Deck 9: Liver

Question 1

Elevation of serum bilirubin results in:

A) hepatocellular disease.
B) ascites.
C) jaundice.
D) hemolysis.

Answer 1

C

Question 2

Patients who have hepatocellular carcinoma are more likely to have had:

A) hemochromatosis.
B) adenosis.
C) cirrhosis.
D) carcinosis.

Answer 2

C

Question 3

Which one of the following actions should be done to image the near field of the liver?

A) Decrease transducer frequency
B) Use a sector transducer
C) Use a curved array transducer
D) Increase the near gain

Answer 3

C

Question 4

Echinococcal cysts have the highest incidence in countries in which:

A) fishing is common.
B) rock climbing is prevalent.
C) poultry is abundant.
D) sheep herding is common.

Question 5

Fatty infiltration may be observed in all patients except those with:

A) diabetes mellitus.
B) chronic alcoholism.
C) hepatoportal fistula.
D) hepatitis.

Question 6

Jim MacDonald, a sheep farmer, arrives at the hospital with right upper quadrant pain, fever, and an elevated white blood cell count. He states that 3 months earlier, he was kicked in the ribs. An irregular mass showing low-level echoes is found on the sonogram. What is your differential diagnosis?

A) Amebic abscess
B) Hematoma
C) Echinococcal cyst
D) Hepatic abscess

Question 7

The most common benign tumor of the liver is:

A) mesenchymal hamartoma.
B) adenoma.
C) cavernous hemangioma.
D) infantile hemangioendothelioma.

Question 8

Which one of the following tumors consists of large blood-filled spaces?

A) Adenoma
B) Hamartoma
C) Ewing angioma
D) Cavernous hemangioma

Question 9

Typical symptoms a patient may have with an abscess formation include all of the following except:

A) fever.
B) decreased white blood count.
C) pain.
D) increased white blood count.

Question 10

What benign liver tumor has been found in patients with type I glycogen storage disease?

A) Lipoma
B) Adenoma
C) Cavernous hemangioma
D) Hamartoma

Question 11

In severe hepatocellular destruction, the aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels are:

A) high.
B) moderately high.
C) moderate.
D) mild.

Question 12

The most common form of neoplastic involvement of the liver is:

A) metastases.
B) hepatocellular carcinoma.
C) hepatoma.
D) hamartoma.

Question 13

Dilated intrahepatic bile ducts may be seen with all of the following except:

A) intrahepatic mass in the area of the porta hepatis.
B) gallstones in the fundus of the gallbladder.
C) obstructive stone in the cystic duct.
D) lymphadenopathy in the porta hepatis.

Question 14

The fossae of the right portal vein (RPV) and gallbladder are found in the:

A) main lobar fissure.
B) left intersegmental fissure.
C) right intersegmental fissure.
D) left lobar fissure.

Question 15

The liver is suspended from the diaphragm and anterior abdominal wall by the:

A) ligamentum teres.
B) falciform ligament.
C) round ligament.
D) triangular ligament.

Question 16

Sonographic findings of acute hepatitis include:

A) accentuated brightness, more extensive demonstration of portal vein radicles, and an overall decreased echogenicity of liver.
B) decreased brightness and echogenicity of liver.
C) increased brightness and echogenicity of liver, and no demonstration of portal vein radicles.
D) ascites, decreased brightness, and echogenicity.

Question 17

Elevation of alkaline phosphatase is associated with:

A) biliary obstruction.
B) cavernous hemangioma.
C) fatty infiltration.
D) simple hepatic cysts.

Question 18

The falciform ligament extends from the umbilicus to the diaphragm in a parasagittal plane containing the:

A) ligamentum venosum.
B) ligamentum teres.
C) quadratus ligamentum.
D) ligamentum falciforme.

Question 19

Budd-Chiari syndrome is a rare disorder caused by obstruction of the:

A) portal veins.
B) superior mesenteric vein.
C) hepatic veins.
D) splenic vein.

Question 20

Diminished vascular structures within the liver parenchyma most likely represent:

A) obstructive portal disease.
B) cirrhosis.
C) Budd-Chiari syndrome.
D) acute viral hepatitis.

Question 21

All of the following describe normal portal venous flow except:

A) low-flow velocity.
B) hepatofugal flow.
C) spontaneous flow.
D) phasic flow.

Question 22

Hepatocellular disease can be defined as a process that affects the:

A) spherocytes and interferes with liver function.
B) phagocytes and does not interfere with liver function.
C) phagocytes and interferes with liver function.
D) hepatocytes and interferes with liver function.

Question 23

The amebic abscess may reach the liver through the:

A) hepatic artery.
B) gastroduodenal artery.
C) hepatorectal artery.
D) portal vein.

Question 24

Common malignancies affecting the pediatric population include all of the following except:

A) neuroblastoma.
B) Wilms tumor.
C) leukemia.
D) hepatoblastoma.

Question 25

In glycogen storage disease, type I is the most common and is also known as ____________ disease.

A) von Gierke
B) von Gussel
C) von Gerpe
D) von Slurpie

Question 26

Which one of the following is noted in type I glycogen storage disease?

A) Small liver and hypoechoic parenchyma
B) Hyperechoic, attenuating liver and hepatomegaly
C) Normal texture and hepatomegaly
D) Normal texture and prominent intrahepatic biliary ducts

Question 27

The most common site for echinococcal virus growth is in the:

A) lungs.
B) bones.
C) liver.
D) brain.

Question 28

All of the following statements are true about the features most often observed in an extrahepatic mass except:

A) internal invagination of the liver capsule.
B) formation of a triangular fat wedge.
C) discontinuity of the liver capsule.
D) anteromedial shift of the IVC.

Question 29

All of the following statements are true about the features most often observed in an intrahepatic mass except:

A) anterior displacement of the right kidney.
B) displacement of the hepatic vascular radicles.
C) external bulging of the liver capsule.
D) posterior shift of the IVC.

Question 30

What benign liver tumor is located near the free edge of the liver and is solitary, well-circumscribed, and a nonencapsulated multinodular mass?

A) Adenoma
B) Cavernous hemangioma
C) Focal nodular hyperplasia (FHN)
D) Lipoma