Imaging SBAs Unit 3

Question 1

Commonest pancreatic neuroendocrine tumours

Answer 1

Insulinomas
Gastrinomas are commonest in MEN1

Question 2

Right hepatic vein divides

Answer 2

Anterior (segments 5 and 8) and posterior (6&7) segments of right lobe of liver

Question 3

Primary vs secondary haemochromatosis distribution

Answer 3

Primary: Liver, pancreas, heart, pituitary, thyroid, synovium.
Secondary: Spleen and kupffer cells

Question 4

Spontaneous rupture of the oesophagus typical location

Answer 4

Lower third, left lateral (anatomical weakness at this point)

Question 5

Distal ileum, Diffuse circumferential wall thickening, bulky masses, extension into small bowel mesentery

Answer 5

Lymphoma

Question 6

New liver lesions in metastatic GIST

Answer 6

Can be sign of treatment response in previous occult lesions

Question 7

Sign of progression in metastatic GIST with liver mets

Answer 7

New enhancing nodule within hypodense lesion

Question 8

Sigmoid cancer vs diverticulitis on CT

Answer 8

Enlarged pericolonic lymph nods suggests cancer

Question 9

T Staging of rectal cancer

Answer 9

T3 = extension into perirectal fat.
T3a: <1mm
T2b: 1-5mm
T3c: 5-15mm
T3d: >15mm

Question 10

SBO secondary to laparoscopic Roux-en-Y, commonest cause

Answer 10

Internal hernia (open surgery has more adhesions and less internal hernias compared to laparoscopic)

Question 11

Commonest fluoroscopic finding in gastric MALT

Answer 11

Ulceration (various size, depth, number)

Question 12

Diabetic, RUQ pain, echogenic GB wall with echogenic foci in lumen

Answer 12

Emphysematous cholecystitis

Question 13

Trauma, focal areas of linear hyperattenuation (155HU) in liver

Answer 13

Active haemorrhage

Question 14

Proportion of L rib fractures in blunt trauma associated with splenic injury

Answer 14

20%

Question 15

Commonest manifestation of abdominal TB

Answer 15

Lymphoma

Question 16

Lymphoma vs TB: Nodes

Answer 16

TB: Peripancreatic, mesenteric, portal
Lymphoma: Para-aortic

Question 17

Peripheral or homogenously enhancing lymphadenopathy (abdomen)

Answer 17

TB

Question 18

Hernia between lateral edge of rectus abdominis and medial edge of lateral abdominal wall muscles

Answer 18

Spigelian hernia

Question 19

Littre’s hernia

Answer 19

Hernia involving incarcerated meckel’s diverticulum

Question 20

Richter’s hernia

Answer 20

Only one edge of bowel is trapped in hernia

Question 21

Petit’s hernia

Answer 21

Hernia through inferior lumbar triangle

Question 22

Grynfeltt’s hernia

Answer 22

Through superior lumbar triangle

Question 23

Clinically carcinoid tumour, best Ix

Answer 23

SPECT with octreotide

Question 24

Most commonly injured part of pancreas in blunt trauma

Answer 24

body

Question 25

Indications for TIPS

Answer 25

Variceal haemorrhage resistant to medical or endoscopic therapy Refactory ascites Budd chiari Hepatorenal syndrome

Question 26

Contraindications for TIPS

Answer 26

Portal vein occlusion

Question 27

Gaucher's disease abdominal finding

Answer 27

Splenomegaly

Question 28

Duodenal yellow plaques on OGD, proximal small bowel mucosal thickening, bulky low density adenopathy.

Answer 28

Whipple's

Question 29

Whipple's vs Sprue

Answer 29

Sprue usually spares duodenum

Question 30

Standard initial staging Ix for oesophageal cancer

Answer 30

18FDG PET/CT

Question 31

Inadequate breath holding in MRCP can cause

Answer 31

Bile duct apparent stenosis or dilatation

Question 32

Known diverticular disease, well defined midline pelvic structure containing pocket of gas on barium enema

Answer 32

Colo-vesical fistula

Question 33

Polycystic liver disease prognosis

Answer 33

Usually asymptomatic, rarely progresses to advanced liver disease

Question 34

Bouveret syndrome vs gallstone ileus

Answer 34

Bouveret syndrome is gallstone impacted in distal stomach or proximal duodenum. Gallstone ileus classically refers to stone in the terminal ileum

Question 35

Signs of pneumoperitoneum on supine AXR

Answer 35

RUQ gas (several locations), Rigler's sign, Ligament visualisation (falciform, umbilical-medial, lateral), Urachus, Triangular air, Football sign, Scrotal air in kids