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What are the functional cells of the liver called?
What is a disease of the hepatocytes?
Diffuse liver disease
Diffuse liver diseases are treated __________ rather than surgically.
AST and ALT (increase/decrease) as liver function decreases?
AST levels may also elevate with diseases of _________ or ____________ systems
GGT and albumin are likely to (increase/decrease) in cases of long-standing hepatic cellular damage.
Acute damage to liver cells may lead to (increase/decrease) in albumin.
___________ is a blood-clotting protein manufactured in the liver
What is Prothrombin Time (PT) used for?
To measure how long it takes the prothrombin in blood to merge and form a clot.
Bilirubin is produced by the breakdown of __________.
The process of producing Bilirubin begins in the _______ and continues to the _______.
The terms "direct" and "indirect" reflect the way the two types of bilirubin __________
What is direct bilirubin?
(conjugated) Bilirubin that has been absorbed by the hepatocytes.
Levels of direct bilirubin are likely to (increase/decrease) in cases of biliary obstruction and liver cellular diseases.
Indirect, or unconjugated, bilirubin levels may (increase/decrease) in cases of anemia or other diseases that lead to increased breakdown of red blood cells.
What is the term for excess of bilirubin circulating in the blood?
What causes jaundice?
Bilirubin leaking out into surrounding tissues.
What is another lab value that should be considered in determining a definitive diagnosis?
The liver may be enlarged especially in _______ stages of hepatocellular disease.
The liver often becomes _____ as changes become chronic.
What are hepatocytes replaced by?
Replacement of hepatocytes eventually leads to (increased/decreased) liver function and (increase/decrease) in liver enzymes.
What can complicate the evaluation of liver parenchyma for possible masses?
Regeneration of liver nodules
Damage to the hepatocytes can lead to an (increase/decrease) in both direct and indirect bilirubin levels.
Decrease in hepatocyte function can lead to what in the portal vein?
And what is this known as?
high blood pressure
What may develop as pressure within the liver increases?
(collaterals and varices also)
What is the normal direction of the portal venous system?
Is hepatopetal towards or away from the liver?
What is the term for reverse blood flow in the portal-splenic circulatory system?
(fugitives run away from a crime scene)
What are ways to help return portal blood to the systemic circulation?
Is fatty liver disease acquired or congenital?
Is fatty liver reversible or irreversible?
What are the three most common causes of fatty liver disease?
the fatty replaced liver has (increased/decreased) echogenicity? Why?
increased attenuation of the sound beam
What vascular structures are especially hard to visualize with fatty liver?
fatty sparing is often seen where?
anterior to the GB
the right portal vein
within the left lobe
Use of a (lower/higher) frequency transducer may help with fatty liver.
How is Hep A usually spread?
Ingesting fecal matter
How is Hep B usually spread?
Blood, semen, any bodily fluid enters the body of someone
(sexual contact, needles, syringes)
Can also be passed from infected mother to infant
How is Hep C usually spread?
Blood from someone infected enters the body of someone who is not
Which Hepatitis is a growing concern for healthcare workers?
Acute Hep C occurs within the first __ _________ after someone is exposed.
What is the leading indication for liver transplantation in the US?
Chronic Hep C
After liver cells are damaged, they are healed by the ___________ system.
What is the name for when walls of the portal vein appear more hyperechoic than normal
What is an abnormal liver condition in which there is irreversible scarring of the liver?
Cirrhosis is the ____ leading cause of death in the US.
What are the main causes of cirrhosis?
sustained excessive alcohol consumption
viral Hep B and C
What does cirrhosis lead to?
With cirrhosis, the liver becomes _____ and ______.
Cirrhotic liver changes often start and are associated with what?
fatty liver replacement
Patients with cirrhosis have ________, __________, and ____________.
Regenerating nodules are _______ compared to surrounding liver.
_______ to the caudate lobe and _______ of the right lobe may also be identified with cirrhosis.
A caudate-to-right lobe ratio greater than __________ is considered abnormal.
What is the most common cause of portal hypertension in North America?
Portal HTN is an increase in portal venous pressure exceeding __________.
Patients with portal HTN have _______ portal veins.
MPV normal is ________
<13mm in diameter
A common collateral pathway that forms is the ________
the remnant of the _______ _______ vein lies in the space occupied by the ligament of ___________ in the __________ lobe of the liver.
The development of collaterals via the recanalized umbilical vein is called ________________-_______________ syndrome.
In the left gastric vein pathway blood is diverted from the _______ vein to the _________.
What shunt is it called when blood is redirected from the main portal vein at the confluence of the SMV directly into the IVC?
What shunt is it called when blood is shunted from the splenic vein into the left renal vein?
Which shunt is the blood shunted from the SMV directly to the IVC?
A normal functioning TIPS should demonstrate flow towards the IVC with an average velocity of _______
What is the most common type of primary liver cancer?
HCC (also called malignant hepatoma)
Patients with a history of ________ or _______ are at a greater risk to develop HCC.
long standing hepatitis
The presence of HCC rarely affects liver enzymes although it may produce an increase in ________.
Contrast-enhanced harmonic imaging with microbubble contrast agents generally causes hepatic lesions to appear _____vascular.
Hepatic imaging must occur within _____ minutes after contrast agent administration.
When multiple organs contain lymphoma, the disease is referred to as _________________. When just the lymph nodes are affected pathologically, the disease is referred to as ____________.
An increased incidence of _________ and ___________ pathologies is noted in patients with HIV.
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