38

What is an Amebic abscess?

Back 38

Liver infection most commonly caused by the parasite Entamoeba hystolytic

Front 39

Candidaisis is a fungal/yeast infection commonly seen in ___ patients?

Back 39

Immunocompromised patients

Front 40

How does candidiasis appear on ultrasound?

Back 40

"Wheel within a Wheel" or target sign