Body Flashcards
(141 cards)
1
Q
Testicular mass in a 60 yo?
A
Lymphoma
2
Q
What’s the treatment for testicular lymphoma?
A
Surgery
3
Q
Malignant causes of intussusception?
A
Melanoma Lymphoma
4
Q
The most common extra nodal site of NHL?
A
Stomach
5
Q
Barrett’s appearance in esophogram?
A
Reticular mucosal pattern.
6
Q
What’s T3 esophageal cancer?
A
Tumor involving adventitia. T4 is invasion into adjacent organs.
7
Q
What’s the appropriate length of narrowed esophagus after Nissen?
A
Less than 2 cm; if it’s longer –> slipped wrap!
8
Q
What’s the location for esophageal Web?
A
ANTERIOR C5-C6. Could be idiopathic or could be seen in GVH disease!!
9
Q
Hidebound bowel in small bowel follow through?
A
Scleroderma
10
Q
Candida-like shaggy esophagus in asymptotic old patient?
A
Glycogenic Acanthosis.
11
Q
Carney Triad:
A
- Chondroma (pulmonary hamartoma). - Extra adrenal pheo. - GIST.
12
Q
What’s Menetrier’s disease?
A
- Idiopathic gastric fold thickening. - SPARES THE ANTRUM. - Involves the fundus. - pts can have low albumin eventually.
13
Q
Enlatged Areae Gastricae seen in?
A
- Elderly. - H. Pylori. > 5 mm is enlarged.
14
Q
Atrophic, featureless bowel on fluoro?
A
“Ribbon bowel” … Seen in Graft vs Host!
15
Q
Cloverleaf duoddenum?
A
Healed peptic ulcer.
16
Q
On which side epiploic appendigitis is more common?
A
LEFT;
17
Q
On which side omental infarct is more common?
A
RIGHT; ROI: Right omental infarct.
18
Q
Onion sign on US at the region of the appendix?
A
Appendix mucocele.
19
Q
Intestinal mucosal diaphragms seen in?
A
NSAID- induced enteropathy results in thin (usually less than 3 mm) circumferential rings of mucosa that cause focal strictures referred to as mucosal diaphragms
20
Q
McKittrick Wheelock Syndrome?
A
Villous colon adenoma leading to mucous diarrhea and electrolytes imbalance.
21
Q
What’s stage 3 Rectal cancer?
A
Tumor grows into the peri-rectal fat.
22
Q
Trauma to the bare area of liver results in what type of bleed?
A
RP Bleed.
23
Q
The most common hepatic vascular variant?
A
Replaced right hepatic from SMA.
24
Q
What’s the appearance of well-differentiated HCC on Eovist?
A
Can look BRIGHT!
25
Organism in single liver abscess?
Klebsiella
26
Organism is multiple liver abscesses?
E. Coli
27
Significance of amebic liver abscess in left lobe?
Should be drained, could rupture into the pericardium.
28
Primary hemochromatosis involvement
- Liver. - Pancreas (P=P). - Heart, thyroid, pituitary. - Spleen is spared
29
Secondary hemochromatosis involvement
- Liver - Spleen (S=S). - Pancreas is spared.
30
Pseudo-cirrhosis seen in?
Treated breast cancer mets. (lobulated liver contour with capsular retraction and caudate hypertrophy.
31
Which side is recurrent pyogenic cholangitis more common?
Left lobe; due to longer left bile duct (opposite to artery).
32
Papillary stenosis og bile ducts seen in?
AIDS cholangiopathy.
33
Mirizzi syndrome
- Occurs more with low cystic duct insertion. - Has x5 times increased risk for GB cancer!
34
How to measure tardus?
The time from the end diastole to the peak systole. (have of the hump). acceleration time of \>0.07 correlates with \>50% stenosis.
35
What's parvus and how to measure it?
Decreased systolic velocity (parVus = Velocity). Measured by calculating the acceleration index; which is the change in velocity from end diastole to first peak systole. Index \<3.0 m/sec correlates with \>50% stenosis.
36
Reversed diastolic flow in pancreas transplant.
- Acute rejection.( MC cause of graft failure). - Splenic vein thrombosis (2nd MC cause of failure).
37
Can you rely on RI in pancreas transplant?
NO; because the organ doesn't have a capsule!
38
The most common site of GI sarcoidosis?
Gastric antrum.
39
Most sensitive CT phase to detect RCC?
Nephrographic phase (80 seconds).
40
T2 dark renal mass ddx?
- Papillary RCC. (Less aggressive than clear cell). - Lipid poor AML. - Hemorrhagic cyst.
41
Fat-containing renal mass with calcifications?
RCC; AML should NEVER have calcs.
42
Linitis plastica is a submucosal process
Mucosal biopsy could be negative!
43
Goblet sign in renal fluoro
Urothelial TCC cancer.
44
Bouveret Syndrome
Gastric/duodenal obstruction 2/2 Eroded gallstone.
45
The most common extra-pulmonary site for TB?
Renal.
46
How does uric acid stones behave on DE CT?
They don't change in HU between 80 kv and 140kv scans! Non-uric acid stones will have higher HU on 80 kv relative to 140 kv.
47
Medullary sponge kidney
- Could be unilateral.
- Less dense than other causes of medullary nephrocalcinosis.
- Caused by cystic dilation of collection tubules.
48
Medullary sponge kidney associated with which syndromes?
- Beckwith Weidenmann. - Caroli's - Ehlers-Danlos syndrome.
49
Most common fluid collection to cause post-transplant hydronephrosis?
Lymphocele. Usually medial to the graft.
50
When does PTLD commonly occur?
1st year after transplant.
51
Reversed diastolic flow in the renal artery post transplant?
Suspect renal vein thrombosis. Usually occurs in the first week.
52
What's the most common vascular complication in renal tranplant?
Renal artery stenosis.
53
Where should tardus parvus be evaluated?
At the hilum (main renal artery), not intra-renally.
54
What's the diagnosis?
Ureteritis Cystica. Filling defects within the ureters from recurrent UTI or DM.
55
What malignant tumor is associated with Leukoplakia?
Squamous cell carcinoma.
56
How can RP fibrosis look on PET?
Can look hot in both PET and Galium in EARLY stages even without malignant cells.
57
Bladder adenocarcinoma?
- Urachus.
- Bladder exstrophy.
58
the most common benign bladder tumor?
Leiomyoma.
59
What's the diagnosis?
A "psoas hitch" is a method of ureteric re-implantation following distal ureteric resection or injury.
60
What's fossa navicularis?
The most anterior part of the male urethra.
61
Where's the verumonatum located?
In the posterior wall of the prostatic urethra. The center of it is the prostatic Utricle.
62
Straddle injury affects which part of the urethea?
Bulbar.
63
Gonococcal strictures affects which part of the urethea?
Distal Bulbar. Long and irregular stricures.
64
Chromophobe RCC seen in which disease?
Burt-Hogg Dube (oval lung cysts peripherally).
65
What to look for in Unicornuate uterus?
Look for presence or absence of a rudimentary horn and whether it's communicating or non-communicating. Endometrial tissue in a noncommunicating rudimentary horn can manifest clinically with pelvic pain caused by the increased prevalence of endometriosis due to retrograde flow of menses through the obstructed horn or due to an obstructed, distended horn
66
How to differentiate between bicornuate from septate uteri?
- When the apex of the fundal contour is more than 5 mm (arrow) above a line drawn between the tubal ostia, the uterus is septate.
- When the apex of the fundal contour is below (arrow in b) or less than 5 mm above (arrow in c) a line drawn between the tubal ostia, the uterus is bicornuate.
67
What's the cause of red degeneration of fibroid during pregnancy?
Venous thrombosis. Fibroid will have T1 hyPERintense RIM.
68
Findings of adenomyosis in MRI?
- Thickened junctional zone \> 12 mm.
- Cystic foci in the junctional zone.
69
What's stage 2 endometrial cancer?
When there's cervicsl stromal invasion. High LM mets and possicble radiation.
70
What's stage IIB cervical cancer?
When there's parametrial invasion (the fibrous band that separates the cervix from the bladder). The uterine artery runs in the parametrium.
71
What's the diagnosis?
Gartner duct cysts; located in the anterolateral wall of the proximal (superior) portion of the vagina
72
What's the diagnosis?
Bartholin gland cysts; found in the posterolateral inferior third of the vagina and are associated with the labia majora.
73
What's the diagnosis?
Theca Lutein Cysts.
Seen in:
- Molar pregnancy.
- Hyperstimulation syndrome (clomiphene).
- Multi-fetal pregnancy.
74
What's the maximum allowed ovarian volume in postmenopausal women?
6 ml.
75
Pregnant woman with enlarged ovary? What's the diagnosis?
Decidualized endometrioma.
76
What type of ovarian tumor seen in Meig's syndrome?
Benign!
Most commonly Fibroma.
77
What's the key finding in para-ovarian cysts?
They DO NOT distort adjacent ovary.
They arise from remnant of the Wolffian duct.
78
Ovarian vein thrombophlebitis?
- Posst-partum.
- More on the RIGHT.
- Treat with Abx and AC.
- PE is the feared complication.
79
What defines a penile fracture?
rupture of a corpus cav- ernosum and its surrounding fibroelastic sheath, the tunica albuginea.
80
What's the diagnosis?
Prostatic utricle cyst. DOES NOT extend beyond the upper aspect of the gland. Mullerian duct cyst DOES!
Associated with:
- Hypospadius.
- Unilateral renal agenesis.
- Imporforate anus.
81
What's the diagnosis?
Müllerian Duct Cyst.
They do not communicate with the posterior urethra. Utricle cyst DO; hence they opacify in RUG.
82
Coffee bean sign
seen in sigmoid volvulus.
83
**Benign Pneumatosis**
* COPD,
* scleroderma,
* SLE
* or steroids therapy!
84
High-residue diet
increases the risk of sigmoid volvulus.
85
Where's the tear located in Boerhaave syndrome?
the left posterolateral wall of the distal esophagus.
86
What's annotated by arrow?
Cowper glands. (Male equivalent of Batholins)
87
CT Renal protocol
* corticomedullary: 25-30 secs,
* nephrographic 90-120
* and delayed excretory ~8 mins
88
CT urogram:
* (Arterial
* nephrograhpic
* and late delayed 8 mins)
89
Adrenal adenoma shows more than 50% washout in HU in delayed phase.
Adrenal adenoma shows more than 50% washout in HU in delayed phase.
90
The pancreas is rertoperitoneal except for
tail, which runs in the splenorenal ligament.
91
What's the most sensitive sign of pancreatic Trauma?
Fluid seen between splenic vein and the pancreas
92
What's the most common vascular complication after liver transplant?
Hepatic Artery thrombosis in mostly at anastomosis site.
93
if you see liver abscess after transplant?
Suspect HA thrombosis. Abscess from biliary necrosis.
94
the right triangular ligament
is long and separates the right sub-phrenic space from the right sub-hepatic space.
95
The left triangular ligament is short and doesn't separate the sub-phrenic and the sub-hepatic spaces.
The left triangular ligament is short and doesn't separate the sub-phrenic and the sub-hepatic spaces.
96
The connection between the left paracolic gutter and the left sub-phrenic space is partially limited by which ligament?
the phrenicocolic ligament.
97
Why HCC might look hyperdense on dry CT?
Abundant copper-binding protein in HCC may lead to excessive copper accumulation in the tumor makes it look hyper-dense on unenhanced CT and high signal on T1 MRI.
98
What's the MC location for GI lymphoma?
Stomach
99
In GIST, most common growth pattern is
EXOPHYTIC
100
cavitating mesenteric lymph node syndrome seen in?
Celiac disease.
101
Which GI tumor has positive immunoreactivity to CD117?
GIST.
(KIT, a tyrosine kinase growth factor receptor).
102
Abdominal pain with long history of NSAIDs use?
Mucosal diaphragm disease of the bowel.
103
Replaced left hepatic artery runs in
the fissure of ligamentum venosum.
104
How can you upgrade Li-RADS by using the Ancillary features?
No higher than LR-4!
105
The subhepatic spaces are contiguous with the sunphrenic spaces bilaterally.
The subhepatic spaces are contiguous with the sunphrenic spaces bilaterally.
106
Primary omental infarction
* most often seen in young patients 20 to 40 years
* men more often affected than women
* there may be a history of marathon running.
107
Abdominal Compartment Syndrome
defined as intra-abdominal pressure of at least 20 mm Hg with dysfunction of at least one thoracoabdominal organ.
108
the MCC of death in VHL pts.
RCC
109
A collision tumor
represents metastasis into an adrenal gland with a pre-existing adenoma.
110
What's the best internal control organ to determine chemical shift artifact in adrenal gland?
Spleen!
111
Primary neoplasms arising within bladder diverticula are
most commonly transitional cell carcinoma (TCC)
112
What kind of prostatitis can occur after TURP?
Granulomatous prostatitis
113
What's the name of the sign?
Intra-decidual sign. Sagittal view of the uterus demonstrates an intrauterine fluid collection (arrow) lying within the echogenic decidua (D) posterior to a thin echogenic line (arrowheads) representing the collapsed uterine cavity.
114
What's the name of th sign?
Double Decidual Sac Sign. intrauterine fluid collection (long arrow) with an inner echogenic ring (arrowheads) directly around the collection and an outer ring (short arrows) in the peripheral aspect of the decidua.
115
How should the technique be done to evaluate for placenta previa on US?
With empty Bladder; full bladder can give False Positive.
116
Decidua basalis.
Where the placenta attaches to endometrium.
117
What's Placental lacunae?
* vascular structures of varying size and shape that are found in the placental parenchyma, creating a “moth-eaten” or “Swiss cheese” placental appearance.
* visualization of lacunae has the highest sensitivity in the diagnosis of Placenta Acreta.
118
What's the MC placental tumor?
* Chorio-angioma.
* has pulsating flow.(differ from hematoma).
* Near the cord insertion.
119
Most associated anomalies with two-vessel cord?
Cardiac and GU.
120
Nuchal translucency
* Mesured in 1st trimester.
* Should be less than 3 mm.
121
Nuchal Fold thickness
* Measured in 2nd trimester..
* Should be less than 6 mm.
122
What's the most common neural tube defect?
Spina Bifida.
123
What's Uterine dehiscence?
Uterine dehiscence is characterized by incomplete rupture of the uterine wall, usually involving the endometrium and myometrium but with an intact overlying serosal layer. Difficult to diagnose by imaging.
124
What's Fetus papyraceus?
describes a mummified fetus in a multiple gestation pregnancy in which one fetus dies and becomes flattened between the membranes of the other fetus and uterine wall
125
what's adrenal adenoma washout equation?
Consider mets or pheo if arterial or PV HU\> 120.
126
MCC of postmenopausal bleeding?
Endometrial atrophy.
Hormone therapy in the 2nd.
127
What's hydatid of Morgagni?
The appendix testis
128
What's scrotal Pearl?
Calcified previously torsed testicular appendix
129
When can you give methotrexate in ectopic?
* size less than 3.5 cm.
* Not ruptured.
* No heart beat.
130
The best diagnostic clue for a hydrocele on ultrasound
when scrotal fluid collection surrounds the testis except for the "bare area" where tunica vaginalis does not cover the testis and is attached to the epididymis.
131
The most important factor predicting malignancy within an intrascrotal mass
is whether the mass is within (very likely cancer) or outside (unlikely cancer) the testicle.
132
Which part of the testicle is more prone to infarct?
The upper pole of the testis is more prone to infarction because of dual supply to the lower pole from the posterior epididymal artery.
133
What's Erdheim chester?
* Symmetrical bone sclerosis in tibia and femors.
* Bilateral peri-irenal fibrosis/ fat stranding. (Hairy kidneys).
* Diffuse interlobular septal thickening.
134
What are risk factors for malignnat transformation of hepatic adenoma?
* Male gender
* Anabolic steroid use
* Beta- catenin subtype
* more than 5cm.
135
What's cecal bascule?
a **variant of cecal volvulus** (accounting for 10% of cases) caused by **anterior**, **superior**, and **medial** folding of the cecum on the ascending colon.
136
S/p Gastric banding comes in with pain and vomiting, what's the diagnosis?
**Posterior** slippage.
* Less common than anterior.
* "O-sign" band en face.
137
What's Corona mortis?
Obturator artery arises from inferior epigastric artery.
\* in the picture.
EIA: Inferior epigastric artery.
138
Patient is s/p R-en-Y bypass with abdominal pain, what the diagnosis?
Closed loop obstruction at the JJ anastomosis.
Whenever you see the J-shaped excluded stomach dilated in a RenY bypass; think about JJ anastomosis obstruction.
139
S/p Gastric banding comes in with pain, what's the diagnosis?
Anterior slippage.
* More common than posterior.
* When band becomes more horizontal, Phi angle\> 58 degrees.
140
What's gastrinoma triangle?
141
If you see an amniotic sac without an embryo?
This is suggestive of pregnancy failure. **(Empty amnion sign)**
Order of appearance: Gest sac \> YS \> **Embryo** \> Amnion
