Liver

• Hepatomegaly is:

  an enlarged liver
• A liver larger than ___ is enlarged.

  15.5 cm
• Fatty infiltration is a ___ liver disease.

  reversible
• What are the key markers of fatty infiltration ?

  diffuse hyper echogenicity of liver parenchyma ; liver may be enlarged
• What are the 2 leading causes of fatty infiltration ?

  Obesity and alcohol consumption.
• Glycogen storage disease is an ___ recessive disorder; excessive deposits of ____ to be stores in liver, intestinal tract, and kidney but body is unable to ____ it.

  autosomal , glycogen , synthesize
• Glycogen storage disorder may cause:

  hypo glycemia , abdominal distension , fatigue and irritability
• Glycogen storage disease is marked by:


  diffuse increase in parenchymal echogenicity, decreased penetration, and hepatomegaly
• What is hepatitis ?

  Inflammation in response to viral infection or toxins such as drugs or alcohol
• Which forms of hepatitis have vaccines available ?

  A, B, & D
• Hepatitis A & E:

  short - term infection; fecal-oral route from consuming contaminated food/water
• Hepatitis B:

  via contact with body fluids; both acute and chronic; monitor for cirrhosis and liver cancer
• Hepatitis C:

  via contact with blood; both acute and chronic; treatment is available; monitor for cirrhosis and liver cancer
• Hepatitis D:


  Only infects those with history of Hepatitis B
• Alcoholic hepatitis:

  caused by excessive alcohol consumption
• Autoimmune hepatitis:

  Inflammation that occurs when immune system attacks liver
• Acute hepatitis:


  Inflammation, portal veins appear more hyperechoic, called starry night sign
• Chronic Persistent Hepatitis:

  Hyper echoic texture, portal vein walls are less prominent, risk of liver cancer
• Chronic Active Hepatitis:

  may progress to liver cirrhosis or failure
• Cirrhosis:

  Liver function test abnormalities depend on stage and extent of disease; ALP may be elevated; AST and ALT elevated
• Cirrhosis:

  Hepatomegaly, possible liver atrophy, surface nodularity, caudate lobe hypertrophy
• Portal Hypertension:

  Portal vein velocities may be reduced or become hepatofugal; hepatic artery may enlarge
• Secondary findings of cirrhosis include:

  Portal hypertension, splenomegaly, varices, ascites
• What does hepatofugal mean ?

  flow directed away from the liver
• Liver is perfused by:

  the hepatic artery and portal vein
• Liver is drained by the:

  hepatic veins
• Budd- Chiari syndrome:

  Uncommon condition of hepatic venous outflow obstruction due to congenital flap in a hepatic vein or thrombus in IVC or hepatic veins
• Budd-Chiari syndrome is clinically significant if:

  occlusion of 2 hepatic veins
• Acute phase of passive liver congestion:

  liver enlarges, causing RUQ discomfort
• In passive liver congestion usually:

  all veins in body will dilate and be pulsatile
• Hepatic cysts are either ___ or ____.

  congenital , acquired
• Congenital cysts:

  TRUE hepatic cysts
• Acquired cysts can result from:

  trauma, parasites or inflammatory reactions
• Hydatid diseases - acquired cysts


  caused by a parasite
• Hepatic abscess usually due to:

  bacterial or parasitic infection
• Amebic Abscess:

  usually in right liver lobe
• Schistosomiasis:

  parasitic infection that causes fibrosis
• Pneumocystis jiroveci is the most common opportunistic infection in ___ infected persons.

  HIV
• Cavernous hemangioma:


  most common benign liver tumour
• Are hemangiomas more common in men or women ?

  Women