ARDMS Abdomen Ultrasound Registry Review Exam 272 Questions with Verified Answers
How many segments does the Couinaud system divide the liver into? - CORRECT ANSWER Eight surgical segments
What divides the right lobe of the liver into an anterior and posterior segment? - CORRECT ANSWER Righ...
ARDMS Abdomen Ultrasound Registry Review Exam 272 Questions with Verified Answers
How many segments does the Couinaud system divide the liver into? - CORRECT ANSWER Eight surgical segments
What divides the right lobe of the liver into an anterior and posterior segment? - CORRECT ANSWER Right hepatic vein
What vessel separates the right and left lobe? Where does it lie (fissure)? - CORRECT ANSWER Middle hepatic vein, which lies in the main lobar fissure
LLL is divided into medial and lateral segments by: - CORRECT ANSWER Left hepatic vein
The caudate lobe is separated from the LLL by which ligament? - CORRECT ANSWER ligamentum venosum
Main portal vein is created by the merging of which two vessels? What is this area
referred to as? - CORRECT ANSWER Superior mesenteric vein and splenic vein. Known as the splenic portal confluence
What is the name of the capsule surrounding the liver? - CORRECT ANSWER Glisson capsule
Normal AP measurement of the MPV? - CORRECT ANSWER 13mm or less
What is an enlarged (>13mm) portal vein signify? - CORRECT ANSWER Portal hypertension
Normal MPV flow? - CORRECT ANSWER Hepatopetal and monophasic w/ some respiratory variation
Where do the hepatic veins drain? - CORRECT ANSWER IVC These veins are considered both interlobar and intersegmental - CORRECT ANSWER hepatic veins. They are located between the segments and the lobes
normal hepatic vein flow - CORRECT ANSWER -Hepatofugal - away from liver -pulsatile, triphasic due to right atrial pressure changes -respiratory variation
Narrowing or occlusion of the hepatic veins is indicative of: - CORRECT ANSWER Budd-Chiari syndrome
The liver hilum is also know as - CORRECT ANSWER The porta hepatis
flow pattern of the hepatic artery should be - CORRECT ANSWER low resistance since it is feeding the liver
After birth the umbilical vein becomes - CORRECT ANSWER ligamentum teres aka round ligament
-runs along with the falciform ligament
-will usually be seen near left portal vein in left liver
Where can the main lobar fissure be seen? - CORRECT ANSWER -in sag plane -will appear to connect the neck of the GB with the RPV
-also separates right and left hepatic veins
hepatic steatosis - CORRECT ANSWER fatty liver
Causes of fatty liver disease - CORRECT ANSWER Fatty deposits within the hepatocytes.
Once it becomes cirrhosis, it is non-reversible.
1. Alcoholic fatty liver disease
2. Non-alcoholic fatty liver disease: -obesity -starvation -chemotherapy -diabetes mellitus -hyperlipidemia -pregnancy -von Gierke disease (glycogen storage dx) -total parental nutrition -cystic fibrosis
steatohepatitis - CORRECT ANSWER inflammation of the liver associated with fat
precursor for chronic liver dx leading to fibrosis, cirrhosis, and HCC
hepatomegaly size - CORRECT ANSWER >15cm
need to correlate with clinical hx
don't confused Riedel's lobe as hepatomegaly
Fatty liver symptoms and labs - CORRECT ANSWER Symptoms: -usually asymptomatic Labs: -Increased LFTs (especially AST and ALT)
Sono appearance of fatty liver dx and focal fatty infiltration - CORRECT ANSWER -
Diffusely echogenic liver
-Increased attenuation of sound beam
-Walls of hepatic vasculature and diaphragm will not be easily imaged due to increased attenuation
-Fatty changes will be diffuse or focal
Focal fatty infiltration sono app: -hyperechoic area next to the GB, near the porta hep, or part of lobe may appear echogenic
Focal fatty sparing sonographic appearance - CORRECT ANSWER -entire liver is involved with diffuse fatty infiltration with certain areas spared -Area of sparing can look like a solid hypoechoic mass
-Hypoechoic area will be near GB, porta hep, or entire lobe may be spared
-Can appear to look like pericholecystic fluid
Two most common types of hepatitis: - CORRECT ANSWER A and B
A: Fecal-oral route: contaminated water or food
B: Contact with body fluids, mother-to-infant transmission, blood contact (IV drugs)
Most common type of hepatitis in healthcare workers - CORRECT ANSWER Hep C
-Spread by blood and body fluid contact
Which type of hepatitis is the leading indication for liver transplantation in US? - CORRECT ANSWER Hepatitis C
Wilson disease
Hemochromatosis
Autoimmune disorders
Drugs
All of the above can be causes for chronic ________ of the liver - CORRECT ANSWER Hepatitis
What is Wilson disease? - CORRECT ANSWER -An inherited disorder that causes too much copper to accumulate in the liver, brain and other vital organs.
-Also called hepatolenticular degeneration. -Causes fatty changes & fibrosis in the liver. Leads to chronic hepatitis Trademark feature: Copper ring around iris
What is hemochromatosis? - CORRECT ANSWER Iron overload disease resulting in abnormal deposition of iron
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