Rad Pathology - Exam 4

What is the hepatobiliary system composed of?

- Liver
- Gallbladder
- Biliary tree

Which quadrant of the abdomen is the liver in?

RUQ

What are the 2 minor lobes of the liver called?

- Caudate
- Quadrate

What is the role of the liver?

- Metabolize substances
- Synthesize substances
- Store Vitamin B
- Detoxify and excrete various substances

A system of ducts that act to drain bile produced by the lover into the duodenum

Biliary Tree

What forms the common bile duct?

- Cystic duct
- Common hepatic duct

A pear shaped digestive organ that is located on the right lobe of the liver

Gallbladder

What is the function of the gallbladder?

To store and concentrate bile that has been produced in the liver

Which duct transports bile from the liver to the gallbladder?

Hepatic duct

What is the exocrine function of the pancreas?

The production of 3 digestive organs

What are the 3 digestive organs produced by the pancreas?

- Trypsin
- Amylase
- Lipase

What does the endocrine portion of the pancreas consist of?

Multiple clusters of specialized cells; termed the islets of Langerhans

What makes up a gallstone?

- Cholesterol
- Bile pigment (bilirubin)
- Calcium salts

Another term for gas in the biliary tree

Pneumobilia

Abnormal enlargement of the liver

Hepatomegaly

Which type of jaundice is caused by hepatocellular dysfunction?

Medical

Which type of jaundice results from biliary obstruction?

Surgical/Obstructive

Which modality is the primary choice for imaging the gallbladder?

Sonography

Chronic alcohol abuse often leads to what disease?

Fatty liver

Which modality is the primary choice for imaging fatty liver?

CT

What can fatty liver lead to?

Alcoholic hepatitis

What is another term for fatty liver disease?

Hepatic steatosis

T/F? Fatty liver disease is only caused by alcohol?

False

Chronic liver condition resulting when the liver parenchyma and architecture are destroyed, fibrous tissue is laid down, and regenerative nodules are formed in attempts to repair damages

Cirrhosis

What causes cirrhosis?

- Chronic alcohol abuse
- Drugs
- Autoimmune disorders
- Chronic hepatitis
- Cardiac problems
- Chronic biliary tract obstruction

What is the 11th leading cause of death in the US?

Cirrhosis

The accumulation fluid within the peritoneal cavity

Ascites

What causes ascites?

- Portal hypertension
- Leakage of excessive fluids from the portal capillaries

Which modality is commonly used to confirm acites?

Abdominal sonography

What is the most characteristic finding of cirrhosis?

Increase in the ratio of the caudate lobe and the right lobe

Portal hypertension causes blood to flow which way in the hepatobiliary system?

Blood flows away from the liver

Common liver condition, with an estimated 70,000 cases per year

Hepatitis

What is the main cause of hepatitis?

Viral infections

What does hepatitis prevent?

The liver's ability to excrete bilirubin

What is another term for gallstones?

Cholelithiasis

How many people have gallstones?

At least 20% of people develop them by the age 65

Who is more likely to get gallstones?

Females

The presence of stones in the common bile duct is termed?

Choledocholithiasis

What are the 2 main types of stones?

- Cholesterol
- Pigment

About 80% of stones are composed of what?

- Mixture of cholesterol
- Bilirubin
- Calcium salts

About 20% of stones are composed of what?

Pure cholesterol or a calcium-bilirubin mixture

What is the most sensitive imaging test for choledocholithiasis?

ERCP

Another term for inflammation of the gallbladder

Cholecystitis

Which modality is the primary choice for diagnosing cholecystitis?

Sonography or CT

An absence of gallstones is termed?

Acalculous cholecystitis

What percentage of people with acute cholecystitis experience perforation of the gallbladder?

5%-15%

What condition is it when a gallstone erodes through the wall of the gallbladder and creates a fistula to the bowel, causing an obstruction of the small bowel?

Gallstone ileus

How can you treat chronic cholecystitis?

Laparoscopic removal of the inflamed gallbladder

Inflammation of the pancreatic tissue?

Pancreatitis

What causes pancreatitis?

- Chronic alcohol consumption
- Obstruction of the hepatopancreatic ampulla
- Surgery
- Trauma
- Viral infections
- Steroid use
- Injection of contrast during ERCP (sometimes)

A fluid collection with a defined fibrous capsule that develops 4-6 weeks after the onset of acute pancreatitis

Pancreatic pseudocyst

What does pancreatitis look like on a radiograph?

Displacement of the C Loop or the stomach

Which modality is the primary choice for imaging acute pancreatitis?

Contrast-enhanced CT

Yellowish discoloration of the skin and white of the eyes. (Not a disease, but rather a sign of disease).

Jaundice

What causes jaundice?

Accumulation of excess bile pigments in the body tissues

A large gallstone gets impacted in the gallbladder or cystic duct

Mirizzi syndrome

Serous fluid collections in the liver

Simple hepatic cysts

Benign tumor of the liver and is also known as hepatic adenoma?

Hepatocellular adenoma

Who is most likely to have hepatocellular adenoma?

Females that use oral contraceptives

The second most common benign tumor of the liver behind the hepatic cyst

Hemangioma

Who is most likely to have a hemangioma?

Women who are pregnant or postmenopausal females

The most common primary malignancy neoplasm of the liver?

Hepatocellular carcinoma

Where do most primary hepatomas originate?

Liver parenchyma

What does hepatocellular carcinoma appear as on an abdominal radiograph?

Hepatomegaly

What is the best treatment for someone with hepatocellular carcinoma?

- Resection of the tumor
- Liver transplantation

Heat generating electrodes that provoke necrosis of a tumor

Radiofrequency ablation (RFA)

Which imaging modality is used to diagnose metastatic liver disease?

Contrast-enhanced CT and MRI

What is the most common treatment for metastatic liver disease?

Chemotherapy

Carcinoma of the gallbladder are benign or malignant?

Most are malignant (85%)

Who is most affected by carcinoma of the gallbladder?

Females

What is the best method for imaging gallbladder carcinoma?

CT and sonography

What is the 5-year survival rate of gallbladder carcinoma?

4%

Malignancy of the bile ducts?

Cholangiocarcinoma

What imaging study is most commonly used for diagnosing cholangiocarcinoma?

ERCP

The 5th most common cause of cancer-related death in the United States?

Pancreatic cancer

Who is more likely to be affected
by pancreatic cancer?

African American Males

Most common malignant pancreatic neoplasm?

Adenocarcinomas (90%)

Where does pancreatic cancer most commonly spread to?

- Liver
- Peritoneum

Which imaging modality is used to diagnose pancreatic cancer?

CT

What percentage of pancreatic cancers are resectable?

10%

What is the 5-year survival rate for pancreatic carcinoma?

2%

What anatomy makes up the urinary system?

- Kidneys
- Ureters
- Urethra
- Bladder

What is the main function of the urinary system?

Remove waste from the blood for excretion by forming urine

What is the functional unit of the kidney?

Nephron

Function of nephron?

Blood filtration and formation of urine

How many nephrons are in each kidney?

Approximately 1 million

How long are the ureters?

28 cm to 34 cm

Function of the ureters?

Drain urine from the kidneys into the bladder

How much urine can the normal adult bladder store?

350-600 mL

How much urine is in the bladder when you feel the need to void it?

250 mL

How long is the female urethra?

4 cm

How long is the male urethra?

17.5 cm to 20 cm

What anatomic structure allows the urethra to open to the exterior of the body?

Urinary meatus

What is the main cause of congenital anomalies of the kidneys and ureters

Errors in development

Rare anomaly with the absence of a kidney on one side, associated with an unusually large kidney on the other side?

Renal agenesis or aplasia

Term for the absence of both kidneys?

Bilateral agenesis

Condition where there is a presence of a small third kidney?

Supernumerary Kidney

Rare anomaly involving a kidney that is less than normal size but contains normal nephron structure?

Hypoplasia

Condition where the kidney is overdeveloped?

Hyperplasia

Most common fusion anomaly that affect males 2x more the females?

Horseshoe kidney