Podcast
Questions and Answers
What type of fatty liver appearance is typically seen in GSD type 1?
What is the primary transmission route for Hepatitis A?
Which of the following is a common complication associated with Hepatitis C?
What enzyme deficiency is associated with GSD type 1?
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What is the most common cause of acute liver failure in the United States?
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Which form of hepatitis is preventable by vaccination?
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In terms of its pathophysiology, alcoholic hepatitis is primarily caused by what?
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What condition is referred to as Steatosis?
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Which of the following is a characteristic sonographic finding in fatty infiltration of the liver?
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What is a typical sonographic appearance in a patient with glycogen storage disease?
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Focal fatty sparing in a fatty infiltrated liver is typically seen as what on ultrasound?
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Which type of hepatitis is most frequently spread through sharing needles?
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Which of the following areas is commonly a location for focal fatty sparing?
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What is the effect of increased sound attenuation in the liver due to disease progression?
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What is the incidence of fatty infiltration in the U.S. population?
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What happens to liver echo density as hepatocellular disease progresses?
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Study Notes
Diffuse Hepatocellular Disease
- Hepatocellular disease disrupts normal liver function and can progress from simple fatty changes to severe hepatitis or cirrhosis.
- Disease progression alters liver texture, making it more difficult to penetrate with ultrasound due to increased sound attenuation.
- Acetaminophen overdose is the leading cause of acute liver failure in the US.
Fatty Infiltration (Steatosis)
- Accumulation of triglycerides within hepatocytes.
- Common causes include metabolic syndrome, alcohol abuse, medications, nutritional deficiencies, and severe hepatitis.
- Prevalence in the US is estimated at 30%.
- Reversible, with severity ranging from mild to severe.
Sonographic Findings for Fatty Infiltration
- Increased echogenicity of the liver.
- Decreased acoustic penetration.
- Increased attenuation, making it challenging to visualize the posterior liver and diaphragm.
Focal Fatty Infiltration
- Localized regions of increased echogenicity within the normal liver.
- Commonly observed near the porta hepatis and throughout the liver.
Focal Fatty Sparing
- Regions of normal liver within a fatty infiltrated liver.
- Appear as hypoechoic areas within a hyperechoic liver.
- Typically seen adjacent to the gallbladder, in the porta hepatis, the caudate lobe, and at liver margins.
Sonographic Findings for Focal Fatty Sparing
- Hypoechoic areas within normal or echogenic liver.
- Most commonly observed anterior to the gallbladder, in the gallbladder fossa, anterior to the portal vein at the porta hepatis, around liver margins, and within the left lobe.
- Impaired visualization of vessels is often more severe.
Glycogen Storage Disease (GSD)
- Autosomal recessive disorder.
- Genetic defect resulting in excessive glycogen deposits in the liver.
- Deficiency or absence of enzymes responsible for glycogen metabolism.
- Associated with fatty infiltration and hepatic adenomas.
- 11 different types of GSD exist.
- Type 1 (Von Gierke's disease) is characterized by a defect in the glucose-6-phosphatase enzyme.
- Clinical manifestations of Type 1 include hypoglycemia, abdominal distension, fatigue, and irritability.
Sonographic Appearance of GSD Type 1
- Fatty liver with increased echogenicity and decreased penetration.
- Hepatomegaly.
- Hepatic adenomas (hypoechoic lesions) are possible.
Hepatitis
- Inflammation of the liver caused by infectious (viral, bacterial, fungal, parasitic) or noninfectious (medications, toxins, autoimmune disorders) agents.
- Can elevate liver enzymes (ALT, AST) and bilirubin levels.
- Viral hepatitis, accounting for most cases, can range from mild to extensive.
- Hepatitis A, B, C, D, and E account for 95% of acute hepatitis cases.
Hepatitis Transmission and Types
- Hepatitis A: Highly contagious, fecal-oral transmission.
- Hepatitis B: Serious, preventable by vaccination, bloodborne and body fluid transmission.
- Hepatitis C: Bloodborne, often associated with needle sharing and historically through blood transfusions and organ transplants. It is a leading cause of chronic liver disease and liver transplantation.
Alcoholic Hepatitis
- Liver inflammation caused by excessive alcohol consumption.
Autoimmune Hepatitis
- Liver inflammation due to immune system attack on the liver.
Viral Hepatitis Pathology
- Liver cell injury, swelling, varying cellular degeneration, potential necrosis, an immune response, and regeneration.
Fulminant Hepatitis Pathology
- Massive necrosis of liver parenchyma, decrease in liver size (acute yellow atrophy), sudden and severe onset leading to liver failure.
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Description
Explore the impacts of hepatocellular disease on liver function. This quiz covers the progression from fatty changes to severe liver conditions and the sonographic findings associated with fatty infiltration. Test your knowledge on the causes, prevalence, and reversibility of liver diseases.
