Liver -Boards

Front 1

This patient has visited places of Philippines, West Africa and South America, and swam a lot while visiting. Their experiencing stomach issues. (Host could be something of a snail.) What is this finding.

Infections may affect what other organs?

Back 1

Schistosomiasis: Mansoni, Mekongi, japonicum, mekongi, intercalatum, haematobium.

Infection may affect intestines, liver, urinary tract.

Front 2

Where does the adult schistosomes go to?

Back 2

Superior or inferior mesenteric veins

Front 3

Schistosomiasis mansoni, Schistosomiasis Japonicum, Schistosomiasis Haematobium are found in what bodily fluid?

Back 3

Mansoni: in feces

Japonicum: feces and urine

Haematobium: feces and urine

Front 4

Liver fibrosis can lead to?

Back 4

Cirrhosis

Front 5

Liver fibrosis can lead to?

Back 5

Cirrhosis

Front 6

Pt presents with a fever, chills, edema, rash, hepatosplenomegaly, portal venous system also seems abnormal. Pt has recently traveled a lot.

Back 6

Katayama Fever (Serum sickness - like illness)

Front 7

Liver fibrosis can lead to?

Back 7

Cirrhosis

Front 8

Pt presents with a fever, chills, edema, rash, hepatosplenomegaly, portal venous system also seems abnormal. Pt has recently traveled a lot.

Back 8

Katayama Fever (Serum sickness - like illness)

Front 9

What is a manifestation of acute schistosomiasis?

Back 9

Katayama Fever

Front 10

Pt presents with a fever, chills, lethargy, myalgia, edema, rash, hepatosplenomegaly, portal venous system also seems abnormal. Pt has recently traveled a lot.

Back 10

Katayama Fever (Serum sickness - like illness)

Front 11

Schistosomiasis can not only affect the liver but can develop deposits in what organ?

Back 11

Deposits in renal glomeruli and may cause major kidney disease.

Front 12

Schistosomiasis can not only affect the liver but can develop deposits in what organ?

Back 12

Deposits in renal glomeruli and may cause major kidney disease.

Front 13

Why does schistosomiasis cause hepatomegaly and splenomegaly?

Back 13

The size of S. manosoni gets stuck in the presinusoidal sites causing granuloma to form (inflamed tissue). This enlargement of the tissue being inflamed contribute to the liver becoming enlarged.

Front 14

Schistosomiasis can not only affect the liver but can develop deposits in what organ?

Back 14

Deposits in renal glomeruli and may cause major kidney disease.

Front 15

Why does schistosomiasis cause hepatomegaly and splenomegaly?

Back 15

The size of S. manosoni gets stuck in the presinusoidal sites causing granuloma to form (inflamed tissue). This enlargement of the tissue being inflamed contribute to the liver becoming enlarged.

Front 16

How is portal venous system affected with schistosomiasis?

Back 16

The presinusoidal portal block causing portal HTN and portosystemic collateral development at the esophagogastric junction.

Hence causing esophageal varices- pt vomits or spits up blood.

Front 17

Schistosomiasis can not only affect the liver but can develop deposits in what organ?

Back 17

Deposits in renal glomeruli and may cause major kidney disease.

Front 18

Why does schistosomiasis cause hepatomegaly and splenomegaly?

Back 18

The size of S. manosoni gets stuck in the presinusoidal sites causing granuloma to form (inflamed tissue). This enlargement of the tissue being inflamed contribute to the liver becoming enlarged.

Front 19

How is portal venous system affected with schistosomiasis?

Back 19

The presinusoidal portal block causing portal HTN and portosystemic collateral development at the esophagogastric junction.

Hence causing esophageal varices- pt vomits or spits up blood.

Front 20

Liver fibrosis can be developed through fibrotic lesions in the liver from?

Back 20

Schistosomiasis

Front 21

Schistosomiasis can not only affect the liver but can develop deposits in what organ?

Back 21

Deposits in renal glomeruli and may cause major kidney disease.

Front 22

Why does schistosomiasis cause hepatomegaly and splenomegaly?

Back 22

The size of S. manosoni gets stuck in the presinusoidal sites causing granuloma to form (inflamed tissue). This enlargement of the tissue being inflamed contribute to the liver becoming enlarged.

Front 23

How is portal venous system affected with schistosomiasis?

Back 23

The presinusoidal portal block causing portal HTN and portosystemic collateral development at the esophagogastric junction.

Hence causing esophageal varices- pt vomits or spits up blood.

Front 24

Liver fibrosis can be developed through fibrotic lesions in the liver from?

Back 24

Schistosomiasis

Front 25

Cirrhosis of the liver can be developed from nutritional or infectious agents like?

Liver fibrosis can lead to?

Back 25

Hep B and C virus.

Liver fibrosis.

Front 26

Schistosomiasis can not only affect the liver but can develop deposits in what organ?

Back 26

Deposits in renal glomeruli and may cause major kidney disease.

Front 27

Why does schistosomiasis cause hepatomegaly and splenomegaly?

Back 27

The size of S. manosoni gets stuck in the presinusoidal sites causing granuloma to form (inflamed tissue). This enlargement of the tissue being inflamed contribute to the liver becoming enlarged.

Front 28

How is portal venous system affected with schistosomiasis?

Back 28

The presinusoidal portal block causing portal HTN and portosystemic collateral development at the esophagogastric junction.

Hence causing esophageal varices- pt vomits or spits up blood.

Front 29

Liver fibrosis can be developed through fibrotic lesions in the liver from?

Back 29

Schistosomiasis

Front 30

Cirrhosis of the liver can be developed from nutritional or infectious agents like?

Liver fibrosis can lead to?

Back 30

Hep B and C virus.

Cirrhosis

Front 31

Schistosoma Haematobium is found in what organ?

Schistosoma Mansoni is found in what organ?

(2 important in the U.S)

Back 31

S. Haematobium: Urinary bladder (swims up urethra)

S. Mansoni: Gallbladder

They both live in fluid filled cavity.

Front 32

This pt presents with weakness and malaise. They have always been healthy but randomly not feeling well now. They are known to travel a lot, diet consists of seafood. Mainly in areas of Cambodia, Korea, Thailand, Lao.

Back 32

They are biliary hepatic flukes.

Fasciola Hepatica - ingestion of metacercariae on aquatic plants or in water.

Opisthorchis viverrini- ingestion of metacercariae in freshwater fish.

Clonorchis Sinensis: Ingestion of contaminated fish in China, Philippines, Cambodia, Korea.

Signs / Sx takes 25 years- longer period of time.

Front 33

This pt presents with weakness and malaise. They have always been healthy but randomly not feeling well now. They are known to travel a lot, diet consists of seafood. Mainly in areas of Cambodia, Korea, Thailand, Lao.

Back 33

They are biliary hepatic flukes.

Fasciola Hepatica - ingestion of metacercariae on aquatic plants or in water.

Opisthorchis viverrini- ingestion of metacercariae in freshwater fish.

Clonorchis Sinensis: Ingestion of contaminated fish in China, Philippines, Cambodia, Korea.

Signs / Sx takes 25 years- longer period of time.

Front 34

How does Urinary Schistosomiasis affect the body??

Chronic stage of infection is assoc with?

Back 34

Granuloma formation (inflamed tissue) occurs at the lower end of the urethra. So this obstructs urinary flow, backing up of urine. Hydronephrosis or hydroureter is the result.

Chronic stage of infection assoc with scarring and deposition of calcium in the bladder wall.

Colicky abdominal pain, diarrhea, fatigue, inability to perform daily functions, growth retardation.

Front 35

Pt had just got back from traveling internationally and several days into vacation developed a rash. Pt suspected bug bites but it didn’t go away.

Back 35

Swimmers itch: 2-3 days after invasion of schistosomiasis.

Front 36

What are the three stages of schistosomiasis?

Back 36

First stage: 2-3 days of invasion- swimmers itch.

Second stage: acute schistosomiasis (Katayama Fever): Fever, generalize lymphadenopathy, hepatosplenomegaly.

Third stage: chronic schistosomiasis. Intestinal species: all except haeumatobium that Cause hepatosplenomegaly or portal HTN. Intestinal phase: few months after infection or even last for for years. Bloody Diarrhea, colicky abd pain, fatigue, inability to perform daily routine function, growth retardation.

Front 37

What is ascariasis?

Back 37

Parasitic round worm found in soil, fields, bushes. Location: humid, tropics / subtropics. (Pigs can get this.)

Front 38

What is ascariasis?

Back 38

Parasitic round worm found in soil, fields, bushes. Location: humid, tropics / subtropics. (Pigs can get this.)

Front 39

Stage 3 of schistosomiasis; late stage disease cause the liver to??

Back 39

Fibrotic changes to the liver deteriorating it causing onset of ascites, hypoalbuminemia, defects in coagulation.

Front 40

Worldwide, what is the most common deaths of parasites?

Back 40

Schistosomiasis.

Front 41

Of all the parasitic diseases, globally, what is the most deaths?

Back 41

Malaria

Front 42

This infection can be asymptomatic or symptomatic. Usually travelers are victims. If symptomatic: Bloody diarrhea, weight loss, malaise, lower abdominal pain.

Sono appearance: Round oval hypoechoic structure in liver, distal acoustic enhancement, peripheral in location and close to the diaphragm. Absence of prominent walls. Fine level echoes. Suspect?

Back 42

Amebic Abscess (E. Histolytica)

Front 43

This infection can be asymptomatic or symptomatic. Usually travelers are victims. If symptomatic: Bloody diarrhea, weight loss, malaise, lower abdominal pain.

Sono appearance: Round oval hypoechoic structure in liver, distal acoustic enhancement, peripheral in location and close to the diaphragm. Absence of prominent walls. Fine level echoes. Suspect?

Back 43

Amebic Abscess (E. Histolytica)

Front 44

Increased risk of getting Amebic Abscess are?

Amebic Abscess occurs with the liver and what other organs?

Back 44

Men having sex with men.

Liver, lungs, brain. It affects the small and large intestine. (Travels by being carried by the bloodstream)

Front 45

This infection can be asymptomatic or symptomatic. Usually travelers are victims. If symptomatic: Bloody diarrhea, weight loss, malaise, lower abdominal pain.

Sono appearance: Round oval hypoechoic structure in liver, distal acoustic enhancement, peripheral in location and close to the diaphragm. Absence of prominent walls. Fine level echoes. Suspect?

Back 45

Amebic Abscess (E. Histolytica)

Front 46

Increased risk of getting Amebic Abscess are?

Amebic Abscess occurs with the liver and what other organs?

Back 46

Men having sex with men.

Liver, lungs, brain. It affects the small and large intestine.

Front 47

How does someone become a victim of amebic abscess?

What does the liver look like sonographically?

Amebas are usually found ?

Back 47

Ingestion of fecally contaminated food, water, or hands.

Holes in liver parenchyma (dissolves the liver parenchmya), anchovy paste. Amebic liver abscess- hypoechoic echoes and hypoechoic wall surrounds it.

Amebas tend to be near to capsule of the abscess.

Front 48

This infection can be asymptomatic or symptomatic. Usually travelers are victims. If symptomatic: Bloody diarrhea, weight loss, malaise, lower abdominal pain.

Sono appearance: Round oval hypoechoic structure in liver, distal acoustic enhancement, peripheral in location and close to the diaphragm. Absence of prominent walls. Fine level echoes. Suspect?

Back 48

Amebic Abscess (E. Histolytica)

Front 49

Increased risk of getting Amebic Abscess are?

Amebic Abscess occurs with the liver and what other organs?

Back 49

Men having sex with men.

Liver, lungs, brain. It affects the small and large intestine.

Front 50

How does someone become a victim of amebic abscess?

What does it look sonographically?

Amebas are usually found ?

Back 50

Ingestion of fecally contaminated food, water, or hands.

Holes in liver parenchyma (dissolves the liver parenchmya), anchovy paste.

Amebas tend to be near to capsule of the abscess.

Front 51

Is the most common amebic infection asymptomatic or symptomatic?

Back 51

Asymptomatic cyst.

Symptomatic amebic colitis develop 2-6 weeks after ingestion of the infectious cysts.

Front 52

This infection can be asymptomatic or symptomatic. Usually travelers are victims. If symptomatic: Bloody diarrhea, weight loss, malaise, lower abdominal pain.

Sono appearance: Round oval hypoechoic structure in liver, distal acoustic enhancement, peripheral in location and close to the diaphragm. Absence of prominent walls. Fine level echoes. Suspect?

Back 52

Amebic Abscess (E. Histolytica)

Front 53

Increased risk of getting Amebic Abscess are?

Amebic Abscess occurs with the liver and what other organs?

Back 53

Men having sex with men.

Liver, lungs, brain. It affects the small and large intestine.

Front 54

How does someone become a victim of amebic abscess?

What does it look sonographically?

Amebas are usually found ?

Back 54

Ingestion of fecally contaminated food, water, or hands.

Holes in liver parenchyma (dissolves the liver parenchmya), anchovy paste.

Amebas tend to be near to capsule of the abscess.

Front 55

Is the most common amebic infection asymptomatic or symptomatic?

Back 55

Asymptomatic cyst.

Symptomatic amebic colitis develop 2-6 weeks after ingestion of the infectious cysts.

Front 56

For intestinal amebiasis: if the cecum is involved what mimics acute appendicitis

Back 56

Typhlitis- necrotizing inflammation condition of the cecum.

Front 57

This infection can be asymptomatic or symptomatic. Usually travelers are victims. If symptomatic: Bloody diarrhea, weight loss, malaise, lower abdominal pain.

Sono appearance: Round oval hypoechoic structure in liver, distal acoustic enhancement, peripheral in location and close to the diaphragm. Absence of prominent walls. Fine level echoes. Suspect?

Back 57

Amebic Abscess (E. Histolytica)

Front 58

Increased risk of getting Amebic Abscess are?

Amebic Abscess occurs with the liver and what other organs?

Back 58

Men having sex with men.

Liver, lungs, brain. It affects the small and large intestine.

Front 59

How does someone become a victim of amebic abscess?

What does the liver look like sonographically?

Amebas are usually found ?

Back 59

Ingestion of fecally contaminated food, water, or hands.

Holes in liver parenchyma (dissolves the liver parenchmya), anchovy paste.

Amebas tend to be near to capsule of the abscess.

Front 60

Is the most common amebic infection asymptomatic or symptomatic?

Back 60

Asymptomatic cyst.

10% Symptomatic amebic colitis develop 2-6 weeks after ingestion of the infectious cysts.

Front 61

For intestinal amebiasis: if the cecum is involved what mimics acute appendicitis?

Back 61

Typhlitis- necrotizing inflammation condition.

Front 62

What is the most common extraintestinal organ involved with Amebic Abscess?

How many people actually develop amebic liver abscess from infestation?

What is the most frequent complication of amebic liver abscess? (20-30% of patients)

Sx?

Back 62

Liver.

95% develop in first 5 mo from infestation.

Pleural effusion (pleuropulmonary Involvement).

Fever, RUQ pain or radiate to shoulder. Right sided pleural effusion are common.

Front 63

This finding occurs with hospitalized patients. These patients had had a catheter before. Known as the fourth or firth most common cause of nosocomial bloodstream infections in the U.S.

Back 63

Candida

Front 64

This finding occurs with hospitalized patients. These patients had had a catheter before. Known as the fourth or firth most common cause of nosocomial bloodstream infections in the U.S.

Back 64

Candida

Front 65

What’s the most common cause of mucosal candidiasis?

Back 65

Candida albicans

Front 66

This bacteria can be found in the mouth, throat, gut, vaginal, skin, skin. (Overgrowth of yeast).

Back 66

Candidiasis.

Front 67

This bacteria can be found in the mouth, throat, gut, vaginal, skin, skin. (Overgrowth of yeast).

Back 67

Candidiasis.

Front 68

This candida is from perineum and can enter the urinary tract through an in dwelling bladder catheter.

Back 68

Vulvovaginal candidiasis

Front 69

What patients are susceptible to getting candidiasis?

Back 69

Chemo transplant, organ transplant (low immune system) / nosocomial, pt with diabetes, HIV, dentures

Front 70

Pt presents with fever, RUQ pain, hepatomegaly.

Sono appearance:

Visualized peripheral hypoechoic area with an inner echogenic wheel. Central hypoechoic area.

Visualized hyperechoic center and hypoechoic rim.

Back 70

Candidiasis

Front 71

Inpatient has developed a fever, RUQ pain, hepatomegaly. Labs show he has HIV. Has diabetes.

Visualize peripheral hypoechoic area with an inner echogenic wheel. Central hypoechoic area.

Visualize hyperechoic center and hypoechoic rim.

Back 71

Candidiasis

Front 72

What candidiasis is subject when involved with diapered area of infants, under pendulous breast, or on hands constantly in the water or covered by occlusive gloves?

Back 72

Cutaneous candidiasis

Front 73

Pt presents with fever, RUQ pain, hepatomegaly.

Sono appearance:

Visualized peripheral hypoechoic area with an inner echogenic wheel. Central hypoechoic area.

Visualized hyperechoic center and hypoechoic rim.

Back 73

Candidiasis

Front 74

What candidiasis is subject when involved with diapered area of infants, under pendulous breast, or on hands constantly in the water or covered by occlusive gloves?

Back 74

Cutaneous candidiasis

Front 75

Candidiasis findings sono signs are?

Which one is the most common?

Back 75

Wheel within a wheel: peripheral hypoechoic area with inner echogenic wheel and a central hypoechoic area which is liver necrosis.

Bulls eye: hyperechoic center which contains inflammatory cells, and hypoechoic rim.

Hypoechoic lesions most common (Progressive fibrosis)

Hyperechoic lesions- calcifications, old lesions. (Chronic)

Front 76

What can cause portal HTN?

Back 76

Schistosomiasis, cirrhosis, alcoholic hepatitis, peribiliary cyst

Front 77

Schistosomiasis is also called?

Back 77

Bilharzia

Front 78

Fatty liver is synonmous to?

Considered focal or diffuse liver disease?

Back 78

Hepatic steatosis.

Diffuse.

Front 79

This patient may feel tired, RUQ discomfort, increased LFT’s. Pt is overweight, abnormal labs of cholesterol, high blood pressure, high blood glucose, Von Gierks Disease, pregnancy, gastric bypass.

Back 79

Nonalcoholic fatty liver

Front 80

This patient may feel tired, RUQ discomfort, increased LFT’s. Pt is overweight, abnormal labs of cholesterol, high blood pressure, high blood glucose, Von Gierks Disease, pregnancy, gastric bypass.

Back 80

Nonalcoholic fatty liver

Front 81

What is worse to have: Alcoholic Fatty liver disease or non alcohol steatohepatitis?

Back 81

Non alcohol Steatohepatitis is worse to have. Increased LFT.

Front 82

Non alcoholic fatty liver or Nonalcoholic steatohepatitis can be fixed? If so how?

Back 82

Diet change, physical activity, weight loss.

Front 83

What is a precursor to cirrhosis?

What is present with one who binge and chronic drinkers?

Large or small percentage of alcoholics develop alcoholic hepatitis and cirrhosis?

Back 83

Alcoholic hepatitis.

Fatty liver

Much smaller percentage

Front 84

What gender is more susceptible to alcoholic liver injury; men or female?

Back 84

Female, they develop advanced liver disease with substantially less alcohol intake.

Front 85

What gender is more susceptible to alcoholic liver injury; men or female?

Back 85

Female, they develop advanced liver disease with substantially less alcohol intake.

Front 86

What is the major enzyme that is responsible for alcohol metabolism?

Back 86

Dehydrogenase

Front 87

What is alcoholic hepatitis?

Is it reversible?

Back 87

Hepatocyte injury with spotting necrosis. Precursor to development of cirrhosis.

Yes potentially reversible like fatty liver if drinking stopped.

Front 88

Is cirrhosis ever present with alcoholic hepatitis?

Back 88

Yes 50% of patients. Potentially reversible with abstention from drinking yet the repair is hard.

Front 89

Fatty liver has two types? What is the most common?

Back 89

Diffuse (entire organ) and focal (specific location).

Diffuse is most common; most of the liver filled with fat.

Front 90

Focal fatty sparring is usually located??

Back 90

Adjacent to the gallbladder.

(Hypoechoic)

Fat is echogenic.

Front 91

Fatty liver reversible?

Back 91

If caught early, condition is reversible.

Front 92

What are the grades for diffuse fatty liver?

Back 92

Grade 1- The liver is bright echogenic but structures behind the liver like diaphragm and kidney can be seen - hyperechoic.

Grade 2- liver is bright echogenic attenuating occurs in the distal field and most of the kidney can’t be seen.

Grade 3- only superficial part of the liver can be seen ( bright echogenic) remaining is dark because of attenuation of sound by far. (Hypoechoic)

Front 93

Differentiate focal fatty and focal sparing?

Back 93

Focal fatty will be hypoechoic liver with a area that is hyperechoic.

Focal sparing- echogenic liver with a hypoechoic area.

Front 94

Differentiate focal fatty and focal sparing?

Back 94

Focal fatty will be hypoechoic liver with a area that is hyperechoic.

Focal sparing- echogenic liver with a hypoechoic area.

Front 95

Most common leading death by liver disease in U.S?

Second most common?

Back 95

Cirrhosis

Hepatitis

Front 96

What causes cirrhosis?

When macronodular or micronodular visualized what is associated with them?

Back 96

Hepatitis C and alcohol.

Macronodular- Hep C and Cirrhosis.

Micronodular- Alcohol.

Front 97

What causes cirrhosis?

When macronodular or micronodular visualized what is associated with them?

Back 97

Hepatitis C and alcohol.

Macronodular- Hep C and Cirrhosis.

Micronodular- Alcohol.

Front 98

Hepatoma screening consists of??

Back 98

RUQ, evaluating liver capsule with linear probe. Evaluating nodularity on surface of liver.

Front 99

What causes cirrhosis?

When macronodular or micronodular visualized what is associated with them?

Back 99

Hepatitis C and alcohol.

Macronodular- Hep C and Cirrhosis.

Micronodular- Alcohol.

Front 100

Hepatoma screening consists of??

Back 100

RUQ, evaluating liver capsule with linear probe. Evaluating nodularity on surface of liver.

Front 101

What are the following causes of liver cirrhosis?

Back 101

Hep C, Alcohol, Wilson’s disease, Cholangitis, primary biliary cirrhosis, hemochromatosis.

Front 102

What causes cirrhosis?

When macronodular or micronodular visualized what is associated with them?

Back 102

Hepatitis C and alcohol.

Macronodular- Hep C and Cirrhosis.

Micronodular- Alcohol.

Front 103

Hepatoma screening consists of??

Back 103

RUQ, evaluating liver capsule with linear probe. Evaluating nodularity on surface of liver.

Front 104

Causes of cirrhosis?

Back 104

Hep C, Alcohol, Wilson’s disease, Cholangitis, primary biliary cirrhosis, hemochromatosis.

Front 105

What is the term called of excessive copper or excessive iron??

Back 105

Excessive copper- Wilson’s disease.

Excessive iron - Hemochromatosis

Front 106

Is cirrhosis reversible?

Sono appearance texture?

Back 106

No. Chronic injury of the hepatic parenchyma, distortion of vascular bed, hepatocyte necrosis.

Coarse.

Front 107

What is the cirrhosis sequence?

Back 107

Starts with alcohol / hepatitis. (Irreversible chronic injury)

Hepatocyte necrosis, fibrosis, portal HTN, Nodular regeneration (micro or macronodular)

Front 108

What is the cirrhosis sequence?

Back 108

Starts with alcohol / hepatitis. (Irreversible chronic injury)

Hepatocyte necrosis, fibrosis, portal HTN, Nodular regeneration (micro or macronodular)

Front 109

Pt presents with jaundice, fatigue, weight loss, diarrhea. Portal HTN, liver function compromised. Sono- coarse liver, nodularity, signs of portal HTN, increased echogenicity.

Finding?

Back 109

Cirrhosis.

Front 110

What is the cirrhosis sequence?

Back 110

Starts with alcohol / hepatitis. (Irreversible chronic injury)

Hepatocyte necrosis, fibrosis, portal HTN, Nodular regeneration (micro or macronodular)

Front 111

Pt presents with jaundice, fatigue, weight loss, diarrhea. Portal HTN, liver function compromised. Sono- coarse liver, nodularity, signs of portal HTN, increased echogenicity.

Finding?

Back 111

Cirrhosis.

Front 112

There are dilated cutaneous veins around the umbilicus. They are mostly seen in what patients??

Back 112

Caput Medusae; cirrhosis patients.

Front 113

What are the complications and causes of death with cirrhosis?

Back 113

Edema / Ascites- lead to heart failure. infection, hepatic encephalopathy (disease of the brain), massive bleeding (varices), liver failure (End stage liver disease)

Front 114

This is a chronic infection with Hep C is an important risk factor in the progression and acceleration alcoholic liver disease?

Back 114

Alcoholic liver disease.

Front 115

This is a chronic infection with Hep C is an important risk factor in the progression and acceleration alcoholic liver disease?

Back 115

Alcoholic liver disease.

Front 116

Severe alcoholic liver disease with another factor increases five to tenfold. Poorer survival rates.

Back 116

ALD and Hep C.

Front 117

How is cirrhosis sono appearance early versus later stages?

Associations include?

Back 117

Early- Hepatomegaly, hyperechoic, diffuse parenchyma changes.

As it continues to later stages atrophies. Attenuation increases, increased fibrosis, vascular structures not well seen. Assoc with splenomegaly / ascites.

Front 118

What is the caudate lobe to right lobe ratio??

Back 118

Ruling out cirrhosis when knowing ratio.

Less than 0.6 (Normal sized liver)

0.6- 0.65 Borderline

Greater than 0.65 Cirrhotic

Front 119

Normally the caudate lobe is 50% larger or smaller than the right lobe of the liver?

Between the right portal vein and left portal vein, are the diameters the same size?

Back 119

Smaller.

Right portal vein is larger in diameter because the right lobe of the liver is bigger than the left.

Front 120

Normally the caudate lobe is 50% larger or smaller than the right lobe of the liver?

Between the right portal vein and left portal vein, are the diameters the same size?

Back 120

Smaller.

Right portal vein is larger in diameter because the right lobe of the liver is bigger than the left.

Front 121

What are the common collateral pathways?

Back 121

Para-umbilical collateral, gastroesophageal collateral, gastrorenal-splenorenal collateral, pancreatico-duodenal collateral, retroperitoneal paravertebral collateral, hemorrhoidal collaterals

Front 122

Normally the caudate lobe is 50% larger or smaller than the right lobe of the liver?

Between the right portal vein and left portal vein, are the diameters the same size?

Back 122

Smaller.

Right portal vein is larger in diameter because the right lobe of the liver is bigger than the left.

Front 123

What are the common collateral pathways?

Back 123

Para-umbilical collateral, gastroesophageal collateral, gastrorenal-splenorenal collateral, pancreatico-duodenal collateral, retroperitoneal paravertebral collateral, hemorrhoidal collaterals

Front 124

Recanalizatjon of the paraumbilical vein is in the area of which vessels?

Back 124

Area of Left portal vein

Front 125

What are sono findings for cirrhosis?

Back 125

Portal HTN, enlarged caudate lobe and left lobe / small right lobe, coarse pattern, nodularity surface, increased echogenicity, caudate: right lobe ratio > 0.65, LPV and RPV diameter (Normally RPV diameter larger).

Front 126

What separate the right and left lobe of the liver?

Back 126

Falciform ligament

Front 127

What is the threshold for the liver to not work and stop working altogether?

Back 127

70% threshold (upper limit) to stop working.

Front 128

What are the sono findings with portal HTN?

Back 128

Hepatofugal flow- abnormal.

Increased pressure in the portal splenic venous system.

very common with cirrhosis.

Collateral pathways develop, varices, recanalized umbilical vein.

Front 129

The use of a low scale versus high scale.

What is the normal hepatic venous system flow?

Sample volume size should be?

Back 129

Low scale for slow flow.

High scale for fast flow.

Low, therefore lower PRF.

Flow > 40cm/sec increase PRF to avoid aliasing.

Sample volume 1/3 of the vessel diameter.

Front 130

The use of a low scale versus high scale.

What is the normal hepatic venous system flow?

Sample volume size should be?

Back 130

Low scale for slow flow.

High scale for fast flow.

Low, therefore lower PRF.

Flow > 40cm/sec increase PRF to avoid aliasing.

Sample volume 1/3 of the vessel diameter.

Front 131

Portal HTN is associated with what findings in the liver?

Back 131

Ascites, cirrhosis, portosystemic collateral pathways, hepatofugal reverses venous flow, portal vein diameter > 13 mm, splenic and SMV diameter > 10 mm, lack of normal respiratory changes in diameter of splenic and superior mesenteric veins, coronary vein diameter >5mm.

Front 132

With low resistance and high resistance what is the flow rate?

With right sided heart failure, how do the hepatic veins appear?

Back 132

Low resistance waveform- high flow rate. (It gets to vital organs)

High resistive waveform- low flow rate.

Hepatic veins will be dilated and pulsatile.

Front 133

With low resistance and high resistance what is the flow rate?

With right sided heart failure, how do the hepatic veins appear?

Back 133

Low resistance waveform- high flow rate. (It gets to vital organs)

High resistive waveform- low flow rate.

Hepatic veins will be dilated and pulsatile.

Front 134

What would cause the IVC waveform to have a monophasic with high velocities (choppy appearance)?

Back 134

Thrombosis in IVC.

Eval for thrombus in renal veins as well.

Front 135

With low resistance and high resistance what is the flow rate?

With right sided heart failure, how do the hepatic veins appear?

Back 135

Low resistance waveform- high flow rate. (It gets to vital organs)

High resistive waveform- low flow rate.

Hepatic veins will be dilated and pulsatile.

Front 136

What would cause the IVC waveform to have a monophasic with high velocities (choppy appearance)?

This finding would further Eval what other structure?

Back 136

Thrombosis in IVC.

Eval for thrombus in renal veins as well.

Front 137

Near the porta hepatis, there is visual of multiple vascular channels. This occurrence can be near the splenic hilum to. What is this finding?

What else should be evaluated?

Back 137

Cavernous transformation; look for a recannalized umbilical vein.

Front 138

PV > 1.3 cm, Hepatofugal flow, recanalize umbilical vein =

Back 138

Portal HTN

Front 139

PV > 1.3 cm, Hepatofugal flow, recanalize umbilical vein =

Back 139

Portal HTN

Front 140

What is TIPS?

Back 140

Treatment for portal HTN.

Transjugular intrahepatic portosystemic shunt; Right portal vein to Right or middle hepatic vein to bypass liver to the IVC.

*(RPV to RHV)

Front 141

What is Budd Chiari Syndrome?

Sx?

Sono finding?

Back 141

Occlusion or narrowing of the hepatic veins or the IVC. It can be one or the other or both.

Sx- abdominal pain, massive ascites, hepatomegaly.

Caudate lobe enlarged, atrophy of right lobe liver and enlarged hepatic veins.

Front 142

What is Budd Chiari Syndrome?

Sx?

Sono finding?

Back 142

Occlusion or narrowing of the hepatic veins or the IVC. It can be one or the other or both.

Sx- abdominal pain, massive ascites, hepatomegaly.

Caudate lobe enlarged, atrophy of right lobe liver and enlarged hepatic veins.

Front 143

Budd chiari syndrome is secondary to?

Back 143

Birth control pills, chemo, cancers, pregnancy, tumor invasion of HCC

Front 144

What is Budd Chiari Syndrome?

Sx?

Sono finding?

Back 144

Occlusion or narrowing of the hepatic veins or the IVC. It can be one or the other or both.

Sx- abdominal pain, massive ascites, hepatomegaly.

Caudate lobe enlarged, atrophy of right lobe liver and enlarged hepatic veins.

Front 145

Budd chiari syndrome is secondary to?

Back 145

Birth control pills, chemo, cancers, pregnancy, tumor invasion of HCC

Front 146

Hematoma is?

Sono appearance?

Back 146

Hemorrhage: Bruise.

Can cause weakness / tender.

Depends on age; fresh blood- anechoic.

Front 147

What is Budd Chiari Syndrome?

Sx?

Sono finding?

Back 147

Occlusion or narrowing of the hepatic veins or the IVC. It can be one or the other or both.

Sx- abdominal pain, massive ascites, hepatomegaly.

Caudate lobe enlarged, atrophy of right lobe liver and enlarged hepatic veins.

Front 148

Budd chiari syndrome is secondary to?

Back 148

Birth control pills, chemo, cancers, pregnancy, tumor invasion of HCC

Front 149

Hematoma is?

Sono appearance?

Back 149

Hemorrhage: Bruise.

Can cause weakness / tender.

Depends on age; fresh blood- anechoic.

Front 150

What’s a neoplasm?

Are they benign or malignant?

Back 150

New growth.

Benign are most common in neonates and infants.

Malignant are more common with older children and adults.

Front 151

What are benign neoplasms?

Back 151

Cavernous Hemangioma (1)

Focal Nodular Hyperplasia (2)

Adenoma (3)

Front 152

What are benign neoplasms?

Back 152

Cavernous Hemangioma (1)

Focal Nodular Hyperplasia (2)

Adenoma (3)

Front 153

This benign neoplasm is the most common tumor of the liver. Avascular, asymptomatic, incidental finding, increased frequency with age. Finding?

Back 153

Cavernous Hemangioma

Front 154

What are benign neoplasms?

Back 154

Cavernous Hemangioma (1)

Focal Nodular Hyperplasia (2)

Adenoma (3)

Front 155

This benign neoplasm is the most common tumor of the liver. Avascular, asymptomatic, incidental finding, increased frequency with age. Finding?

Back 155

Cavernous Hemangioma

Front 156

Cavernous hemangioma sono appearance?

Size?

Back 156

Round, hyperechoic lesion, hypoechoic but also hypoechoic and complex. < 3cm

Front 157

What are benign neoplasms?

Back 157

Cavernous Hemangioma (1)

Focal Nodular Hyperplasia (2)

Adenoma (3)

Front 158

This benign neoplasm is the most common tumor of the liver. Avascular, asymptomatic, incidental finding, increased frequency with age. Finding?

Back 158

Cavernous Hemangioma

Front 159

Cavernous hemangioma sono appearance?

Size?

Back 159

Round, hyperechoic lesion, hypoechoic but also hypoechoic and complex. < 3cm

Front 160

What’s the second most common benign tumor of liver?

Back 160

Focal Nodular hyperplasia

Front 161

What are benign neoplasms?

Back 161

Cavernous Hemangioma (1)

Focal Nodular Hyperplasia (2)

Adenoma (3)

Front 162

This benign neoplasm is the most common tumor of the liver. Avascular, asymptomatic, incidental finding, increased frequency with age. Finding?

Back 162

Cavernous Hemangioma

Front 163

Cavernous hemangioma sono appearance?

Size?

Back 163

Round, hyperechoic lesion, hypoechoic but also hypoechoic and complex. < 3cm

Front 164

What’s the second most common benign tumor of liver?

Back 164

Focal Nodular hyperplasia

Front 165

This is most common in women under 40yo, focal scar; radiating star like, Hypervascular, asymptomatic.

Back 165

Focal Nodular hyperplasia

Front 166

What are benign neoplasms?

Back 166

Cavernous Hemangioma (1)

Focal Nodular Hyperplasia (2)

Adenoma (3)

Front 167

This benign neoplasm is the most common tumor of the liver. Avascular, asymptomatic, incidental finding, increased frequency with age. Finding?

Back 167

Cavernous Hemangioma

Front 168

Cavernous hemangioma sono appearance?

Size?

Back 168

Round, hyperechoic lesion, hypoechoic but also hypoechoic and complex. < 3cm

Front 169

What’s the second most common benign tumor of liver?

Back 169

Focal Nodular hyperplasia

Front 170

This is most common in women under 40yo, focal scar; radiating star like, Hypervascular, asymptomatic.

Back 170

Focal Nodular hyperplasia

Front 171

What is the sono appearance for Spoke wheel appearance, coin sign?

Back 171

Spoke wheel- FNH

Coin sign- Hemangioma

Front 172

What are benign neoplasms?

Back 172

Cavernous Hemangioma (1)

Focal Nodular Hyperplasia (2)

Adenoma (3)

Front 173

This benign neoplasm is the most common tumor of the liver. Avascular, asymptomatic, incidental finding, increased frequency with age. Finding?

Back 173

Cavernous Hemangioma

Front 174

Cavernous hemangioma sono appearance?

Size?

Back 174

Round, hyperechoic lesion, hypoechoic but also hypoechoic and complex. < 3cm

Front 175

What’s the second most common benign tumor of liver?

Back 175

Focal Nodular hyperplasia

Front 176

This is most common in women under 40yo, focal scar; radiating star like, Hypervascular, asymptomatic.

Back 176

Focal Nodular hyperplasia

Front 177

What is the sono appearance for Spoke wheel appearance, coin sign?

Back 177

Spoke wheel- FNH

Coin sign- Hemangioma

Front 178

This is most common in childbearing ages, third common. Small potential becoming malignant. Encapsulated, identifiable margins. Linked to tuberscerlosis.

Back 178

Hepatic adenoma

Front 179

What are benign neoplasms?

Back 179

Cavernous Hemangioma (1)

Focal Nodular Hyperplasia (2)

Adenoma (3)

Front 180

This benign neoplasm is the most common tumor of the liver. Avascular, asymptomatic, incidental finding, increased frequency with age. Finding?

Back 180

Cavernous Hemangioma

Front 181

Cavernous hemangioma sono appearance?

Size?

Back 181

Round, hyperechoic lesion, hypoechoic but also hypoechoic and complex. < 3cm

Front 182

What’s the second most common benign tumor of liver?

Back 182

Focal Nodular hyperplasia

Front 183

This is most common in women under 40yo, focal scar; radiating star like, Hypervascular, asymptomatic.

Back 183

Focal Nodular hyperplasia

Front 184

What is the sono appearance for Spoke wheel appearance, coin sign?

Back 184

Spoke wheel- FNH

Coin sign- Hemangioma

Front 185

This is most common in childbearing ages, third common. Small potential becoming malignant. Encapsulated, identifiable margins. Linked to tuberscerlosis.

Back 185

Hepatic adenoma

Front 186

This neoplasm increases with use of oral contraceptives and has a high risk for bleeding and rupture.

Back 186

Hepatic adenoma

Front 187

Focal Nodular hyperplasia plasma sono appearance?

Back 187

Well circumscribed, hypoechoic, or hyperechoic mass. Focal scar, radiating star. Hypervascular.

Front 188

Focal Nodular hyperplasia sono appearance?

Back 188

Well circumscribed, hypoechoic, or hyperechoic mass. Focal scar, radiating star. Hypervascular.

Front 189

Hepatic adenoma sono appearance?

Back 189

Solid and hypoechoic versus hyperechoic, isoechoic or mixed echogenicities. More vascular, may hemorrhage. If blood in peritoneum (adenoma ruptured)

Front 190

What’s the risk of hematoma?

Back 190

Trauma, surgery. (Arteriovenous fistula)

Front 191

What’s the risk of hematoma?

Back 191

Trauma, surgery. (Arteriovenous fistula)

Front 192

What is lipoma?

Back 192

Fat; Asymptomatic- Hyperechoic mass. Has edge refraction.

Front 193

What are malignant neoplasms?

Back 193

Hepatoma (HCC), metastases (mets), primary hepatic tumor, hepatoblastoma (children).

Front 194

What are malignant neoplasms?

Back 194

Hepatoma (HCC), metastases (mets), primary hepatic tumor, hepatoblastoma (children).

Front 195

When one has a malignant neoplasm; clinical findings include?

Back 195

Jaundice, weight loss, hepatomegaly, palpable mass, ascites, portal HTN, splenomegaly.

Front 196

What are malignant neoplasms?

Back 196

Hepatoma (HCC), metastases (mets), primary hepatic tumor, hepatoblastoma (children).

Front 197

When one has a malignant neoplasm; clinical findings include?

Back 197

Jaundice, weight loss, hepatomegaly, palpable mass, ascites, portal HTN, splenomegaly.

Front 198

What is the primary malignancy of the liver?

Back 198

Hepatoma (Hepatocellular carcinoma)

Front 199

What are malignant neoplasms?

Back 199

Hepatoma (HCC), metastases (mets), primary hepatic tumor, hepatoblastoma (children).

Front 200

When one has a malignant neoplasm; clinical findings include?

Back 200

Jaundice, weight loss, hepatomegaly, palpable mass, ascites, portal HTN, splenomegaly.

Front 201

What is the primary malignancy of the liver?

Back 201

Hepatoma (Hepatocellular carcinoma)

Front 202

What is the most common Malignancy of the liver?

Back 202

Metastases (primary site elsewhere).

Front 203

What are malignant neoplasms?

Back 203

Hepatoma (HCC), metastases (mets), primary hepatic tumor, hepatoblastoma (children).

Front 204

When one has a malignant neoplasm; clinical findings include?

Back 204

Jaundice, weight loss, hepatomegaly, palpable mass, ascites, portal HTN, splenomegaly.

Front 205

What is the primary malignancy of the liver?

Back 205

Hepatoma (Hepatocellular carcinoma)

Front 206

What is the most common Malignancy of the liver?

Back 206

Metastases (primary site elsewhere).

Front 207

This neoplasm causes RUQ pain, palpable mass, rapid liver enlargement, fever. Diffuse. Appearance range: large / small / circumscribed, isoechoic to hyperechoic.

Back 207

Hepatoma (HCC)

Front 208

What are malignant neoplasms?

Back 208

Hepatoma (HCC), metastases (mets), primary hepatic tumor, hepatoblastoma (children).

Front 209

When one has a malignant neoplasm; clinical Sx and findings include?

Back 209

Jaundice, weight loss, hepatomegaly, palpable mass, ascites, portal HTN, splenomegaly.

Front 210

What is the primary malignancy of the liver?

Back 210

Hepatoma (Hepatocellular carcinoma)

Front 211

What is the most common Malignancy of the liver?

Back 211

Metastases (primary site elsewhere).

Front 212

This neoplasm causes RUQ pain, palpable mass, rapid liver enlargement, fever. Diffuse. Appearance range: large / small / circumscribed, isoechoic to hyperechoic.

Back 212

Hepatoma (HCC)

Front 213

This is most common 4, 5th decade of life, RUQ pain, wt loss, hx of Hep C. AFP (marker)

Back 213

HCC

Front 214

Hx of Hep B, Hep C, alcohol abuse, chronic hepatitis, cirrhosis and wt loss and RUQ pain. 50-60 yo and sometimes referred to 4,5 decade of life.

Back 214

HCC

Front 215

Where does metastases lesion rose from? (Primary set elsewhere)

Asymptomatic?

What does Multiple nodules suggest?

Back 215

GI (colon), breast (females), lungs (male).

Asymptomatic until lesion gets larger.

Seeding.

Front 216

Where does metastases lesion rise from? (Primary set elsewhere)

Asymptomatic?

What does Multiple nodules suggest?

Back 216

GI (colon), breast (females), lungs (male).

Asymptomatic until lesion gets larger.

Seeding.

Front 217

Sono appearance for mets in the lungs or colon?

Lymphoma?

Back 217

Lungs / colon: target appearance and halo around mets.

Hypoechoic lesions.

Front 218

What is hemangioendothelioma?

It may cause?

Back 218

Most common benign childhood tumor.

Hepatomegaly and have hemangiomas of the skin.

Front 219

What is hemangioendothelioma?

It may cause?

Back 219

Most common benign childhood tumor.

Hepatomegaly and have hemangiomas of the skin.

Front 220

What is the most common malignant liver tumor in children under 5 years old?

Back 220

Hepatoblastoma

Front 221

What is hemangioendothelioma?

It may cause?

Back 221

Most common benign childhood tumor.

Hepatomegaly and have hemangiomas of the skin.

Front 222

What is the most common malignant liver tumor in children under 5 years old?

Back 222

Hepatoblastoma

Front 223

This tumor is linked with Beckwith Wiedemann syndrome- occurs in first three years of life, more common in boys, affects right lobe liver usually. Malignant mass; AFP is high.

Back 223

Hepatoblastoma

Front 224

What is hemangioendothelioma?

It may cause?

Back 224

Most common benign childhood tumor.

Hepatomegaly and have hemangiomas of the skin.

Front 225

What is the most common malignant liver tumor in children under 5 years old?

Back 225

Hepatoblastoma

Front 226

This tumor is linked with Beckwith Wiedemann syndrome- occurs in first three years of life, more common in boys, affects right lobe liver usually. Malignant mass; AFP is high.

Back 226

Hepatoblastoma

Front 227

2 year male ultrasound findings: hepatomegaly, palpable abdominal mass. Hyperechoic pattern, anechoic foci, dense or coarse calcifications which cause shadow.

Sx- fever, nausea, jaundice, bone fx from mets, wt loss.

AFP high.

Back 227

Hepatoblastoma

Front 228

This occurs mostly in females, asymptomatic. Clinical finding: fever, RUQ pain. Cyst follow FAWDE. In addition, Cysts can be seen parallel to bile duct and portal vein as well.

Back 228

Liver cyst and parallel to bile duct and portal vein (Peribiliary cyst)

Front 229

This occurs mostly in females, asymptomatic. Clinical finding: fever, RUQ pain. Cyst follow FAWDE. In addition, Cysts can be seen parallel to bile duct and portal vein as well.

Back 229

Liver cyst and parallel to bile duct and portal vein (Peribiliary cyst)

Front 230

This occurs most commonly in the right lobe of liver. Multiple cysts do not connect to each other.

Sx- Abdominal / flank pain, hematuria, UTI, nephrolithiasis, large palpable kidneys.

Back 230

APKD

Front 231

This occurs mostly in females, asymptomatic. Clinical finding: fever, RUQ pain. Cyst follow FAWDE. In addition, Cysts can be seen parallel to bile duct and portal vein as well.

Back 231

Liver cyst and parallel to bile duct and portal vein (Peribiliary cyst)

Front 232

This occurs most commonly in the right lobe of liver. Multiple cysts do not connect to each other.

Sx- Abdominal / flank pain, hematuria, UTI, nephrolithiasis, large palpable kidneys.

Back 232

APKD

Front 233

Enlarged kidneys, Bright echogenic cyst <2mm. May appear to be web like.

Assoc with renal failure.

Back 233

IPKD

Front 234

This occurs mostly in females, asymptomatic. Clinical finding: fever, RUQ pain. Cyst follow FAWDE. In addition, Cysts can be seen parallel to bile duct and portal vein as well.

Back 234

Liver cyst and parallel to bile duct and portal vein (Peribiliary cyst)

Front 235

This occurs most commonly in the right lobe of liver. Multiple cysts do not connect to each other.

Sx- Abdominal / flank pain, hematuria, UTI, nephrolithiasis, large palpable kidneys.

Back 235

APKD

Front 236

Enlarged kidneys, Bright echogenic cyst <2mm. May appear to be web like.

Back 236

IPKD

Front 237

What is Biliary Hamartoma?

Linked to?

Mistaken for?

Also referred by another name?

Sono appearance:

Back 237

Von meyenburg Complex;

Linked with APKD, congenital hepatic fibrosis, cholangiocarcinoma, HCC. Asymptomatic. Mistaken for mets sometimes. Hyper or hypoechoic well defined nodule or dilated biliary duct in the liver with distal comet tail artifact.

Front 238

What is Hepatitis?

Back 238

Acute viral hepatitis: malaise, low grade fever, LFT’s elevated, dark urine, jaundice.

Chronic viral hepatitis: asymptomatic usually incidental finding.

Hep A-E

Front 239

What is Hepatitis?

Back 239

Acute viral hepatitis: malaise, low grade fever, LFT’s elevated, dark urine, jaundice.

Chronic viral hepatitis: asymptomatic usually incidental finding.

Hep A-E

Front 240

Most common cause of e-coli?

Back 240

Pyogenic abscess.

Front 241

What is Hepatitis?

Back 241

Acute viral hepatitis: malaise, low grade fever, LFT’s elevated, dark urine, jaundice.

Chronic viral hepatitis: asymptomatic usually incidental finding.

Hep A-E

Front 242

Most common cause of e-coli?

Back 242

Pyogenic abscess.

Front 243

Pyogenic abscess usually occur where?

Sx?

Sono appearance?

Back 243

Right lobe liver.

Abdominal pain, fever, nausea, high WBC.

Complex with dirty shadowing, well encapsulated, irregular walls, debris present, increased vascularity,

Front 244

What is viral Hepatitis?

Back 244

Acute viral hepatitis: malaise, low grade fever, LFT’s elevated, dark urine, jaundice.

Chronic viral hepatitis: asymptomatic usually incidental finding.

Hep A-E

Front 245

Most common cause of e-coli?

Back 245

Pyogenic abscess.

Front 246

Pyogenic abscess usually occur where?

Sx?

Sono appearance?

Back 246

Right lobe liver.

Abdominal pain, fever, nausea, high WBC.

Complex with dirty shadowing, well encapsulated, irregular walls, debris present, increased vascularity,

Front 247

Sono appearance to all hepatitis? (Acute, Chronic, Late chronic)

Back 247

Acute- liver enlarge, hypoechoic, increased vascularity with prominent portal vein wall- Sono sign: starry night.

Chronic- liver enlarged, hyperechoic, liver appearance clear and East to identify. Sono sign: ground glass.

Late chronic: liver shrinks, hyperechoic, calcifications night he seen over liver parenchmya.

Front 248

What is Hepatitis?

Back 248

Acute viral hepatitis: malaise, low grade fever, LFT’s elevated, dark urine, jaundice.

Chronic viral hepatitis: asymptomatic usually incidental finding.

Hep A-E

Front 249

Most common cause of e-coli?

Back 249

Pyogenic abscess.

Front 250

Pyogenic abscess usually occur where?

Sx?

Sono appearance?

Back 250

Right lobe liver.

Abdominal pain, fever, nausea, high WBC.

Complex with dirty shadowing, well encapsulated, irregular walls, debris present, increased vascularity,

Front 251

Sono appearance to all hepatitis? (Acute, Chronic, Late chronic)

Back 251

Acute- liver enlarge, hypoechoic, increased vascularity with prominent portal vein wall- Sono sign: starry night.

Chronic- liver enlarged, hyperechoic, liver appearance clear and East to identify. Sono sign: ground glass.

Late chronic: liver shrinks, hyperechoic, calcifications night he seen over liver parenchmya.

Front 252

Hep B strongly linked to?

Back 252

HCC.

(Hep B linked to cirrhosis that is linked to HCC)

Front 253

What is Hepatitis?

Back 253

Acute viral hepatitis: malaise, low grade fever, LFT’s elevated, dark urine, jaundice.

Chronic viral hepatitis: asymptomatic usually incidental finding.

Hep A-E

Front 254

Most common cause of e-coli?

Back 254

Pyogenic abscess.

Front 255

Pyogenic abscess usually occur where?

Sx?

Sono appearance?

Back 255

Right lobe liver.

Abdominal pain, fever, nausea, high WBC.

Complex with dirty shadowing, well encapsulated, irregular walls, debris present, increased vascularity,

Front 256

Sono appearance to all hepatitis? (Acute, Chronic, Late chronic)

Back 256

Acute- liver enlarge, hypoechoic, increased vascularity with prominent portal vein wall- Sono sign: starry night.

Chronic- liver enlarged, hyperechoic, liver appearance clear and East to identify. Sono sign: ground glass.

Late chronic: liver shrinks, hyperechoic, calcifications night he seen over liver parenchmya.

Front 257

Hep B strongly linked to?

Back 257

HCC.

(Hep B linked to cirrhosis that is linked to HCC)

Front 258

Hep D is dependent on which hepatitis?

Hep C symptomatic or Asymptomatic?

Back 258

Hep B.

Asymptomatic

Front 259

What is acute viral and chronic viral Hepatitis symptoms?

Back 259

Acute viral hepatitis: malaise, low grade fever, LFT’s elevated, dark urine, jaundice.

Chronic viral hepatitis: asymptomatic usually incidental finding.

Front 260

Most common cause of e-coli?

Back 260

Pyogenic abscess.

Front 261

Pyogenic abscess usually occur where?

Sx?

Sono appearance?

Back 261

Right lobe liver.

Abdominal pain, fever, nausea, high WBC.

Complex with dirty shadowing, well encapsulated, irregular walls, debris present, increased vascularity,

Front 262

Sono appearance to all hepatitis? (Acute, Chronic, Late chronic)

Back 262

Acute- liver enlarge, hypoechoic, increased vascularity with prominent portal vein wall- Sono sign: starry night.

Chronic- liver enlarged, hyperechoic, liver appearance clear and East to identify. Sono sign: ground glass.

Late chronic: liver shrinks, hyperechoic, calcifications night he seen over liver parenchmya.

Front 263

Hep B strongly linked to?

Back 263

HCC.

(Hep B linked to cirrhosis that is linked to HCC)

Front 264

Hep D is dependent on which hepatitis?

Hep C symptomatic or Asymptomatic?

Back 264

Hep B.

Asymptomatic

Front 265

Explain Hep B Hepatitis?

Back 265

Acute- serum sickness like syndrome with arthralgia, rash, fatigue, anorexia,jaundice, elevated ALT.

Chronic- ongoing anorexia, wt loss, fatigue, ALT/AST/bilirubin/PT elevated, decreasing liver size, signs of encephalopathy

Front 266

How does one get amebic abscess?

Back 266

Ingesting contaminated food or water that have feces.

Front 267

What liver pathology looks similar to mets?

Back 267

Biliary hamartoma (Von Meyenburg Complex)

Front 268

Viral hepatitis: which labs are elevated?

Back 268

Acute: ALT is higher than AST.

Chronic: Fluctuations in ALT