Abdomen Flashcards

(52 cards)

1
Q

Where are Gastric diverticula located within the stomach?

A

Fundus (congenital and less curve) or

antrum (acquired and greater curve)

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2
Q

When does pyloric stenosis occur?

What are the imaging criteria for diagnosis?

A

Infantile pyloric stenosis: First 6 weeks of life with projectile bilious vomiting.

Pylorus length of 15mm and diameter of 3mm

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3
Q

What are the types of volvulus?

Which is more common?

A

Organoaxial- long axis rotation (most common)

Mesenteroaxial- Rotation along mesenteric axis

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4
Q

Which type of hiatal hernia is associated with gastric volvulus?

A

Oganoaxial gastric volvulus is associated with sliding hiatal hernia

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5
Q

What are benign causes of diffuse gastric thickening?

Malignant?

A

Benign

  • Pseudolymphoma
  • Gastritis
  • Varicies

Malignant

  • Lymphoma
  • Carcinoma (Linitis Plastica)
  • mets
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6
Q

Factors which suggest a gastric ulcer is malignant?

A
  • Non-antral location
  • Eccentric position on mucosal mound
  • Irregular margin
  • Absence of or irregular Hampton’s line (i.e. ulcer collar)
  • mucosal folds do not reach ulcer margin
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7
Q

What are complications of benign gastric ulcers?

A
  • perforation
  • erosion into vessel
  • antral scaring (and gastric outlet obstruction)
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8
Q

What type of gastric ulcers is Crohn’s disease associated with?

What is their morphology

A
  • Aphthous ulcers

- small bull’s eye appearance on UGI

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9
Q

What is the most commonly affected GI organ in sarcoidosis?

A

The stomach

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10
Q

Types of infectious gastritis? Populations each affects?

A
  • phlegmanous: alcoholics
  • emphysematous: diabetics
  • tb: endemic areas
  • syphilis
  • candidal: immunocompromised
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11
Q

What is menetrier disease?

A

AKA hypertrophic gastritis. Gastritis with gastric fold hypertrophy, hypoalbuminemia, and weight loss.

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12
Q

Most common causes of gastritis?

A
  • Helicobactor pylori
  • NSAIDS, KCl, clopidogrel, steroids
  • EtOH
  • Crohn Diseas
  • CMV, HSV
  • Behchet syndrome
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13
Q

Imaging findings associated with Zollinger Ellison Syndrome?

A
  • Massive ulceration of the gastric antrum and proximal small bowel including the jejunum
  • Hypervascular arterially enhancing small tumor in the duodenum (most common) or pancreas
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14
Q

What is the pathophysiology of atrophic gastritis?

A

Gastrinoma > parietal cell hyperplasia and acid hypersecretion > ulcers

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15
Q

What is the etiology of atrophic gastritis?

A
  • Prolonged H. Pylori

- Autoimmune gastritis

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16
Q

What syndromes are associated with adenomatous gastric polyps?

A

Adenomatous polyps are associated with carcinoma
Gardner
Familial polyposis coli

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17
Q

What syndromes are associated with hamartomatous gastric polyps?

A
  • Peutz Jeghers

- Crobkhite Canada

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18
Q

What organs are affected in Cowden syndrome?

A
  • GI
  • breast cancer
  • thyroid follicular cancer
  • CNS dysplasia - lhermitte duclose
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19
Q

Where do gastrointestinal stromal tumors most commonly arise?

What is their histologic location?

A
#1 stomach
#2 small intestine
#3 esophagus

Submucosal. Arise from cells of cajal which express c kit

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20
Q

Carney Triad?

A
  • GIST
  • Extra adrenal paraganglioma
  • pulmonary chondroma
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21
Q

Imaging appearence of GIST?

A
  • Smooth submucosal mass with possible central ulcer if large
  • heterogeneous enhancement with areas of necrosis is larger.
  • 25% demonstrate calcification
22
Q

Symptoms of ectopic pancreas?

Location of ectopic pancreas?

A

Bleeding

Submucosal of gastric antrum or proximal duodenum

23
Q

Imaging characteristics of ectopic pancreas

A
  • submucosal mass in antrum or duodenum with central umbilication that represents rudimentary pancreatic duct
24
Q

What disease is are Gastric varicies associated with?

Esophageal varicies?

A
  • Splenic vein thrombosis (secondary to pancreatitis or pancreatitis). Although may also be seen in portal htn
  • portal htn
25
What are risk factors associated with gastric adenocarcinoma?
- H pylori - EtOH - smoking - pernicious anemia - stomach surgery - salted and smoked food (fish) - nitrates/nitrites
26
What is the Carman meniscus sign?
Central tumor ulcer crater with heaped up edges-- suggests malignancy
27
Types of gastric carcinoma?
- GE juncional/cardinal - Scirrhous - frequently causes linitus plastica - Polypoid carcinoma- commonly ulcerates
28
Patterns of gastric carcinoma metastasis?
- Krukenberg tumors | - Peritoneal spread: omental caking
29
What factors differentiate malignant GISTs from benign GISTs?
- Tend to be larger - Exophytic extension - Polypoid morphology - Frequent ulceration
30
What is the most common location for extranodal lymphoma?
The GI tract | The stomach is the most commonly affected organ in the GI tract
31
What is the most common type of lymphoma in the GI tract?
Diffuse large B Cell lymphoma
32
What is PTLD? What the the etiology?
Posttransplat lymphoproliferative disorder. Secondary to immunosuppresion and EBV
33
What organs are most commonly affected in PTLD?
In descending order of frequency - Small bowel - Colon - Stomach - Esophagus
34
Imaging features of GI lymphoma
- Circumferential wall thickening - Aneurysmal luminal dilation - Ulceration/perforation
35
What is the classic presentation of Burkitt Lymphoma
Central African child with maxillary tumor 2/2 to EVB
36
What are the types of Burkitt Lymphoma?
- Endemic - Sporadic (ileocecal lymphoma) - Immunodeficiency associated Burkitt lymphoma
37
What cancers metastasize to the stomach? What's the classic appearance of these lesions
- Melanoma - Breast cancer - Lung cancer Multiple "bull's eye lesions"
38
What are the imaging features of linitus plastica?
- No mucosal folds - Luminal narrowing - Starts with the antrum and spreads proximaly
39
What is EATL? What disease is it associated with? What organ does it usually affect?
- Enteropathy associated T cell lymphoma. - Celiac disease - Jejunum
40
What are malignant causes of linitis plastica?
- Gastric carinoma - Lymphoma - Mets (breast and lung)
41
What are non-malignant causes of linitis plastica?
- Eosinophilic gastroenteritis - Crohn disease - TB, syphilis - Caustic ingestion - Sarcoidosis - Zollinger Ellison (2/2 to multiple ulcers)
42
What is a Bilroth i?
pylroantrectomy with end to end gastroduodenostomy
43
What is a Bilroth ii?
Pyloroantrectomy with side to side gastrojejunostomy with blind ending duodenum as afferent limb. (preverved
44
What is a Roux en Y gastric bypass?
Gastric pouch gastroejunostomy. Excluded stomach continuous with physiologic anatomy until jejunojenostomy with
45
Common late complications of gastric surgery?
- Gastric cancer - Marginal Ulcer - Gastroparesis - Anastamotic stricture - Dumping syndrome
46
What are brunner's glands?
Glands in the duodenum that produce alkaline fluid to neutralize gastric chyme
47
What is Rigler's sign?
Inner and outer edge of bowel wall is seen. Sign of pneumoperitoneum.
48
What are the imaging findings of gangrenous cholecystitis?
- Nonenchancement of the gallbladder mucosa | - Other findings of acute chole: wall thickening, stones, pericholecystic fluid
49
Whats the next step after identifying diverticulitis/appendicitis?
- Look for perf: pneumoperitoneum
50
Whats an important differential for colonic diverticulitis?
Epiploic appendigitis.
51
How to differentiate phlebolith from ureteric stone?
Soft tissue rim sign: nephrolithiasis will demonstrate "soft tissue halo" indicative of inflamed ureter. Phlebolith will immediately be surrounded by fat
52
What can help identify transition point in an SBO
Fecalization is often seen just proximal to the transition point in an SBO