liver pathology

what causes the liver to be inflammed

hepatitis

what are the resulting infections of hepatitis

viral, bacterial, fungal, and parasitic organism

what is the resulting noninfectious causes of hepatisis

meds, toxins, and autoimmune disorders

hepatisis causes an elevation in what blood tests

ALT, AST, conjugated bilirubin, and uncogugated bilirubin

what causes hep A

fecal/oral

what causes hep B

blood/body fluids

what causes hep C

blood/ body fluids (sharing needles)

which type of hepatisis is most commonly caused by a liver transplant

hep C

what causes hep D

occurs in people who are also infected with the hep B virus

what causes hep E

found in the stool of an infected person and is spred when someone unknowingly ingests the virus

what is the hepatisis that appears as a starry night, has a sudden onset, hypoechoic liver parenchyma, causes enlargement of the liver, and hyperechoic PV walls

acute hepatitis

what is the type of hepatitis that appears with a hyperechoic liver parenchyma, the liver is small in size, and decreased echogenicity of PV walls

chronic hepatitis

what type of abscess is usually found in the right lobe of the liver because of air reaching the liver by the bile ducts, PV, and Hepatic arteries

pyogenic (bacterial) abscess

what type of artifact does the pyogenic (bacterial) abscess show

reverberation artifact

what is a echinococcal cyst

a cyst inside a cyst; daughter cyst

what is leukocystosis

an increased white blood cell count

when a parasite reaches the liver by the PV what does this cause

amebic abscess

what does a amebic abscess appear as on ultrasound

round hypoechoic complex cyst

where is a amebic abscess usually found

right lobe dome area of the liver

what can you see on an xray that is an indication of an amebic abscess

the rigth dome of the diaphragm is raised

what is a fungal infection of the blood that results in small abscesses in the liver

fungal abscess (candidiasis)

what is the common appearance of the fungal abscess (candidiasis)

wheel within a wheel (early manifestation)

in a late disease process of the fungal abscess (candidiasis) what is the appearance

echogenic focus - scar looking formation

what is the result of a parasitic (tapeworm) associated with sheeo and cattle raising countries (where eggs are swallowed by the host and moved to the portal system where they hatch and move to liver)

echinococcal cyst (hydatid disease)

what is the appearance of echinococcal cyst (hydatid disease) on US

varies from a simple cyst, cysts within a cyst, cyst with multiple daughter cysts, water lily sign, and a calcified mass

casoni skin test is ___ accurate for echinococcal cyst (hydatid disease)

70%

T/F: echinococcal cyst (hydatid disease) is not associated with anaphylatic shock

false

what is on of the most common parasitic infections in humans

schistosomiasis

schistosomiasis is a major cause of ______

portal hypertension

where is schistosomiasis found the most often

tropical areas

what is the appearance on ultrasound of schistosomiasis

occluded intrahepatic portals, thickened and increase echogenicity of PV walls; secondary, spleenomegaly, ascites, esophegeal variceal bleeding, and portosystemic collaterals

what is the most common infections in AIDS

pneumocytosis carini

what does the portal triad consists of

main portal vein, proper hepatic veins, and common hepatic duct

what does the portal triad resemble

mickey mouse sign

what divides the right and left lobes of the liver

MLF

what is the MLF a landmark for

GB, IVC, MHV

what divides the left and caudate lobe of the liver

ligamentum venosum

the ligamentum venosum is a remnant of the _________

ductus venosus

______is a remnant of the umbilical vein that runs from the umbilicus to the left PV

ligamentum venosum

what is the fold created by a passage of embryonic umbilical vein from the umbilicus to the left banch of the PV

falcisform ligament

what extends from the liver to the diaphragm and surrounds the bare area

coronary ligament

what is normal flow of the portal vein

hepatopedal

what is abnormal flow of the PV that occurs when the umbilical vein reopens

hepatofugal

is the hepatopedal or hepatofugal flow above the baseline

hepatopedal

what vein in the liver has thin has thin walls that flows below the baseline (away) that dumps into the IVC

hepatic vein

what does the hepatic artery run parallel to

main portal vein

does the hepatic artery flow above or below the baseline

above

how is the liver measured

superior to inferior at mid clavicle or coronal plane

T/F: everyones liveer is the same size

false

what is hepatomegaly

enlarged liver

how large does the liver measure when considered hepatomegaly

>15.5 cm

what is the appearance of the liver compared to the kidney

hyperechoic to the kidney

what is an inferior projection of the right lobe of the liver

reidels lobe

what is the gender that a reidels lobe is mostly seen in

women

what are the small calcifications seen on the liver and spleen

granulomas

what are granulomas caused by

histoplasmosis or a TB infection (bird or bat poop)

what is the most common malignant liver tumor in early childhood

hepatoblastoma

hepatoblastoma is the third common ____ childhood malignancy after wilms tumor and neuroblastoma

intraabdominal

hepatoblastoma causes an increase in ______

serum alpha fetoprotein

what is associated with beckwith-wiedemann and familial adenomatous polyps

lung mets and portal vein invasion

what is the most common solid mass on the liver

metastatic disease

when mets reaches the liver where is it most likely from

GI, lung, breasts

what is the most common primary malignancy of the liver

hepatocellular carcinoma (HCC)

hepatocellular carinoma occurs in ____ of patients who have had cirrhosis in the US

10-25%

hepatocellular carcinoma is associated with an increase in

alpha fetoprotein, AST (SGOT), ALT (SGPT)

____is found in asia and africa where hep b and c are prevalent

HCC

what is a rare fatty tumor associated with tuberous sclerosis

hepatic lipoma

what does hepatic lipoma appear as on US

hyperechoic mass with propagation speed artifact

what causes budd-chiari syndrome

thrombus of the HV and IVC

what is hepatic adenoma associated with

birth control pills

when having hepatic adenoma a patient can have pain from tumor hemorrhage what is it associated with

glycogen storage disease

what does the mercedes benz incision found with

liver transplant

what is the accumulation of triglycerisdes within the hepatocytes

fatty liver disease

on US what does fatty liver appear as

increased echogenicity of the liver and a decrease in acoustic penetration

where does focal fatty infiltration common occur

porta hepatis (around the GB)

what is a genetically acquired disorder that results in excess deposits of glycogen in the liver

gylcogen storage disease

what is the technical term for a fat pocket

lipoma

what is the diffuse process of fibrosis and distortion of normal liver architecture that initially causes enlargement of the liver then atrophy

cirrhosis

what is the number 1 cause of cirrhosis

hep c

what are some of the causes of cirrhosis of the liver

alcohol, fatty liver disease, NASH, hep b

what can cirrhosis lead to

cancer

what is portal hypertension

increased pressure of the portal system

what is the normal pressure in the portal vein

5-10 mmHg

what is the normal diameter of the portal

greater than 13 mm

what are the US findings of portal hypertension

splenomegaly, ascites, and portal systemic venous collaterals

what is a splenorenal shunt called

linton shunt

what is a distal splenorenal shunt called

warren shunt

what can help to lower pressure in the portal vein

TIPS

what does TIPS connect

portal and hepatic vein

what does TIPS eliminate

ascites

what is an indication for a liver transplant

cirrhosis

what is the most common cause of a liver transplant

hep c

after getting a liver transplant what supplies blood to the biliary tree

hepatic artery

what is the scoring system for assessing severity of disease

model end stage liver disease (MELD)

why would children most likely have a liver transplant

biliary atresia (no biliary system)

budd-chiari can be ___ and __

congenital; idiopathic

who is mostly likely to get budd-chiari

young women

what is the 2nd most common benign solid liver mass that is a lesion related to an area of congenital vascular malformation

focal nodular hyperplasia

what gender is focal nodular hyperplasia most common in

women

where is focal nodular hyperplasia most commonly found

free edge of liver