GI Flashcards
1
Q
liver –> Couinaud segmts –> sup segmts? inf?
A
- sup: 2, 4, 8, 7, 1
- inf: 3, 4, 5, 6
2
Q
liver –> caudate lobe –> draining V?
A
IVC
3
Q
liver MRI –> steatosis vs hemochromatosis –> inphase/out phase signal?
A
- out of phase –> low signal –> fat
- in phase –> low signal –> iron
4
Q
liver –> amyloid –> CT appearance?
A
hypodense –> focal or diffuse
5
Q
Wilson dz –> copper deposit –> locations? (3)
A
- basal ganglia
- cornea
- liver
6
Q
Wilson dz –> liver –> CT appearance?
A
mult hyperdense nodules
7
Q
iron overload –> accum in what cell type? —> hemochromatosis vs hemosiderosis
A
- hemochromatosis –> hepatocytes
- hemosiderosis –> reticuloendothelial system –> hepatic Kupffer cells
8
Q
hemochromatosis vs hemosiderosis –> affected organs?
A
hemochromatosis:
- liver
- pancreas
- myocardium
- skin/jt
hemosiderosis:
- liver
- spleen
- BM
9
Q
hemochromatosis vs hemosiderosis –> MOA?
A
- hemochromatosis: genetic defect –> inc iron absorb
- hemosiderosis: blood transfusion or defective erythrocytosis
10
Q
hemochromatosis vs hemosiderosis –> tx?
A
- hemochromatosis: phlebotomy
- hemosiderosis: iron chelator
11
Q
what is 2ary hemochromatosis?
A
chronic hemosiderosis –> RES saturated –> hepatic damage
12
Q
noncontrast CT –> hyperdense liver –> HU?
A
> 75
13
Q
noncontrast CT –> hyperdense liver –> ddx? (4)
A
- iron overload
- med (amiodarone, gold, methotrexate)
- copper overload (Wilson dz)
- glycogen excess
14
Q
mult tiny hypodense liver lesions –> (5)
A
- candidiasis –> microabscesses
- mets
- lymphoma
- biliary hamartoma
- Caroli dz
15
Q
liver abscess –> MC etiology?
A
bowel process:
- diverticulitis
- appendicitis
- Crohn
- bowel surg
16
Q
hepatic echinococcus –> hydatid cyst –> CT appearance?
A
well-defined hypodense mass –> floating membrane or assoc daughter cyst
17
Q
cirrhosis –> early findings? (3)
A
- preportal space expand
- caudate lobe enlrg –> caudate to R lobe size ratio >0.65
- empty gallbladder fossa sign
18
Q
what is Gamma-Gandy bodies?
A
cirrhosis –> 2nary finding –> splenic microhemorrhage
19
Q
liver cirrhosis –> regenerative nodule –> arterial phase –> enhance or not?
A
not enhance
20
Q
liver cirrhosis –> what is siderotic nodule?
A
iron-rich regenerative or dysplastic nodule
21
Q
cirrhosis –> hypervasc liver mass –> ddx? (1)
A
HCC until proven otherwise
22
Q
HCC –> classic enhancemt pattern?
A
- arterial phase –> enhance
- portal venous phase –> washout
23
Q
cirrhosis –> what is “nodule in a nodule”?
A
enhancing nodule w/in dysplastic nodule –> early HCC
24
Q
fibrolamellar HCC –> epidemiology?
A
young –> no cirrhosis
25
fibrolamellar HCC --> MRI findings? (3)
- lrg heterogeneous mass
- central fibrotic scar --> T1/T2 hypo
- 10% --> capsular retract
26
liver mets --> best seen on what phase imaging?
most --> hypovasc --> portal venous --> hypodense
27
hypervasc liver mets? (5)
- neuroendocrine tumor --> pacnreatic, carcinoid
- RCC
- thyroid CA
- melanoma
- sarcoma
28
liver mets --> T1/T2 signal?
- T1 hypo
| - T2 hyper
29
what is pseudocirrhosis?
mult scirrhous liver mets --> macronodular liver contour
30
pseudocirrhosis --> MC etiology?
treated breast CA
31
liver --> capsular retraction --> ddx? (6)
- mets --> usu post-tx
- fibrolamellar HCC
- HCC
- epithelioid hemangioendothelioma
- intrahep cholangioCA
- confluent hepatic fibrosis
32
what is epithelioid hemangioendothelioma?
liver --> rare vasc malig --> mult round subcapsular mass --> can confluent
33
epithelioid hemangioendothelioma --> mass appearance?
halo or target
34
what is focal nodular hyperplasia (FNH)?
disorganized liver tissue
35
focal nodular hyperplasia (FNH) --> assoc w OCP --> T/F?
F
36
focal nodular hyperplasia (FNH) --> enhancemt pattern?
- arterial --> avid enhance --> quick washout
- portal venous --> unenhancing central "scar"
- delayed --> scar enhance
37
what is hepatic hemangioma? blood supply?
benign mass --> disorg endothelial-lined pockets of blood vessels --> supplied by hep A
38
liver --> giant hemangioma --> nonenhancing central area --> what is it?
cystic degen
39
hepatic hemangioma --> enhancemt pattern?
peripheral nodular enhance --> progress fill-in
40
hepatic hemangioma --> noncontrast CT --> density?
hypo
41
what is hepatic adenoma?
benign neoplasm:
- hepatocytes
- scattered Kupffer cells
- no bile ducts
42
focal nodular hyperplasia (FNH) --> contain bile ducts --> T/F?
T
43
hepatic adenoma --> assoc RF? (2)
- OCP
| - anabolic steroid
44
mult hepatic adenoma --> synd? (1)
von Gierke dz (type 1 glycogen storage dz)
45
hepatic adenoma --> tx? why?
resect --> high risk hemorrhage
46
hepatic adenoma --> MRI appearance? (3)
- arterial phase --> hypervasc
- if fatty --> hypo OOP
- hemorrhage --> T1 hyper
47
what is Budd-Chiari?
hepatic venous outflow obstruct --> thrombotic vs non
48
acute Budd-Chiari --> clinical triad?
- abd pain
- hepatomeg
- ascites
49
Budd-Chiari --> vascular findings? (3)
- hep V --> no flow
- hep V/IVC --> thrombus
- collateral vessels
50
liver --> what is veno-occlusive dz?
patent hep V --> destruction of post-sinusoidal venules
51
liver --> what is veno-occlusive dz --> epidemiology?
BM tx
52
liver --> what is veno-occlusive dz --> imaging findings? (4)
nonspecific:
- hepatomeg
- heterogen enhance
- narrow hep V
- periportal edema
53
what is cardiac hepatopathy?
HF, constrictive pericarditis, R valve dz --> passive hepatic congest --> cirrhosis
54
cardiac hepatopathy --> imaging findings? (3)
- contrast reflux into IVC/hepV
- enlrg IVC/hepV
- enlrg liver --> mottled enhance
55
what is biliary hamartoma (von Meyenburg complex)?
embryology fail normal bile duct formation --> small cystic liver lesions that not comm w biliary tree
56
liver injury --> MDCT grading system? (5)
- grade I: superficial lac or subcapsular hematoma --> <1cm
- II: 1-3cm
- III: >3cm
- IV: >10cm or 1 hep lobe devasc
- V: both hep lobes --> devasc
57
eovist --> excretion? T1 signal?
biliary excretion
T1 hyper biliary fluid
58
choledochal cyst --> Todani classification?
- type I: CBD --> fusiform dilate
- II: extrahep --> saccular dilation
- III: intra-duodenal
- IVA: mult --> intra & extra-hep
- IVB: mult --> extra-hep only
- V (Caroli dz): intrahep
59
choledochal cyst --> tx or no? why?
resect --> inc risk cholangioCA
60
choledochal cyst V (Caroli dz) --> assoc condition?
polycystic kidneys
61
choledochal cyst V (Caroli dz) --> sign?
central dot sign
62
what is Caroli synd?
- Caroli dz
| - hep fibrosis
63
gangrenous cholecystitis --> MOA?
inc intralum pressure --> GB wall ischemia
64
Charcot triad? dx?
ascending cholangitis:
- fever
- abd pain
- jaundice
65
ascending cholangitis --> key imaging finding?
biliary wall --> thick & hyperenhance
66
what is 1ary sclerosing cholangitis (PSC)?
idiopathic --> bile duct inflamm --> destroy
67
1ary sclerosing cholangitis (PSC) --> assoc condition?
ulc colitis
68
1ary sclerosing cholangitis (PSC) --> imaging appearance?
CBD & intrahep bile duct --> beaded irreg appearance
69
1ary sclerosing cholangitis (PSC) --> ddx? (1)
HIV cholangitis (cholangiopathy)
70
1ary sclerosing cholangitis (PSC) --> comp? (3)
- cirrhosis
- cholangioCA
- recurrent biliary infx
71
what is 1ary biliary cirrhosis (PSC)?
smaller bile duct --> inflamm --> destroy
72
1ary biliary cirrhosis (PSC) --> epidemiology?
middle age F
73
1ary biliary cirrhosis (PSC) --> initial ssx? (1)
pruritis
74
HIV cholangitis (cholangiopathy) --> MC org? (2)
- Cryptosporidium
| - CMV
75
HIV cholangitis (cholangiopathy) vs 1ary biliary cirrhosis (PSC) --> differentiating imaging finding?
HIV cholangitis --> papillary stenosis
76
recurrent pyogenic cholangitis (Oriental cholangiohepatitis) --> MC org?
parasite Clonorchis sinensis
77
recurrent pyogenic cholangitis (Oriental cholangiohepatitis) --> imaging triad?
- pneumobilia
- lamellated bile duct filling defect
- intra & extra-hep biliary dilate & stricture
78
what is biliary cystadenoma?
benign cystic neoplasm
79
biliary cystadenoma --> epidemiology?
middle age F
80
biliary cystadenoma --> comm w biliary system --> T/F?
F
81
biliary cystadenoma --> imaging appearance?
lrg multiloculated cystic mass
82
what is cholangioCA?
biliary duct epithelium --> malig tumor
83
what is Klatskin tumor?
MC form of cholangioCA --> at hilum
84
cholangioCA --> imaging appearance?
- intrahep --> confluence of central bile ducts --> mass
- biliary dil
- capsular retraction
- tumor fingers into bile ducts
85
gallbladder CA --> MC appearance?
scirrhous mass --> invade GB wall --> into liver
86
GB mets --> 1ary CA?
melanoma
87
pancreas neoplasm --> 3 broad types?
- solid epithelial
- cystic epithelial
- endocrine
88
pancreas --> solid epithelial neoplasm -->2 types?
- ductal adenoCA
| - acinar cell CA
89
pancreas --> cystic epithelial neoplasm --> 4 types?
- serous cystic
- mucinous cystic
- solid & papillary epithelial neoplasm (SPEN)
- intraductal papillary mucinous neoplasm (IPMN)
90
pancreas --> endocrine neoplasm --> 5 types?
- insulinoma
- gastrinoma
- glucagonoma
- VIPoma
- somatostatinoma
91
pancreas --> cystic epithelial neoplasm --> epidemiology?
- serous cystic
- mucinous cystic
- solid & papillary epithelial neoplasm
- intraductal papillary mucinous neoplasm (IPMN)
- serous cystic: old F (grandmother tumor)
- mucinous cystic: middle age F (mother)
- solid & papillary epithelial neoplasm: young F (daughter)
- intraductal papillary mucinous neoplasm: old M (grandfather)
92
MC pancreatic neoplasm?
pancreas adenoCA
93
pancreas adenoCA --> RF? (3)
- smoke
- alcohol
- chronic panc
94
pancreas adenoCA --> MC location?
panc head
95
CT --> pancreas --> phases?
- noncontrast
- late art
- portal venous
96
pancreas adenoCA --> CT appearance? T1 signal?
- hypodense/T1 hypo --> ill-defined, hypovasc
- panc duct obstruct --> double duct sign
- panc tail --> atrophy
97
pancreas mass --> no duct dil --> ddx? (8)
- autoimmune pancreatitis
- groove pancreatitis
- cystic panc tumor
- neuroendocrine tumor
- duodenal GIST
- peripanc LN
- panc mets
- lymphoma
98
double duct sign --> no panc mass --> ddx? (1)
panc adenoCA
99
pancreas --> what is acinar cell CA?
panc adenoCA variant --> rare, aggressive
100
acinar cell CA --> clinical triad? MOA?
malig cells --> lipase --> lipase hypersecretion synd:
- subQ fat necrosis
- bone infarct --> polyarthralgia
- eosinophilia
101
pancreas --> serous cystadenoma --> benign or malig?
benign
102
pancreas --> serous cystadenoma --> imaging features? (3)
- many small cysts --> >6 cysts --> <2cm --> may appear solid
- hypervasc
- central stellate calc
103
pancreas --> mucinous cystic neoplasm --> benign or malig?
benign
104
pancreas --> mucinous cystic neoplasm --> tx? why?
resect --> malig potential
105
pancreas --> mucinous cystic neoplasm --> imaging feature? (1)
1 or few lrg cysts --> <6 cysts --> >2cm
106
pancreas tumor --> capsule --> ddx? (2)
- mucinous cystic
| - SPEN
107
solid & papillary epithelial neoplasm (SPEN) --> imaging feature? (2)
- lrg heterogeneous solid & cystic mass
| - hemorrhage
108
pancreas --> intraductal papillary mucinous neoplasm (IPMN) --> benign or malig?
variable:
- benign
- indolent
- agg
109
pancreas --> intraductal papillary mucinous neoplasm (IPMN) --> main panc duct vs sidebranch --> which is more malig potential?
main
110
pancreas --> intraductal papillary mucinous neoplasm (IPMN) --> classic imaging appearance?
intra-pancreas --> cystic lesion --> comm w panc duct or sidebranch
111
pancreas --> intraductal papillary mucinous neoplasm (IPMN) --> resect --> indication? (3)
- >3cm
- mural nodule
- panc duct >10mm
112
hypervasc liver mass + assoc pancreatic mass --> ddx? (1)
panc endocrine neoplasm --> liver mets
113
panc endocrine tumor --> hypo- or hypervasc?
hyper
114
panc endocrine tumor --> small vs lrg --> density?
- small --> solid
| - lrg --> central necrosis & calc
115
MC panc endocrine tumor?
insulinoma
116
insulinoma --> clinical triad?
Whipple triad:
- hypoglycemia
- hypoglycemia ssx
- improve w glucose admin
117
2nd MC panc endocrine tumor?
gastrinoma
118
gastrinoma --> assoc synd?
mult endocrine neoplasia (MEN) type 1
119
mult endocrine neoplasia (MEN) type 1 --> gastrinoma --> location?
duodenum --> mult
120
what is gastrinoma triangle?
typical location --> triangle:
- cystic duct & CBD
- duodenum
- panc neck/body
121
gastrinoma --> comp? (1)
high gastrin --> stomach --> carcinoid tumor
122
panc divisum --> MOA?
fail fusion of ventral & dorsal panc ducts
123
panc divisum --> comp? MOA?
Santorinicele --> obstruct minor papilla --> pancreatitis
124
panc divisum --> sign?
crossing sign --> CBD cross main duct
125
what is annular panc?
ventral panc bud --> incomplete rotate --> panc wrap around duodenum
126
adult --> annular panc --> comp? (3)
- pancreatitis
- peptic ulcer dz
- duodenal obstruct
127
neonate --> annular panc --> comp? (1)
duodenal obstruct
128
what is common channel synd (pancreaticobiliary maljx)?
no septum bw distal CBD & panc duct --> reflux bw 2 systems
129
von Hippel-Lindau --> pancreas neoplasms? (2)
- serous cystadenoma
| - neuroendocrine tumor
130
child --> MCC panc atrophy?
cystic fibrosis
131
cystic fibrosis --> panc comp? (2)
- fatty atrophy
| - pancreatic cystosis --> diffuse replace panc w innum cysts
132
what is Schwachman-Diamond dz?
rare --> inherit --> panc --> diffuse fatty replace:
- panc exocrine insuff
- neutropenia
- bone dysplasia
133
child --> 2nd MCC panc atrophy?
Schwachman-Diamond dz
134
intra-panc access spleen --> MC location?
panc tail
135
acute panc --> 2 MCC?
- alcohol
| - obstructing gallstone
136
autoimmune pancreatitis --> assoc condition?
Sjogren
137
autoimmune pancreatitis --> typical imaging appearance?
diffuse "sausage-shape" enlrgmt of pancreas --> however, can be focal
138
autoimmune pancreatitis --> tx?
steroid
139
groove pancreatitis --> epidemiology?
young M --> heavy drink
140
groove pancreatitis --> chronic --> duodenal changes? (2)
- duodenal stenosis
| - cystic change of duodenal wall
141
polysplenia --> assoc anomaly? (3)
- severe congenital cardiac anomaly
- venous anomaly --> ie IVC w hemi/azygous continuation
- preduodenal portal V
142
splenic hemangioma --> assoc synd? (2)
- Kasabach-Merritt
| - Klippel-Trenaunay-Weber
143
Kasabach-Merritt synd? (3)
- anemia
- thrombocytopenia
- consumptive coagulopathy
144
Klippel-Trenaunay-Weber synd? (3)
- cutaneous hemangioma
- varicose veins
- extremity hypertrophy
145
splenic hemangioma --> CT density?
- noncontrast
- contrast
- noncontrast: hypo or iso
| - contrast: hyperenhance
146
splenic hemangioma --> MR signal?
- T2
- contrast
- T2: hyper
| - contrast: peripheral or homogenous enhance
147
splenic hemangioma --> Tc-99m RBC scan --> finding?
delayed --> inc activity in lesion
148
splenic hemangioma --> Tc-99m sulfur colloid scan --> finding?
dec or inc activity
149
what is splenic hamartoma?
malformed red pulp --> benign lesion
150
splenic hamartoma --> assoc condition? (1)
tuberous sclerosis
151
splenic hamartoma --> CT density?
- noncontrast
- contrast
- noncontrast: hypo to iso
| - contrast: heterogeneous enhance
152
splenic hamartoma --> MR signal?
- T2
- enhance
- T2: iso to slight hyper
| - enhance: early heterogeneous enhance --> delayed homogenous enhance
153
spleen --> what is post-traumatic pseudocyst?
spleen --> hematoma --> evolution --> end result
154
spleen --> congenital true (epithelial) cyst vs post-traumatic pseudocyst?
- lining
- internal septations
- mural calc
congenital true (epithelial) cyst:
- epithelial lining
- internal septations
- no mural calc
post-traumatic pseudocyst:
- lining --> fibrotic tissue
- no internal septations
- mural calc
155
spleen --> lymphangioma --> classic imaging appearance?
multilocular cystic structure w thin septations
156
sarcoidosis --> spleen --> MC manifestation? less common?
- #1 splenomeg
| - mult hypodense nodules --> no enhance
157
spleen --> what is inflamm pseudotumor?
unclear etiology --> focal collection --> immune cells + inflamm exudate
158
spleen --> MC org?
- single abscess
- mult
- single abscess --> bact
| - mult --> fungal
159
spleen abscess --> charact US finding?
wheel w/in wheel or bull's eye appearance
160
MC spleen malig?
lymphoma
161
1ary spleen lymphoma --> MC imaging appearance?
solitary hypovasc mass
162
systemic lymphoma --> 2ary spleen involve --> 4 imaging presentations?
- miliary mass
- mult small to mod size mass
- 1 lrg mass
- splenomeg --> no mass
163
spleen lymphoma --> MRI --> T1 post-contrast appearance?
hypoenhance
164
spleen lymphoma --> US appearance?
cystic --> internal flow
165
wandering spleen --> comp?
torsion
166
splenic infarct --> classic imaging appearance? less common?
- #1 peripheral --> wedge --> nonenhance
| - heterogenous mass
167
splenic infarct --> acute & hemorrhagic --> T1 signal?
T1 hyper
168
splenic infarct --> acute & hemorrhagic --> T1 /T2 signal?
- T1 hypo
| - T2 hyper
169
what are Gamna-Gandy bodies?
portal HTN --> spleen --> hemosiderin
170
Gamna-Gandy bodies --> MRI signal?
all seq --> hypo
171
what is Gaucher dz?
AR --> glucocerebrosidase def --> glucocerebrosides accum in RES
172
Gaucher dz --> splenic manifestations? (2)
- splenomeg
| - mult nodules
173
spleen trauma --> pseudoaneurysm vs AV fistula --> CT appearance?
indistinguishable
174
nasopharynx --> anatomy location?
base of skull --> soft palate
175
oropharynx --> anatomy location?
uvula --> hyoid bone
176
hypopharynx --> anatomy location?
hyoid bone --> cricopharyngeus M
177
what is Schatzki ring?
distal esophagus --> focal narrowing of B mucosal ring --> intermittent dysphagia
178
focal narrowing of B mucosal ring --> asx --> dx?
lower esophageal ring
179
Schatzki ring --> assoc condition?
hiatal hernia
180
chronic esophagitis --> comp?
scarring --> smooth tapered stricture above GE jx
181
reflux esophagitis --> imaging finding?
thick distal esophageal folds
182
Barrett esophagus --> imaging features? (3)
- distal esophagus --> featureless
- proximal: reflux esophagitis --> mucosal granularity, superficial erosion
- stricture --> abnormally high location than peptic stricture
183
esophageal candidiasis --> imaging appearance?
variable:
- scattered plaque-like lesions
- shaggy esophagus
184
herpes esophagitis --> imaging appearance?
scattered small uclers
185
CMV/HIV esophagitis --> imaging appearance?
large flat ovoid ulcer
186
esophagus --> malig stricture --> key imaging finding?
shouldered margins
187
esophagus --> long smooth narrow stricture --> ddx? (3)
- caustic stricture
- NG tube stricture
- radiation stricture
188
esophagus --> radiation stricture --> how differentiate from other types of stricture?
spare GE jx
189
esophagus --> MC submucosal tumor?
benign mesenchymal tumor
190
esophagus --> benign mesenchymal tumor --> includes what kind of tumors? (4)
- GIST
- leiomyoma
- lipoma
- hemangioma
191
esophagus --> adenoma --> mucosal or submucosal lesion? benign or malig?
mucosal lesion --> benign --> malig potential
192
esophagus --> what is inflamm polyp? assoc condition?
enlrg gastric fold --> protrude into esophagus
reflux
193
esophagus --> fibrovasc polyp --> MC location? dx feature?
cervical esophagus
CT --> fatty component
194
esophagus --> fibrovasc polyp --> benign or malig?
benign
195
esophagus --> what is "downhill" varices?
SVC obstruct --> varices --> prox esophagus
196
esophageal duplication cyst --> location?
post mediastinum:
- esphagus --> submucosa
- extrinsic to esophagus
197
neurenteric cyst --> assoc anomaly?
vertebral body anomaly
198
esophageal vs bronchogenic duplication cyst --> differentiate on imaging?
indistinguishable
199
what is achalasia?
motility disorder --> Auerbach plexus --> myenteric ganglia abnormal --> distal esophagus --> unable to relax
200
what is vigorous achalasia?
less severe form of achalasia --> repetitive nonpropulsive contractions
201
2ary achalasia --> cause?
Chagas dz
202
achalasia --> tx?
Heller myotomy --> incise lower esophageal muscle fibers
203
what is pseudoachalasia?
GE jx --> obstructing cancer
204
what is nutcracker esophagus?
- chest pain
- normal XR
- manometry --> high amp contractions
205
esophagus --> pulsion diverticulum --> MOA?
inc esophageal pressure
206
esophagus --> traction diverticulum --> MOA?
adj struct --> ie TB mediastinal LN --> traction --> diverticulum
207
Zenker diverticulum --> MOA?
cricopharyngeus M --> fail to relax --> inc hypopharyngeal pressure --> diverticulum
208
Zenker diverticulum --> location?
post
209
Zenker diverticulum --> tx? (2)
- cricopharyngeal myotomy & diverticulopexy
| - diverticulectomy
210
what is pseudo-Zenker diverticulum?
barium trapped in pharyngeal contraction wave
211
Killian-Jamieson diverticulum --> location?
below cricopharyngeus M --> ant --> bilat
212
esophagus --> what is pseudodiverticulosis?
chronic reflex esophagitis --> dilated submucosal glands --> mult tiny outpouchings
213
esophagus --> what is pseudodiverticulosis --> assoc other finding?
upper/mid esophagus --> smooth stricture
214
feline esophagus --> normal variant --> T/F?
T
215
scleroderma --> esophagus --> manifestaiton?
distal 2/3 esophagus --> smooth muscle atrophy & fibrosis --> lack of peristalsis --> marked dilation
216
eosinophilic gastritis --> features? (2)
- h/o allergy
| - stomach & SB --> thick folds
217
what is Menetrier dz?
prox stomach --> parietal cells --> replace w hyperplastic epithelial cells --> achlorhydria --> protein-losing enteropathy --> dx of exclusion
218
stomach --> what is hyperplastic polyp (inflamm polyp)? benign or malig?
chronic inflamm --> gastric gland --> cystic dilate
almost always benign
219
what is fundic gland polyposis synd?
familial adenomatous polyposis synd --> variant that involve stomach
220
stomach --> what is adenomatous polyp? benign or malig?
neoplastic polyp --> malig potential
221
stomach --> hamartomatous polyp --> benign or malig? assoc synd? (3)
benign
- Peutz-Jeghers
- juvenile polyposis
- Cronkhite-Canada
222
MC submucosal gastric tumor?
gastrointestinal stromal tumor (GIST)
223
gastrointestinal stromal tumor (GIST) --> cell of origin?
interstitial cells of Cajal --> pacemaker cell --> drive peristalsis
224
gastrointestinal stromal tumor (GIST) --> location of occurence?
GI tract --> anywhere
225
gastrointestinal stromal tumor (GIST) --> benign or malig?
benign or malig
226
gastrointestinal stromal tumor (GIST) --> features that inc risk of malig? (2)
- location not stomach --> ie. small bowel, rectum
| - size & #mitoses
227
submucosal gastric mass --> ddx? (3)
- mesenchymal tumor
- carcinoid
- ectopic panc rest
228
submucosal gastric mass --> mesenchymal tumor --> types? (4)
- GIST
- fibroma
- lipoma
- neurofibroma
229
ectopic panc rest --> classic imaging appearance?
stomach --> submucosal nodule --> umbilicated
230
gastric adenoCA --> manifestation? (2)
- mass
| - ulcer
231
gastric adenoCA --> RF? (4)
- #1 chronic inflamm
- ingest processed meats
- atrophic gastritis
- pernicious anemia
- post-subtotal gastrectomy
232
what is Krukenberg tumor? (2)
- gastric CA --> mets to ovary
| - any mucinous mets to ovary
233
benign gastric ulcer --> typical imaging features? (3)
- radiating gastric folds --> smooth & symm
- ulcer extend beyond normal contour of gastric lumen
- Hampton line --> nonulcerated mucosa surrounding ulcer crater
234
benign gastric ulcer vs benign ulcer assoc w ASA --> MC location?
- most benign ulcer --> lesser curvature
| - assoc w ASA --> grter curvature, antrum
235
gastric CA --> ulcer --> typical imaging features? (4)
- asymm ulcer crater --> surrounding nodular tissue
- normal gastric wall & surrounding tissue --> abrupt transition
- ulcer crater NOT project beyond expected location of gastric wall
- Carman meniscus sign --> compress --> ulcer splay open
236
Roux-en-Y gastric bypass --> components?
- prox gastric pouch --> gastrojejunostomy
| - distal side-to-side jejunojejunostomy --> panc & bile
237
Roux-en-Y gastric bypass --> comp? (6)
- postop leak
- gastrogastric fistula
- SBO
- internal hernia
- stomal stenosis
- marginal ulcer
238
Roux-en-Y gastric bypass --> acute postop period --> SBO --> cause?
gastrojejunostomy or jejunojejunostomy --> edema or hematoma
239
Roux-en-Y gastric bypass --> late --> SBO --> cause? (2)
- internal hernia
| - adhesion
240
Roux-en-Y gastric bypass --> internal hernia --> location? (3)
- #1 transmesocolic
- Peterson's space
- jejunojejunostomy --> mesenteric defect
241
internal hernia --> imaging features? (3)
- swirling mesentery
- mesentery --> mushroom shape
- small bowel loops --> post to SMA
242
SBO --> (impending) ischemia --> imaging findings? (4)
- engorged mesenteric vessels
- ascites around bowel
- wall thick
- lack of bowel wall enhance
- pneumatosis
243
closed loop obstruct --> cause? (2)
- adhesion
| - hernia
244
closed loop obstruct --> comp? (2)
- ischemia
| - volvulus --> ischemia
245
inguinal hernia --> indirect vs direct --> location relative to inf epigastric vessels?
- indirect: lat to inf epigastric vessel
| - direct: med
246
inguinal hernia --> indirect vs direct --> MOA? go into scrotum?
indirect: congenital --> patent processus vaginalis --> go into scrotum
- direct: ant abd wall --> weak area --> not into scrotum
247
obturator hernia --> epidemiology? MOA?
elder F --> pelvic floor laxity --> bowel herniate thru obturator canal
248
obturator hernia --> key imaging finding?
bowel --> bw pectineus & obturator M
249
internal hernia --> locations? (3)
- transmesenteric
- paraduodenal
- Foramen of Winslow
250
transmesenteric internal hernia --> MC type?
transmesocolic
251
transmesenteric internal hernia --> imaging findings? (3)
- colon --> post displace
- SB --> ant to colon
- SMA/SMV --> displace & engorge
252
child --> MC hernia? MOA?
transmesenteric hernia: prenatal intestinal ischemia --> congenital mesenteric defect
253
2nd MC internal hernia?
paraduodenal
254
paraduodenal internal hernia --> MOA?
embryologic --> mesentery --> fail to fuse --> congenital mesenteric defect
255
paraduodenal internal hernia --> classic clinical presentation?
chronic --> postprandial pain --> relieve w massage (reduce hernia)
256
paraduodenal internal hernia --> L vs R --> which more common?
L
257
left paraduodenal hernia --> key imaging finding?
cluster of SB --> bw panc & stomach
258
Foramen of Winslow hernia --> key imaging finding? (2)
- upper abd --> dilated bowel
| - mesentery --> bw IVC & main portal V
259
small bowel --> lymphoma --> classic appearance?
small bowel wall --> aneurysmal expansion
260
small bowel --> 1ary neoplasm? (3)
- adenoCA
- GIST
- carcinoid
261
gallstone ileus --> what is Rigler's triad?
- pneumobilia
- SBO
- gallstone in small bowel
262
scleroderma --> small bowel --> fluoro findings? (2)
- antimesenteric border --> sacculations
| - "hidebound" bowel
263
scleroderma --> small bowel --> natural progression?
small bowel --> musc layers --> replace w collagen --> impair motility --> slow transit --> bact overgrowth --> progressive dilate --> pseudo-obstruct
264
celiac dz --> charact imaging finding?
reversal of jejunal & ileal fold patterns
265
celiac dz --> fluoro findings? (2)
- "flocculations" of barium
| - moulage sign
266
celiac dz --> comp? (6)
- small bowel --> T cell lymphoma
- intussusception
- pneumatosis
- spleen atrophy
- venous thromboembolism
- cavitating mesenteric LN synd (CMLNS)
267
low density mesenteric LN --> ddx? (4)
- TB
- Whipple dz
- trted lymphoma
- cavitating mesenteric LN synd (CMLNS)
268
SMA & IMA --> watershed region?
splenic flexure
269
TB --> colon --> MC location?
ileocecal valve
270
pseudomembranous colitis --> key imaging finding?
entire colon --> marked thick wall --> accordion sign --> severe colon wall thick w undulating enhancing inner mucosa
271
"lead pipe" colon --> dx?
UC
272
toxic megacolon --> imaging findings? (2)
- colon dilate --> >6cm
| - ileus
273
familial adenomatous polyposis (FAP) --> variants? (2)
- Gardner synd
| - Turcot synd
274
Gardner synd? (5)
DOPE:
- colon polyps
- desmoid tumor
- osteomas
- papillary thyroid CA
- epidermoid cyst
275
Turcot synd? (2)
- colon polyps
| - CNS tumor --> glioma, medulloblastoma
276
hereditary nonpolyposis colon CA synd (HNPCC, Lynch synd) --> assoc other CA? (5)
- endometrium
- stomach
- small bowel
- liver
- biliary
277
what is Peutz-Jeghers synd? (3)
AD:
- hamartomatous polyps --> #1 small bowel
- blue/brown spots --> lips, gums
- neoplasm --> gyn, GI
278
Peutz-Jeghers synd --> small bowel polyp --> comp?
intussusception
279
what is Cowden synd? (2)
AD:
- mult hamartomatous polyps --> skin, external mucus membrane, GI tract
- CA --> thyroid, skin, oral, breast, uterus
280
small bowel --> polyposis synd? (5)
- familial adenomatous polyposis (FAP)
- hereditary nonpolyposis colon CA synd (HNPCC, Lynch synd)
- Peutz-Jeghers synd
- Cowden synd
- Cronkhite-Canada
281
"misty" mesentery --> causes? (4)
- fluid
- inflamm
- tumor
- fibrosis
282
tumor --> "misty" mesentery --> MC ddx? (1)
non-Hodgkin lymphoma
283
carcinoid --> involve mesentery --> classic imaging appearance?
enhance soft tissue mass --> radiating linear bands into mesenteric fat
284
mesenteric mass --> calc --> ddx? (3)
- carcinoid
- desmoid tumor
- sclerosing mesenteritis
285
what is desmoid tumor? benign or malig?
proliferating fibrous tissue --> mass
benign --> local aggressive
286
what is sclerosing mesenteritis?
rare --> inflamm condition --> mesenteric root --> fatty necrosis & fibrosis
287
what is mesenteric panniculitis?
sclerosing mesenteritis --> variant --> inflamm predominate --> acute abd pain
288
mesenteric lymphoma --> sign?
sandwich sign --> 2 bulky lymphomatous mass --> bw is mesenteric fat & vessels
289
peritoneal carcinomatosis --> MC tumor type?
mucinous adenoCA
290
what is pseudomyxoma peritonei?
low grade malig --> mucus in peritoneal cavity
291
pseudomyxoma peritonei --> mucin source --> ddx? (3)
- appendix --> adenoma, adenoCA
- ovary
- colon
292
pseudomyxoma peritonei --> CT finding? (2)
- lobular ascites
| - pathognomic --> scallop liver margin
293
pseudomyxoma peritonei --> tx? (2)
- surg
| - hyperthermic intraperitoneal ctx lavage
