GI Opening Round Flashcards
(185 cards)
1
Q
Case 1
In ischemia, bowel wall may be hyperdense on non-contrast CT
T/F
A
True
2
Q
Case 1
What is the best initial study for SBO?
A
Plain film
Air-fluid levels are typically seen within 48-72 hrs of obstruction
3
Q
Case 2
What is the best initial study for the diagnosis of appendicitis in children and pregnant women?
A
Ultrasound
4
Q
Case 2
Pericolic stranding of the right colon with sparing of the cecal pole is suggestive of what?
A
Cecal diverticulitis
5
Q
Case 3
What is the most common type of colonic volvulus?
A
Sigmoid volvulus (50-75%) is most common
Cecal volvulus is 2nd MC (20-40%)
6
Q
Case 3
Subtype of cecal volvulus where the cecum flips up and over an adhesion across the ascending colon and presents as an air filled subhepatic structure
A
Cecal bascule
7
Q
Case 3
Sign of cecal volvulus on CT
A
Bird beak sign
8
Q
Case 3
Purpose of CT in the setting of cecal volvulus
A
Influence treatment by detecting complications of volvulus
9
Q
Case 4
What type of diaphragmatic hernia is most associated with GERD?
A
Sliding-type
10
Q
Case 4
T/F
1. Bulimia patients are at an increased risk for GERD
- Episodic insomnia is a manifestation of chronic GERD
A
- True
2. True
11
Q
Case 4
Four fluoroscopic findings of chronic GERD
A
Fold Thickening
Granular Appearance
Superficial Ulcerations
Luminal Narrowing
12
Q
Case 4
Three complications of chronic GERD
A
Barrett’s Metaplasia
-precursor of AdenoCA
Stricture
Ulceration
13
Q
Case 5
Which of the following is true regarding colonic diverticulitis?
A. Colonic diverticula are true diverticula
B. Diverticulitis is the MC cause of colovesical fistula
C. Diverticular hemorrhage usu. ensues if diverticulitis is untreated
D. Diverticulitis of the right colon is more likely to progress rapidly to complications
A
B. Diverticulitis is the MC cause of colovesical fistula
14
Q
Case 5
What is the role of BE for diverticular disease?
A
Useful in chronic diverticulosis. Can be helpful for operative planning.
15
Q
Case 5
What is the finding on BE of acute diverticulitis?
A
Appearance of an intramural tract
16
Q
Case 6
What is the MC type of enteric cyst?
A
Esophageal duplication cyst (25%)
They are most commonly asymptomatic
17
Q
Case 6
What nucs study can be helpful for the diagnosis of esophageal duplication cysts?
A
Tc-99m perctechnetate is positive in up to 50% of cases
18
Q
Case 6
Name three Foregut Congenital Cysts
A
Neurogenic
Bronchogenic
Enteric duplication
19
Q
Case 7
What is the MC malignancy of distal small bowel?
A
Carcinoid
19
Q
Case 6
Most common symptom of esophageal duplication cyst
A
- None
20
Q
Case 7
What is the MC tumor of small bowel?
A
GIST
Second MC - Lipoma
20
Q
Case 7 What polyposis syndrome is associated with increased risk of small bowel cancer? A. Lynch syndrome B. Peutz-Jeghers C. Cronkhite-Canada D. Cowden syndrome
A
B. Peutz-Jeghers
21
Q
Case 7
What is the MC location for intussusception in adults?
MC etiology?
In Children?
A
Location - ileoileal
Etiology - polyp / tumor
Location - ileocolonic
Etiology - lymphoid hyperplasia
22
Q
Case 7
Typical manifestations of small bowel tumors
A
Bleeding Bowel Obstruction Intussusception (5-15% in adults) - mainly in children 2o to Lymphoid hyperplasia - most are transient SB tumors are typically asymptomatic
23
Case 8
| What is the BE sign at the site of torsion with sigmoid volvulus?
Bird's beak
24
Case 8
T/F
1. Volvulus is the 3rd most common cause of colonic obstruction, sigmoid is the most common type of volvulus.
2. Laparotomy and sigmoidopexy are the therapy of choice for sigmoid volvulus
3. A redundant sigmoid colon is a predisposing factor to sigmoid volvulus
4. The development of gangrene is suggested by clinical signs of peritonism or imaging signs of pneumoperitoneum or pneumatosis
1. T
2. F
3. T
4. T
25
```
Case 9
Which of the following features is most suggestive of a malignant gastric ulcer?
A. Gastric antrum location
B. Ulcer projects outside gastric lumen
C. Clubbed surrounding rugal folds
D. Associated duodenal ulcer
E. Hampton's line present
```
C. Clubbed surrounding rugal folds.
B and E are suggestive of benign ulcer
26
Case 9
| Describe clubbing of gastric folds
The termination of a fold swells into a clublike configuration
28
```
Case 9
Yes / No
Associated with gastric malignancy
1. AIDS
2. Benign gastric ulcer
3. H. Pylori
4. Nitrites and nitrates
5. Partial gastrectomy
```
1. Yes
2. No
3. Yes
4. Yes
5. Yes
29
Case 9
| Best imaging study for gastric cancer staging
CT
31
Case 10
| DDx for widening of the presacral space
Rectal perforation - abscess
Sacral chordoma - other sacral bony process (metastasis)
Anorectal carcinoma
Pelvic lipomatosis
31
Case 9
| Define Hampton's line
- Well-defined thin lucency at the base of the ulcer
- Ulcer collar
- Characteristic of benign ulcer
32
Case 9
| What is clubbing?
- Indicative of malignant gastric ulcer
| - The termination of a fold swells into a club-like configuration
33
Case 10
| What is the most common retrorectal tumor
Ependymoma
34
Case 11
Cause of duodenal obstruction in young female with h/o weight loss that is worsened in supine position compared to upright?
SMA syndrome
35
Case 11
| What is the abnormal SMA angle in SMA syndrome?
Aortomesenteric angle of less than 25 degrees
36
Case 11
| Four predisposing conditions to SMA syndrome
Young women with eating disorders
Burn patients
Patients in body casts
Severe illness and sudden weight loss
37
Case 11
| What is the surgical intervention for SMA syndrome?
Gastrojejunostomy
38
Case 12
| What is the MC type of solid organ injury in blunt trauma?
Splenic injury (25%)
39
Case 12
| What is a potential latent complication in patients who have undergone splenectomy
Encapsulated bacterial sepsis
40
Case 12
What is a grade 1 splenic injury?
What is a grade 5 splenic injury?
Grade 1: Subcapsular hematoma less than 10% of surface area and /or capsular tear of less than 1 cm, non-expanding and not actively bleeding
Grade 5: Shattered spleen with involvement of vascular pedicle
41
Case 13
| What is the Borchardt triad and what is it diagnostic of?
Pain
Nonproductive retching
Inability to pass NGT
Diagnostic of gastric volvulus
Present 70% of the time
42
Case 13
| What subtype of gastric volvulus results in the antrum being displaced toward the fundus?
Mesenteroaxial volvulus
43
Case 14
| What is the MC histologic subtype of colonic adenomatous polyp
```
Tubular adenoma (80%)
- Very little risk for malignant degeneration
```
44
Case 13
What type of gastric volvulus is most common?
Which type is most serious?
What is the typical anatomic defect?
Most common: organoaxial
Most serious: mesenteroaxial (due to increased risk of strangulation)
Abnormal laxity of the gastric ligaments
45
Case 14
| What type of colonic polyp is associated with malignancy?
Villous adenoma
46
Case 14
What is the malignant potential of a colonic villous adenoma based on size?
1-2 cm
>2 cm
- 10% risk
| - 30-40% risk
47
```
Case 15
Which of the following is an iatrogenic cause of pneumatosis intestinalis?
A. O2 therapy
B. Hyperbaric oxygen
C. Chemotherapy
D. Dialysis
```
C. Chemotherapy
Also, ischemia, C diff colitis, NEC, steroids, obstruction, trauma, endoscopy, malignancy, Crohn's dz
48
Case 15
| What is pneumatosis intestinalis cystica?
Benign condition with subserosal blebs in the distal bowel.
Caused by migration of air along bronchovascular pathways to mesentery (Macklin's pathway)
49
Case 16
| What is the minimal volume for free air to be visible on upright film?
1-2 cc
50
Case 16
| How long does it take for free air to reabsorb following surgery?
Usually 3-10 days.
51
Case 16
| What can affect the reabsorption of pneumoperitoneum?
Body habitus - thin patients taking longer
| Postoperative ileus or peritonitis - can prolong
52
Case 17
| What can occur in the duodenum as a result of hyperacidity?
Brunner gland hypertrophy
53
Case 17
| DDx for multiple small filling defects in the duodenal bulb?
Heterotopic Gastric Mucosa
Benign Lymphoid Hyperplasia
Brunners Gland Hyperplasia
Pancreatic Rests
54
Case 17
| Name 4 polyposis syndromes
Familial Adenomatous Polyposis
Peutz-Jeghers Syndrome
Cronkhite-Canada Syndrome
Filiform Polyposis
55
Case 17
| Which polyposis syndrome does not involve the duodenum?
Filiform polyposis
56
Case 17
Name 4 benign tumors of the duodenum?
What is the MC benign tumor of the duodenum?
Adenoma
Neurofibroma
Leiomyoma (GIST)
Mesenchymal tumors
Mesenchymal tumors
57
Case 18
Which of these viscera are not related to the descending duodenum?
Aorta, Gallbladder, Common bile duct, Right Kidney, Pancreas
Aorta
58
Case 18
| What adjacent organs bear a close relationship with the duodenum and may result in thickened duodenal folds?
Pancreas
Right Kidney
- Duodenal folds may also be thickened due to spasm from pancreatitis
59
Case 18
| MC cause of duodenal inflammation?
Hyperacidity and peptic ulcer dz
60
Case 18
| Other causes of thickened duodenal folds?
Zollinger-Ellison synd
Eosinophilic Enteritis
Crohn's disease
Whipple's disease
Amyloid
Malignancies
Hypoproteinemia
Intramural bleeding
61
Case 18
| What is the MC malignancy of the duodenum?
Adenocarcinoma (64%)
Followed by carcinoid (21%), lymphoma (10%), sarcoma (4%)
62
Case 19
What is the MC cause of acute pancreatitis in Western society?
Other causes?
Alcohol
- mainly younger patients
- oder patients -> billiary
Trauma
Drugs
Iatrogenic - ERCP
Idiopathic
63
Case 19
Cullen sign?
Grey Turner sign?
Bluish discoloration around umbilicus
Discoloration along the flanks
64
Case 19
| Nearly all cases of pancreatitis result in some change in which lung base?
Left
- atelectasis
- effusion
- airspace disease
65
Case 20
| What is the MC primary lymphoma of the stomach?
MALT
| Mucosa-associated Lymphoid Tissue
66
Case 20
| Name 4 known risk factors for gastrointestinal lymphoma
AIDS
H. Pylori
Celiac Dz
Epstein Bar Virus
67
Case 20
| What is the most common area of the GI tract affected by lymphoma?
Stomach
- half primary and half generalized dz
Lymphoma accounts for only 5% of gastric malignancies
Most are Non-Hodgkins
Primarily affects men and older age groups
68
Case 21
| T or F: Arterial obstruction is the MC cause of ischemic colitis
False
Most commonly caused by low-flow states
- Hypotension
- Heart failure
69
Case 21
| Prognosis of ischemic colitis?
Most patients improve and fully recover
70
Case 22
| What are the MC type of splenic cyst?
Post-traumatic cysts
| Congenital epidermoid cysts
71
Case 22
| What is the MC benign neoplasm of the spleen?
Hemangioma
72
Case 22
| What is the MC splenic malignancy?
Lymphoma
73
Case 23
| What are the normal extrinsic impressions of the esophagus on barium swallow?
1. Aortic arch
2. Left mainstem bronchus
3. Left atrium
4. Diaphragmatic Hiatus
74
Case 23
| What can produce an anterior esophageal impression on barium swallow?
Pulmonary sling
75
Case 23
| What is dysphagia lusoria?
Impression on the esophagus by any vascular structure
76
Case 24
| What abdominal neoplasms are seen in VHL?
```
RCC (clear cell)
Pheochromocytoma
Pancreas
- Cystic
- Islet cell
```
77
Case 24
| Describe von Hippel-Lindau dz
AD inheritance
- Capillary angiomatous hamartomas
- CNS involvement of brain and retina
- Typically hemangioblastoma of posterior fossa
- Abd tumors - RCC, pheo, cystic islet cell pancreas
- Mult panc cysts of various sizes
- -> suspect VHL
78
Case 25
| What is the most likely lesion to cause large masses in the gut without obstruction?
Lymphoma
79
Case 25
| What small bowel lesion results in eleveated 5-HIAA in the URINE?
Carcinoid
80
Case 25
| Describe aneurysmal dilation of small bowel
Large mass encasing the small bowel, in which the gut lumen is channeled through the lesion, leaving a false channel surrounded by tumor but without obstruction
- This is a particular characteristic of NH Lymphoma in the SB
81
Case 26
| What is the MC herniated organ in patients with traumatic diaphragmatic rupture?
Stomach
82
Case 27
| What is the MC type of GB polyp?
Cholesterol
Followed by
- Adenoma
- Papilloma
83
Case 27
| Although uncommon, what can metastasize to the gallbladder
Melanoma
Breast CA
Lymphoma
84
Case 28
| What conditions are associated with emphysematous gastritis?
Pulmonary dz
Peptic Ulcer dz
Gastric Outlet Obstruction
Endoscopy (esp w intervention)
85
Case 28
| What is the MC location for intramural gas to occur in the GI tract?
Colon
86
Case 28
| What infectious processes can result in emphysematous gastritis?
Hemolytic Strep
Clostridium species
Coliform bacteria
87
Case 28
| Ingestion of what substances can cause emphysematous gastritis?
Ingestion of corrosive substances
| - such as in suicide attempts
88
Case 29
| What is the MC malignancy at the GE junction?
Adenocarcinoma
89
Case 29
| What inflammatory condition predisposes to Adeno CA of the GE junction?
Barrett's metaplasia
90
Case 30
What is the Carmen meniscus sign and what does it indicate?
How is CMS best seen?
Large semi-lunar or lenticular shaped hypodense zone
- Seen in ulcerating gastric adenoCAs
- Flattened polypoid mass with a broad central ulceration
- Gastric mucosa adjacent to the polyp forms a smooth inner margin
- Must be located along lesser curvature or antrum to see this sign
Single-contrast or biphasic studies
91
Case 30
| What is the Kirkland (Kirklin's) complex?
- Seen in ulcerated gastric cancer
| - Concave lucent margin around the ulceration
92
Case 31
| Which type of inflammatory bowel disease is associated with higher risk of malignancy?
Ulcerative colitis
93
Case 31
| Is the terminal ileum involved with UC?
Never
94
Case 31
| Which is most likely to cause fistulas - UC vs Crohn's?
Crohn's
95
Case 31
| Which IBD has the greatest risk for malignancy?
UC
96
Case 32
| How can you distinguish portal venous gas from pneumobilia?
Portal venous gas is more peripheral
97
Case 32
| What are some benign causes of portal venous gas?
Bowel obstruction
Instrumentation
Bowel surgery
98
Case 32
| In the setting of portal venous gas - what must be excluded?
Catastrophic bowel necrosis
99
Case 33
| How is a malignant gastric stromal tumor distinguished from a benign one on imaging?
Presence of metastasis
| - No other imaging characteristics are specific
100
Case 33
| Most common benign submucosal tumor of the stomach?
Stromal tumor (leiomyoma)
Ectopic pancreatic rest is a congenital abnormality that mimics leiomyoma
101
```
Case 34
Which of the following is a predisposing factor to the development of cholangiocarcinoma?
A. Postviral hepatic fibrosis
B. Recurrent bacterial infection
C. Echinococcal cyst
D. Sclerosing cholangitis
```
D. Sclerosing cholangitis
102
Case 34
| What is a Klatskin's tumor
Cholangiocarcinoma that arises from the confluence of the right and left bile ducts
- Typically scirrhous cholangiocarcinoma
- Grows along the ducts
- Can result in a central mass with focal lobar atrophy
102
Case 35
| What is the MC complication of ovarian dermoids?
Torsion
| - Malignant degeneration is rare
102
Case 34
| What are the different forms in which cholangiocarcinoma can present?
Biliary Stricture
Biliary Polyp
Liver Mass
102
Case 35
| What sign is pathogmonic of ovarian dermoid?
Fat-fluid level on imaging
102
Case 35
| What variety of tissues are recognized within ovarian dermoids?
Fat
Skin
Teeth
Hair
103
Case 36
| What is glycogenic acanthosis?
Benign condition of the esophagus
- Nodular esophageal epithelium
- Occurs in elderly
- Not clinically important
103
Case 36
| Most common cause of infectious esophagitis?
Candida albicans
104
Case 36
| Esophageal papillomatosis is associated with which skin condition?
Acanthosis nigricans
105
Case 35
| How often are ovarian dermoids bilateral?
15%
107
Case 36
| What imaging feature distinguishes esophageal Candida infection in immunocompromised vs immunocompetent patient?
Immunocompromised
- shaggy esophagus
Immunocompetent
- nodular esophagus
107
Case 36
| Name three skin conditions that are associated with multiple tiny esophageal nodular lesions
Acanthosis nigricans
Bullous pemphigoid
Pyoderma gangrenosum
108
Case 37
| What is the definitive treatment for acalculous cholecystitis?
Cholecystectomy
| Drainage of any associated abscess
108
Case 37
| What conditions are associated with acalculous cholecystitis?
```
Surgery
Trauma
Shock
Ischemia
Mechanical Ventilation
AIDS
Burns
Vasculitis
Parenteral Nutrition
```
109
Case 38
| What is the MC source of hematogenous mets to stomach?
Melanoma
110
Case 38
| What is the MC site of melanoma mets to GI tract?
Small bowel
116
Case 38
| In recent decades, what is the most common cause of bull's eye lesions in the stomach?
Kaposi's sarcoma
| - AIDS
117
Case 38
| Name five sources of metastasis to the stomach
```
Melanoma
Lung
Breast
Kaposi's Sarcoma
Lymphoma
```
118
Case 38
| Define the classic bull's eye lesion
Rounded filling defect with a barium collection at its center (ulceration)
119
Case 39
| What polyposis syndrome is assoc with osteomas and cortical hyperostosis?
Familial Adenomatous Polyposis
- Gardner syndrome
- Now a part of FAPS
120
Case 39
| Which polyposis syndrome is autosomal recessive inhertiance?
Cronkhite-Canada
All others are AD
- FAP / Gardner's
- Peutz-Jegher's Syn
- Cowden's Syn
122
Case 39
| What are clinical features of Cronkhite-Canada syn?
Rash
Alopecia
Diarrhea
123
Case 39
| What are the two most common malignancies associated with polyposis syndromes?
Colon is most common
Periampullary carcinoma
- Thyroid increased in women
124
Case 39
| Which polyposis syndrome is associated with CNS tumors such as glioblastomas and medulloblastomas?
Turcot's Syndrome
125
Case 40
| What is the most common etiology of colorectal carcinoma?
Adenoma
126
Case 40
| Name 4 risk factors associated with colon cancer
Adenomatous polyp
Ulcerative colitis
Patient Diet
Family history
127
Case 40
| How common is colon CA relative to other malignancies?
Fourth
Lung
Breast
Prostate
Colon
128
Case 41
| What is the likely cause of GB wall calcification (porcelain GB)?
Chronic cystic duct obstruction with subacute inflammation
128
Case 40
| What is the correlation between polyp size in the colon and chance of malignancy?
Less than 1 cm 1 %
1 to 2 cm 10 %
Over 2 cm 40%
129
Case 41
| What is the MC complication of porcelain GB?
GB carcinoma (up to 30%)
130
Case 42
| What conditions are associated with esophageal intramural pseudodiverticulosis?
- Strictures
- Candida esophagitis
- Other inflammatory conditions
131
Case 42
| Describe Esophageal Intramural Pseudodiverticulosis
- Barium filling of exretory ducts of the mucous glands
- Normal anatomic structures
- Dilate due to underlying inflammatory process
- --> Fill with barium
- Commonly mistaken for ulcers
- Candida organisms commonly found in pts w/ this condition
- May result in benign strictures
- Slightly increased risk of adenocarcinoma
132
Case 43
| How do malignant and benign pelvic lesions affect bowel differently?
Benign masses
- obstruct
Malignant masses
- invade adjacent serosal surface
133
Case 44
| What fungal infection is known to be locally aggressive and breach fascial barriers?
Actinomycosis
134
Case 44
| What would be the MC cause of psoas abscess worldwide?
Tuberculosis
135
Case 45
| What is the MC specific histologic subtype of pancreatic malignancy
Ductal epithelial adenocarcinoma
136
Case 45
| What is the most common clinical presentation of pancreatic cancer?
Pain
137
Case 45
| Where are most pancreatic cancers located?
Head
138
Case 46
| What is the best imaging modality to assess for local spread of gastric cancer?
Endoscopic ultrasound
139
Case 46
| What percentage of gastric cancers are linitis plastica type?
About 10%
140
Case 46
| What is the name of the association of gastric cancer metastatic to the left axilla?
Irish node
142
Case 47
| What is the 2nd MC solid organ injured in blunt trauma?
Liver
143
Case 48
| What is the moulage sign and what is it associated with?
Seen on SBFT. Barium forms smooth, featureless elongated columns or clumps in the jejunum.
Associated with celiac dz.
144
Case 49
| What is the cause of feline esophagus?
Transient spasm of longitudinal muscularis mucosa
145
Case 48
| What is the MC finding seen on SBFT in pts with celiac disease?
1. Diffuse dilation of distal small bowel
| 2. Jejunization of ileum
146
Case 49
| What is the MC symptom of eosinophilic esophagitis?
Solid dysphagia
146
Case 50
| In diverticular hemorrhage, where is the diverticulum typically located?
Right colon
147
Case 49
| What is the 'ringed esophagus' and what is it associated with?
A segment of fixed transverse folds
Eosinophilic esophagitis
148
Case 50
Are colonic diverticula true diverticula?
What is thought to be the pathogenesis of diverticulitis?
No
Infection secondary to impacted fecal matter
150
Case 50
| What percentage of patients older than 60 in the U.S. have colonic diverticula?
60%
151
Case 51
| Through what anatomic area does the hernia sac pass in a spigelian hernia?
Linea semilunaris
- Fibrous band of tissue joining the rectus with the oblique muscles
- Probably a result of weakness or congenital defect
151
Case 51
| What is a Littre hernia?
A hernia containing a Meckel diverticulum
152
Case 52
| What is the MC clinical manifestation of Crohn's disease?
Diarrhea
153
Case 51
| What is the unusual hernia which contains only a portion of the bowel loop and not the entire lumen?
Richter's hernia!!
Important b/c it can incarcerate without obstruction
154
Case 52
| DDx for wall thickening of the terminal ileum
Crohn's
TB
Yersinia
UC -never involves TI but can appear patulous from backwash ileitis
155
Case 52
| Cardinal presentation of Crohn's
Diarrhea
Abdominal pain
Weight Loss
156
Case 52
| What is the MC part of the GI tract involved in Crohn's disease?
Small bowel
Commonly a string sign of the TI on a SBS
157
Case 53
| What is filiform polyposis of the colon?
Diffuse colonic polyps in the colon secondary to chronic 'burned out' ulcerative colitis
158
Case 53
| Most common acute complication of severe UC?
Toxic Megacolon
159
Case 54
| What neoplasm most commonly produces thickened gastric folds?
Lymphoma
160
Case 54
| What causes isolated gastric fundal varices?
Splenic vein thrombosis
161
Case 54
| What is the MC infectious cause of thickened gastric folds?
H. pylori
162
Case 54
| DDx for gastric fold thickening
Gastritis
- EtOH
- Eosinophilic
H. Pylori
Sarcoid
Amyloid
Crohn's
Menetrier's dz
Mets
Adeno CA
Zollinger- Ellison Syn
163
Case 54
| What is Menetrier's disease?
Rare disease characterized by gastric mucosal hypertrophy (giant rugal folds)
Achlorhydria, hypoproteinemia, and edema
164
Case 55
| What lobe is typically spared in hepatic cirrhosis?
Caudate lobe
| -derives blood supply from IVC
165
Case 56
| How can radiating folds help determine whether a gastric ulcer is benign or malignant?
If the radiating fold extends to the center of the edge of the crater - it is most likely benign.
If it stops short, could be benign or malignant.
167
Case 57
| What is required for GI carcinoid tumor to produce carcinoid syndrome?
Liver metastases
167
Case 56
Most common cause of benign gastric ulcer?
Does the size of an ulcer have any bearing on malignant potential?
H. Pylori
No
168
Case 57
| How often are carcinoid tumors multiple?
20%
169
Case 56
| What is a Hampton line sign and is the ulcer benign or malignant?
Thin lucent line at the base or neck of an ulcer
Indicates that the ulcer is benign
170
Case 57
| What substance is produced by carcinoid tumors?
Serotonin
171
Case 57
| What non-imaging test can be used to confirm the diagnosis of carcinoid?
Urine test for 5-HIAA
172
Case 57
| What is the most common site from which carcinoid tumor arises?
Appendix
173
Case 58
What part of the bowel is typically affected with TB?
Viral infections?
TB - ileocecal area
| Viral - colon
174
Case 58
| What is the most common cause of viral colitis?
CMV
175
Case 59
| What type of ulcer suggest Crohn's dz rather than UC?
Aphthous ulcers
176
Case 59
| What diseases produce bowel fistulae?
Crohn's disease, diverticulitis (and rarely, TB)
178
Case 59
| DDx for colonic fistula formation
Crohn's
TB: Deep ulcers that progress to fistulae
Diverticulitis (colovesical)
* Fistulas are never seen w UC
178
Case 60
| What are the tiny diverticula called in adenomyomatosis?
Rokitansky-Aschoff Sinuses
179
Case 59
| What diseases are associated with long, linear mucosal ulcers?
Crohn's
TB
Diverticulitis (colovesical)
* Fistulas are never seen w UC
180
Case 59
| What diseases are associated with long, linear mucosal ulcers?
Crohn's disease
| TB rarely
181
Case 56
| How can location of gastric ulcers help predict benignity?
Lesser curvature - tend to be benign
| Fundus - tend to be malignant
181
Case 57
| What is the MC site in the GI tract for carcinoid?
Appendix
181
Case 60
| What is the clinical significance of GB adenomyomatosis?
None
