abdomen

Question 1

Answer 1

achalasia

Question 2

Answer 2

ZENKERS DIVERTICULUM
diverticulum may contain air, fluid, or ingested materials,
- patchy food

Question 3

Esophagram indication

Answer 3

Evaluates just esophagus

Question 4

Answer 4

achalasia
- dilated esophagus
- fluid line level

sx:
- nausea/vomit
- inability to tolerate lots of food

Question 5

Answer 5

esophageal web
- plummer vincent syndrome
- small cell carcinoma in future

Question 6

Answer 6

esophageal varices
- portal hypertension,
-drinkers
- cirrhosis

Question 7

Answer 7

ESOPHAGEAL VARICES
- portal hypertension, - drinkers
- cirrhosis

In a CT scan, esophageal varices can appear as rounded or tubular structures within the esophageal wall that are enhanced after the administration of intravenous contrast material. They might be seen as a series of beaded enlargements along the normally smooth outline of the esophagus. The appearance can vary based on the severity and the stage of the liver disease causing the portal hypertension.

Question 8

Answer 8

visualization of a thin, circumferential filling defect in the
distal esophagus called a Schatzki Ring

Schatzki ring:
- narrowing of the lower part of the esophagus
-causes dysphagia
- located just above the junction with the stomach, at the level of the lower esophageal sphincter.

On a barium swallow X-ray, which is what this image seems to be, a Schatzki ring appears as a thin ring of constriction and can cause a characteristic “ring” shadow. Below this ring, the esophagus may appear dilated if there is significant obstruction to the flow of food and liquid.

Question 9

Upper GI series indication

Answer 9

Evaluate the anatomy and function of the esophagus, stomach, and duodenum

Question 10

Answer 10

duodenal ulcer
- highly attenuated area
- 1st: UPPER GI SERIES NOT ENDOSCOPY

Question 11

Answer 11

duodenal ulcer
- jagged ulcer
- ulceration area not filled with contrast in duodenum

Question 12

Answer 12

duodenal ulcer

Question 13

Answer 13

gastric ulcer
- Outpouching

Question 15

Answer 15

gastric polyp
- SMOOTH not jagged
- not filled with contrast
- usually cystic or air filled
- need to bx

can see feeding tube

Question 16

Answer 16

gastric polyp

Question 17

Answer 17

Gastric polypoid mass
- bubbly
-jagged

pt presentation + fam hx important

Question 18

barium enema indication

Answer 18

evaluate the anatomy and function of the large intestine (colon and rectum)
involves the introduction of barium sulfate into the rectum via a catheter

Question 19

Answer 19

colon polyp
- Polyps are smooth and symmetric

Question 20

Answer 20

colon polyp
- Polyps are smooth and symmetric

Question 21

Answer 21

colon polyp

Question 22

Answer 22

Colonic tumor
- apple core sign: core is the tumor tissue
- need a CT scan with IV contrast to see if lesion is growing its own vasculature

Question 23

Answer 23

Colonic tumor
- different gray scale suggest tumor

Question 24

Answer 24

lead pipe sign in UC
- Loss of haustra marking - lead pipe deformities

Question 25

Answer 25

Diverticulosis - outpouching Diverticulitis: infection with outpouching - Different presentation: hx of diverticulosis or never screened before; fever, abdominal pain, leukocytosis

Question 26

Answer 26

Diverticulosis - outpouching Diverticulitis: infection with outpouching - Different presentation: hx of diverticulosis or never screened before; fever, abdominal pain, leukocytosis

Question 27

Answer 27

baby ribs: small ribs + smooth bones - generalized air - air in the bowel wall - concern: NECROTIZING Enterocolitis

Question 28

good abdominal xray

Answer 28

can see diaphragm to pubic symphysis alignment: - can see straight pelvic rami - straight spine orientation

Question 29

Answer 29

air in biliary tree - Sign of Gram negative infection: should never be free air in the biliary system normal air in small bowel

Question 30

Answer 30

Cut off sign - looks like air fluid level; not normal

Question 31

Answer 31

generalized free air: - sepsis - post surgery - infection left lateral decubitus - can see extraluminal air that has escaped -distended bowel with generalized free air

Question 32

Answer 32

Calcified outline of the gall bladder Older pts = normal

Question 33

Answer 33

Concern for obstruction with air fluid level localized air in splenic flexure fecal impaction

Question 33

Answer 33

air outlining pancreas gallstone: mostly fat + calcium - indication for surgery cholecystitis -> inflammation -> ileus pheboliths in bladder: calcifications that happen with ag

Question 34

Acute abdominal series

Answer 34

-supine -prone - upright or lateral decubitus - upright chest xray*

Question 35

Answer 35

localized to small bowel - SBO: - step ladder air fluid levels free air under diaphragm

Question 36

Answer 36

1- Right 11th Rib, 2- T12 spinous process/T12 vertebral body, 3- Left 11th Rib/gastric bubble 4- Splenic flexure 5- Transverse Colon 6- Descending Colon 7- Sacrum/S1 8- L SI joint, 9- L femoral head, 10- Ascending Colon/R Ilium 11- R Iliac Crest, 12- Hepatic flexure 13- R psoas muscle.

Question 37

Answer 37

cecal volvulus Young pt classic presentation - sx of obstruction; 20s-30s, no past medical/surgical hx

Question 38

Answer 38

LBO - stool all over -80yrs old - pencil thin stool

Question 39

Answer 39

Coffee bean sign SIGMOID VOLVULUS: older, pencil thin stools