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Flashcards in GI Deck (143):
1

Where are cholesterol deposits located in GB adenomyomatosis?

Rokitanksy aschoff sinuses

2

Where is cholesterol in GB cholesterolosis?

Lamina propria

3

What is Mirizzi Syndrome?

Common hepatic duct is obstructed secondary to impacted cystic stone

4

Direct signs of stenosis Within vessel (2)

Elevated peak systolic velocity

Spectral broadening

5

Indirect signs of vessel stenosis (3)

Tardus parvus downstream

Low RI downstream

High RI upstream

6

Two causes of pulsatile hepatic vein

TR

Right chf

7

D vs s

TR

RHF

D deeper

S deeper

8

Decreased hv pulsatility 2

Cirrhosis

Hepatic venous outflow obstruction

9

Two causes of lipomatous pseudohypertrophy of the pancreas

Shwachman diamond

CF adult

10

Larger calculi in dilated pancreatic duct

Tropic pancreatitis

11

Sausage shaped pancreas

Autoimmune pancreatitis

12

True simple cysts are associated with what three syndromes?

VHL

CF
PCKD

13

Microcystuc mutilocular lobulated lesion with central calcification in the pancreatic head

Serous cyst adenoma

14

Mucinous cystic neoplasm

Unilocular lesion with peripheral calcs in body/tail

Mother

15

SPEN

Daughter lesion

Large lesion in tail with thick capsule

16

Three signs seen in pancreatic adenocarcinoma

Frostburg inverted 3

Wide duodenal sweep

17

Increases risk of pancreatic ampullary carcinoma in what syndrome

Gardeners

18

What are the three borders of the gastrinoma triangle

Superior: junction of cystic and CBD

Inferior: start of the third portion of the duodenum

Medial: start of the body of the pancreas

19

Two sources of blood supply in pancreatic transplant and what they supply

Sma: inferior pancreaticoduodenal artery and donor splenic artery to head

Donor splenic artery to body and tail

20

What are the two Venous drainage in pancreatic transplant

Donor portal vein and recipient smv

21

What are gamma gandy bodies

Hemorrhagic foci in spleen associated with portal hypertension

22

What is peliosis?

Multiple blood filled spaces in spleen and liver

23

What is the triad of felty syndrome?

Smg

RA

Neutropenia

24

What's the most common splenic infection in the us and what does it look like

Histoplasmosis

Multiple rounded calcs

25

What does splenic brucellosis look like on ct

Bulls eye calcification

26

What is the muscular ring above the vestibule?

A ring

27

What is the muscular ring below the vestibule?

B ring

28

Where does a Zenker diverticulum occur?

hypopharynx

29

Where does a killian jamieson diverticulum occur?

cervical esophagus

30

reticular mucosal esophageal pattern

Barretts

31

Ringed Esophagus

eosinophilc esophagitis

32

What defines T3 vs T4 esophageal cancer?

Adventitia vs invasion into adjacent structures

33

Shaggy Esophagus

Candidiasis

34

Multiple elevated benign nodules in an asymptomatic patient

Glycogenic Acanthoses

35

multiple small esophageal ulcers with halo of edema

herpes

36

large flat esophageal ulcer (2)

CMV HIV

37

What is the site of weakness where zenker diverticula arise?

killian triangle (posterior)

38

Multiple small esophageal outpouchings

chronic reflux- esophageal pseudodiverticulosis

39

What is dysphagia lusoria?

compression of esophagus from aberrant right subclavian artery

40

What three things are seen in Scleroderma?

lower 2/3 esophageal dysmotility, NSIP, small bowel with hide bound valvulae conniventes

41

What four things are seen in Gardner Syndrome?

FAP, desmoid tumors, osteomas, papillary thyroid cancer

42

What three things are associated with Turcots

FAP gliomas medulloblastomas

43

What is associated with Peutz Jeghers? (3)

small/large bowel CA, pancreatic CA, GYN CA

44

What three things are seen in Cowden?

Breast CA, Thyroid CA, Lhermitte Duclos

45

What two things are seen in Cronkhite Canada?

Stomach/SB/LB CA, Ectodermal disease

46

WHat is Carneys triad?

Extra adrenal pheo, GIST, Pulmonary chondroma

47

What is done in Billroth 1?

pylorus removed, proximal stomach sewed directly to the duodenum

48

carmen meniscus sign=

malignant stomach ulcer

49

hamptons line=

benign stomach ulcer

50

Linitis plastica can be the result of what three things?

scirrhous adenocarcinoma, breast or lung mets

51

What is the most common met to the stomach?

melanoma

52

What is Menetrier's Disease?

idiopathic gastropathy with rugal thickening involving fundus, sparing antrum

53

What is a rams horn deformity?

tapering of the antrum

54

What is the differential for a rams horn deformity?

peptic ulcer scarring, granuloamtous disease, scirrhous carcinoma

55

What is the most common GI tract location for sarcoid?

stomach

56

What is done in billroth 2?

partial gastrectomy, stomach attached to duodenum

57

What is done in roux en y?

gastric pouch attaced to jejunum, excluded stomach to duodenum, jejunum attached to other jejunum to form bottom of Y

58

Clover leaf sign=

healed peptic ulcer of duodenal bulb

59

Sand like jejunal nodules=

Whipples

60

Pseudo whipples is caused by?

MAI

61

What is Lane Hamilton Syndrome?

celiac sprue + idiopathic pulmonary hemosiderosis

62

What are the CT findings of Celiac Sprue? (2)

fold reversal and cavitary lymph nodes

63

Moulage sign=

dilated bowel with effaced folds seen in Celiac sprue

64

ribbon bowel=

graft vs host

65

Chronic dialysis patients may have what finding?

thickened dudodenal folds

66

Most common primary location of GI carcinoid?

distal ileum

67

NM for carcinoid?

MIBG or octreotide

68

Which hernia is medial to inferior epigastric artery?

direct

69

What causes a direct inguinal hernia?

defect in hesselbachs triangle

70

Which hernia is covered by internal spermatic fascia?

direct

71

What causes an indirect hernia?

failure of processus vaginalis to close

72

What is a superior lumbar hernia called?

Grynfeltt lesshaft

73

What is an inferior lumbar hernia called?

Petit

74

WHere is a spigelian hernia located?

along semilunar line through transversus abdominis aponeurosis

75

What does a littre hernia contain?

meckels diverticulum

76

What does an amyand hernia contain?

appendix

77

Which hernia is at a very high risk of strangulation?

Richter due to only one bowel wall involved

78

What is a Petersen hernia?

behind roux limb mesentery may be retro or antecolic

79

What and where is hte most common type of internal hernia?

paraduodenal, on the left at the duodenojejunal junction/fossa of landzert

80

Where are right sided paraduodenal hernias located?

fossa of waldeyer

81

What is an onion sign?

on ultrasound, layering within a cystic mass= mucocele

82

What two signs are seen in sigmoid volvulus?

coffee bean, inverted 3

83

What is the buzzword for sigmoid volvulus?

frimann dahl sign

84

Cecal volvulus points where?

LUQ

85

What is Behcet's

penile and oral ulcers with pulmonary artery aneurysms

86

What is colitis cystica?

Cystic dilation of the mucous glands

87

What two syndromes are associated with rectal cavernous hemangioma?

Klippel Trenaunay-Weber and Blue Rubber Bleb

88

What three findings are seen in Entamoeba Histolytica?

conced cecum, flask shaped ulcers, spares terminal ileum

89

What three findings are seen in colonic TB?

coned cecum, fleishcner sign (enlarged gaping IC valve), stierlin sign (TI narrowing)

90

accordion sign=

c diff, contrast trapped inside mucosal folds

91

Where does typhilitis occur?

cecum

92

What ic McKittrick Wheelock Syndrome?

Villous adenoma leading to mucous diarrhea

93

What is stage T3 rectal CA?

breaks out of rectum into perirectal fat

94

sandwich sign=

mesenteric lymphoma

95

What is Cantlie's line?

right and left hepatic lobes (functioning)

96

What is the most common hepatic vascular variant?

replaced right hepatic from SMA

97

What ist he most common biliary variant?

right posterior segmental branch emptying into the left hepatic duct

98

What are the MRI characteristics of a regenerative nodule?

T1 and T2 Dark, no enhancement

99

What are the MRI characteristics of a dysplastic nodule?

T1 bright, T2 dark, no enhancement

100

What are the MRI characteristics of a HCC?

T2 bright, enhances

101

NM for FNH?

sulfur colloid

102

Characteristics of FNH scar?

T2 Bright, delayed enhancement

103

When multiple hepatic adenomas think...

Liver adenomatosis or von gierke

104

What is the most common location for hepatic adenoma?

right hepatic lobe

105

NM for fibrolamellar HCC?

gallium

106

Fibrolamellar HCC characteristics

T2 dark, no enhancement

107

What encases the portal vein?

cholangio

108

What are the four classic features of cholangio?

Delayed enhancement, peripheral biliary dilation, liver capsule retraction, no tumor capsule

109

In what two diseases may hepatic angiosarcoma be seen?

NF, hemochormatosis

110

What feature does hepatic Kaposi Sarcoma have?

diffuse periportal hypoechoic infiltration

111

What is Kasabach Merritt?

sequestration of platelets from giant cavernous hemangioma

112

What disease is hepatic angiomyolipoma associated with?

Tuberous sclerosis

113

What defines a Type I Hiatal hernia

sliding. GEJ above diaphgram

114

What defines a type II hiatal hernia?

paraesophageal, fundus above diaphragm. GEJ normal position

115

What defines a Type III hiatal hernia?

elevation of GEJ with herniation of fundus

116

What defines a type IV hiatal hernia?

Large with other organs herniated

117

What is an inflammatory eosphagogastric polyp?

fixed thickened gastric fold at GE junction seen in GERD

118

At what diameter do patients become symptomatic to esophageal stenosis?

< 13mm

119

EBV esophageal ulcers look like what?

deep linear

120

What is Macklin Phenomenon?

alveolar rupture in PIE

121

Where does an esophageal tear most commonly occur?

Left posterolateral wall

122

What does the esophagus look like in caustic ingestion?

Long stricture

123

What is best positioning to view esophageal varices on upper GI?

RAO semiprone collapsed esophagus

124

Three causes of high esophageal web formation

Plummer vinson, bullous pemphigoid, ectopic gastric mucosa

125

Normal angle in gastric lap band

4-58

126

What is the Borchardt triad?

sudden epigastric pain, retching, cant pass NG, seen in gastric volvulus

127

What are the findings on SBFT of celiac?

widened thin folds, transient jejunojenual intussecption

128

What is the most common malignancy in untreated Celiac?

T cell lymphoma

129

What is cavitary lymph node syndrome?

in celiac, villous atrophy, nodal masses, splenic atrophy

130

What worm causes cholangitis/pancreatitis?

ascaris

131

What worm causes anemia?

hookworm

132

What work comes from sushi?

Anisakis

133

What worm causes rectal prolapse?

trichuris

134

What are the borders of hesselbachs triangle?

inguinal ligament inferiorly, IEV superolaterally, conjoined tendon medially

135

Duodenal windsock sign

=intraluminal duodenal diverticulum

136

What is Griffiths critical point?

anastomsis between left colic and marginal artery of drummond

137

What is Sudeck point?

Watershed area at anastomosis between superior rectal artery and last sigmoid branch of IMA

138

De Garengeot hernia?

appendix in a femoral hernia

139

Collar button ulcer=

ulcerative colitis

140

What is the enhancement pattern in peliosis hepatitis?

centrifugal

141

What bacteria is associated with peliosis hepatitis?

bartonella

142

What is the triad of Klippel Trenaunay?

port wine, limb hemihypertrophy, hemagiomatosis

143

Typical splenic angiosarcoma appearance?

complex cystic with central necrosis and enhancing nodularity