ARDMS Liver Exam Questions and Complete Solutions Graded A+, Exams of Medicine

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ARDMS Liver Exam Questions and Complete Solutions Graded A+ [Document subtitle] Denning [Date] [Course title]

ADENOMA - Answer: are benign that do not effect LFTs oral contraceptives and glycogen storage disease - Answer: adenoma is associated with decrease hematocrit - Answer: hepatic hematoma labs value is cavernous hemangioma - Answer: what is the most common benign liver tumor Alkaline phosphate (ALP) - Answer: increase serum usually indicates an extrahepatic biliary obstruction. Fatty infiltration gallbladder and porta hepatis - Answer: fatty infiltration is commonly near the AMEBIC LIVER ABSCESS - Answer: is caused by parasites travelers - Answer: amebic abscess associate with pyogenic abscess - Answer: what is the most common abscess AMYLOIDOSIS - Answer: increase amyloid in the liver ANABOLIC STEROIDS - Answer: is the noninfectious cause for hepatitis non-hepatic - Answer: If AST increase with normal ALT it is ________ BECKWITH - WEDEMANN SYNDROME - Answer: is associated with HEPATOBLASTOMA (fetal syndrome) which has increase alpha feta protein (AFP) and pregnancy (estrogen theory) hepatoblastoma - Answer: Most common malignant liver tumor in early childhood

BUDD CHIARI SYNDROME - Answer: refers to obstruction of the hepatic veins and leads to splenomegaly, portal HTN, and ascites emissary veins - Answer: the caudate lobe is spared and enlarges in budd chiair syndrome due to what? CANDIDASIS (fungal abscess) - Answer: is a fungal infection that leads to multiple abscesses within the liver appearing as hypoechoic masses in a "wheel within a wheel" CIRRHOSIS - Answer: albumin/globulin decrease, increase AST, mild ALT, LDH, and conjugated bilirubin. structures to evaluate: caudate (atrophy), right lobe liver, portal vein will be greater than 13mm Dilated umbilical and coronary vein - Answer: A sign of portal HTN are ______ and ______ Echinococcal Cyst (Hydatid disease) - Answer: cyst within a cyst (daughter cyst). Is common in countries with cow and sheep parasite cause cysts with septations. Is a parasitic infection that leads to cyst formation most common in the liver HYDATID CYST - Answer: An echinococcal cyst is also called Casoni skin test - Answer: What is used to test an echinococcal cyst FOCAL FATTY SPARING - Answer: is most commonly near the portal hepatis FOCAL NODULAR HYPERPLASIA (FNA) - Answer: is the second most common benign liver tumor central fibrous scar - Answer: what is focal nodular hyperplasia significant finding HEMOCHROMATOSIS - Answer: increase level of iron in liver

ACUTE HEPATITIS - Answer: what demonstrated hepatomegaly with decrease echogenicity and scattered bright portal reflections with in the parenchyma (starry night or periportal cuffing) Chronic HEPATITIS - Answer: is caused by chronic use of anabolic steroids. Symptoms are low grade fever, increase levels of lactate dehydrogenase (LDH) Lactate dehydrogenase (LDH) - Answer: what levels increases with cirrhosis and chronic viral hepatitis ALT and AST - Answer: Hepatitis has an significant increase in __________ and a mild increase in __________, it is also begins obstruction Hepatitis C and cirrhosis - Answer: is the primary indication of liver transplant in an adult BILIARY ATRESIA - Answer: is the most common primary indication of liver transplant in children HEPATOCELLUAR CARCINOMA (HCC) - Answer: is the most common primary malignant neoplasm and increases levels of AFP. hepatitis and alcoholism - Answer: what is the most common cause cirrhosis HISTOPLASMOSIS - Answer: granulomatous infection that leads to foci throughout the parenchyma of the spleen and liver Granuloma - Answer: an infection that appears as calcifications in the liver and spleen histoplasmosis and tuberculosis - Answer: what is the Most common causes of granulomas birds and bats droppings - Answer: Histoplasmosis is causes by fungus from GGTP and ALP - Answer: BILIARY OBSTRUCTION has an increase in __________ and __________ also it increases bilirubin, ALT, and prothrombin time

GGTP and ALT - Answer: HEPATOCELLUAR DISEASE has an increase in __________ and __________ INTRAHEPATIC CHOLESTASIS - Answer: is related to HEPATITIS (liver disease) ENTRAHEPATIC CHOLESTASIS - Answer: is related to obstruction KAPOSI'S SARCOMA - Answer: is the most common malignancy of the liver with AIDs KLASKIN' S TUMOR - Answer: is located at the junction of the right and left hepatic duct LIVER METS - Answer: what is the most common mass and malignancy in the liver lung, colon, breast, pancreas, prostate - Answer: what is the order of cancer leading deaths LYMPHADENOPATHY - Answer: lymph nodes near the portal hepatis which is associated with primary carcinoma and METS AST and ALT - Answer: METASTATIC and CIRRHOSIS DISEASE has a significant increase in __________ and a mild increase in __________ normal ALT - Answer: MYOCARDIAL INFARCTION has a significant increase in AST with Normal LFT - Answer: simple cysts, hemorrhagic cysts, poly cystic liver disease (PCLD), adenoma, hemangioma, FNH, and glycogen storage disease PNEUMOCYSTIS CARINII - Answer: fungal infection commonly affect AID people. multiple foci occluded intrahepatic pv and thicken portal walls - Answer: SCHISTOMIASIS causes

Schistosomiasis and portal hypertension - Answer: what is the most common parasite infection. this infection also causes what STEATOSIS - Answer: refers to fatty liver infiltration of the liver ULCERATIVE COLITIS - Answer: allows bacteria to invade the blood through portal system and produces gas in the liver WILSON DISEASE - Answer: autosomal recessive inherited disease; excessive deposition of copper causing HEPATIC DYSFUCTION, HEPATITIES, CIRRHOSIS, AND LIVER FAILURE. Increases copper in liver ligamentum teres, umbilicus, LPV, ductus venosum, ivc - Answer: how does the fetal circulation run ligamentum teres - Answer: is located within the inferior margin of the falciform ligament umbilical vein - Answer: ligamentum teres is a remnant of the ligamentum venosum - Answer: separates the left lobe from the caudate lobe ductus venosus - Answer: remnant of the ligamentum venosum glisson capsule - Answer: what is the liver covered by left intersegmental fissure - Answer: what divides the left lobe of the liver into medial and lateral lobes right intersegmental fissure - Answer: what divides the right lobe into ant and post sections? right hepatic - Answer: what vein divides the the right lobe into anterior and posterior segments

interlobar, hepatic veins - Answer: intersegmental is also called what. what vessels course between intersegmental smv and splenic vein - Answer: What forms the main portal vein? intrasegmenal - Answer: portal veins are in what segment right hepatic replacement artery, sma - Answer: if a proper hepatic artery is not formed it is called a what and originates off what artery low resistance waveform with quick upstroke and graduate deceleration diastole - Answer: a normal hepatic artery demonstrates hepatopetal and low continuous - Answer: the portal vein flows what and has what type of flow less than 3mm - Answer: the portal vein should measure Triphasic - Answer: what phasicity do the hepatic veins have? right atrium - Answer: the hepatic veins drian into the IVC and goes into what SMV IMV splenic vein - Answer: what makes up the portal confluence falciform ligament, ligamentum teres, and left hepatic vien - Answer: what courses within the left intersegmental fissure Main lobar fissure - Answer: separates the anterior right and medial left lobe of the liver The right and left hepatic duct - Answer: course with the portal vein to merge into the common hepatic duct

Quadrate lobe (left lobe) - Answer: is the medial segment of the left lobe caudate lobe - Answer: receives blood from the left and right portal veins and the right and left hepatic arteries emissary - Answer: the caudate lobe drains by what vein entering the IVC diaphragm - Answer: The bare area of the liver is in direct contact with the liver rejection - Answer: high resistance waveform in the liver suggest what Parvus Tardus - Answer: what is considered a small or lose of pulse stenosis - Answer: a parvus tardus hepatic artery suggest von MEYENBURG COMPLEXES - Answer: BILIARY HAMARTOMAS are also known as BILIARY HAMARTOMAS - Answer: They are focal development lesions of the liver that are composed of groups of dilated intrahepatic ducts within dense stroma. congenital hepatic fibrosis, autosomal dominant polycystic disease, and cholangiocarcinoma - Answer: BILIARY HAMARTOMAS associates with Abscess - Answer: after a liver biopsy. heterogeneous appearance with internal debris with echogenic foci GYLCOGEN STORAGE DISEASE - Answer: metabolic disorder that is associated with hepatic adenoma formation and fatty infiltration of the liver and also effects skeletal muscle

alpha fetoprotein (AFP) - Answer: is a normal protein produces by the fetal liver and yolk sac and decreases after age 1 year. Trace amounts of it are seen in normal adults choledochal cysts - Answer: are congenital malformation of the duct and do not normally cause jaundice pancreatic duct - Answer: a mass in the ampulla of vater could cause dilation of the fatty infiltration - Answer: causes an increase in liver size and in the amount scatter of the US beam as it passes through the liver tissue, and will increase LFTs poor visualization of the liver vascularture - Answer: fatty infiltration with its increased attenuation leads to increase in fluid and echogenic - Answer: acute hepatitis causes an _______________ within the liver tissue and the hypoechoic texture of the liver parenchyma causes the portal system to look more

congestive hepatomegaly - Answer: indicates an increase in blood within the liver tissue which can be caused by congenital heart failure due to an inefficient cardiac pump slowing down the blood in the system greater than 15cm - Answer: hepatiomegaly is when the liver measures IVC and hepatic congestion - Answer: if the __________ is dilated with the blood due to a blockage in the venous system from CHF, the blood from the liver can not exit properly causing __________ echogenic foci and posterior shadowing - Answer: the sonographic appearance of pneumocystis carnii includes the presence of multiple __________ within the liver parenchyma and ____________ may be seen with larger calcifications

wolman's disease - Answer: is an autosomal recessive disorder that causes excessive lipids storage in the liver, spleen, and adrenal glands, causing enlargement and most patients die in the first 6 months of life. Tuberous sclerosis - Answer: hepatic lipoma is associated with lipoma, hemangioma, met, and focal fatty infiltration - Answer: what are some hyperechoic masses found in the liver superior inferior, midclavicular - Answer: the ___________ dimension of the liver is used to assess liver size, it is measured in the sagittal view of the ____________ plane common hepatic duct - Answer: merges with the cystic duct to form the common bile duct at the porta hepatis mpv pha chd - Answer: what makes up the porta hepatis portal vein - Answer: 50% of all metastasis of the liver is carried in from other organs through the riedel lobe - Answer: a tonguelike extension of the right hepatic lobe oblique subcostal - Answer: __________ approach angle superior toward the right shoulder should demonstrate three hepatic veins within the liver cirrhosis and hepatitis C - Answer: what causes portal hypertension left gastric vein - Answer: the coronary vein is also called portal hypertension - Answer: splenomegaly, ascites, venous collaterals, reversal flow, and enlargement of the coronary vein are sonographic finding for what?

linton and warren - Answer: splenorenal shunt is also called and distal splenorenal shunt is also called caput medusa - Answer: tortuous collaterals around umbilicus portal vein thrombosis - Answer: sonographic findings of cavernous transformation near the portal hepatis is signs of what? right hepatic vein, right portal vein - Answer: A transjugular intrahepatic portosystemic shunt (TIPS) is commonly placed between the: hepatofugal mpv - Answer: a sign of TIPS malfunction is Hemangioendothelioma - Answer: The most common benign vascular liver tumor of early childhood is