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Radiology > Abdominal > Flashcards

Abdominal Flashcards

1
Q

Ascariasis

A
  • Round wrom 15-30cm long
  • Jejunum>ileum.
  • Imaging:
    • longitudinal filling defects.The worm guts full with barium and can be seen.
    • Worms can cluster and call SBO
    • Cancause biliary obstruction and strictures.
      *
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2
Q

Carney Triad

A
  1. Pulmonary chondromas
  2. Gastric leiomyosarcoma (GIST)
  3. Extra-adrenal paraganglioma
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3
Q

Caroli Disease

A
  • Rare AR disease presents in children and young adults
  • Cystic dilatation of the segmental bile ducts
  • Presentation:
    • frequent cholangitis and jaundice
  • Complications:
    • Liver cirrhosis
    • Intraductal stones
    • Cholagitis
    • Cholangiocarcinoma.
  • Assoc w PKD and medullary sponge kidney
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4
Q

Cowden Syndrome

A
  • Inheritance: AD Ch 10 Age: 20s
  • Features:
    • rectosignoid polyps
    • fibrocystic breast disease
    • dysplastic cerebellar gangliocytoma (Lhermitte-Duclos )
    • Facial skin lesions = trichemmomas
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5
Q

Cronkhite-Canada syndrome

A
  • 60s M>W
  • Multiple harmatomous polyps in stomach> colon>small bowel.
  • Assoc w alopecia and nail atrophy.
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6
Q

Epithelioid haemangioendothelioma

A
  • Middle aged females
  • Assoc w OCP and vinyl chloride
  • Peripherally located with internal calcification.
  • Causes capsular retraction and compensatory hypertropohy of normal liver.
  • Invasion into port and hepatic veins.
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7
Q

Familial Adenomatous polyposis

A

Inheritance: AD Ch 5 Age: 30-40 Features: -colonic carpets -stomach harmatomas -duodenal adenomas -periampullary carcinoma -desmoid tumours

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8
Q

Fibrolamellar HCC

A
  • Lobulated heterogenous mass with a cenral scar in an otherwise normal liver. (Age = 20-40)
  • Fibrous scar is usually hypointense on T2 (= differentiatior from FNH.)
  • Heterogenous inhancement with non-enhancing scar (best seen on delayed imaging.
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9
Q

Gardner syndrome

A
  • Inheritance: AD Ch 5
  • Age: 15-30
  • Features: - colonic polyps -skull osteotomas -poor dentition
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10
Q

Gaucher disease

A
  • Lysosomal storage disease.
  • Deficiency in glucocerebrosidase or beta-glucosidase activity.
  • Accumulation of a glycolipid (glucocerebroside) within the lysosomes of macrophages, particularity in the bone marrow, spleen and liver.

Imaging:

Liver: hepatomegaly

Spleen: massive splenomegaly & focal infarcts.

MSK: Erlenmyer flask deformity, osteopaenia, multiple lytic bone lesions, aseptic necrosis of the femoral head.

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11
Q

Klatskin tumour

A

Old people.

Hilar cholangiocarcinoma.

Non-communicating right and left dilated intrahepatic ducts with normal calibre extrahepatic ducts.

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12
Q

Liver adenoma

A
  • More common in females.
  • Composed of hepatocytes but not bile ducts.
  • Assoc with oral contraceptive pill and glycogen storage disease.
  • Can resolve if stopping OCP.
  • Complications:
    • haemorrhage, infarction and malignant degeneration.

Imaging:

  • CT - peripherally hypodense, isoattenuation to normal liver.
  • MRI - signal fall out on of phase gradient echo. Reticolendothelial contrast uptake but not hepatobiliary.
  • Cold on Tc99 sulfur colloid.
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13
Q

Liver angiosarcoma.

A

RARE! (aka Kupffer cell sarcoma)

Mor common in men.

RF:

  • Thorotrast
  • Vinyl choloride
  • Arsenic
  • Haemochromatosis
  • Neurofibromatosis.

Imaging:

  • CT: hypodense masses pre and post contrast. (high density may be from haemorrage)
  • MR: heterogenous mass wth slow filling post gad.
  • PET: FDG avid.
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14
Q

Liver mets

A

Colon > Stomach > Pancreas > Breast > Lung.

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15
Q

Ménétrier disease

A
  • Rare idiopathic hypertrophic gastropathy.
  • Presentation:
    • Achlorhydria, hypoproteinaemia and oedema comprise the classic triad secondary to protein losing enteropathy.
  • Imaging:
    • Fluro/CT = thickened rugal folds.
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16
Q

Peutz-Jegher syndrome

A
  • Inheritance: AD Ch 11 Age: 25
  • Features: -harmatomous polyps of GI tract - Most commonly TI. -mucocutaneous pigmentation -increased risk of cancer
17
Q

Post liver transplant hepatic artery thrombosis

A

RI <0.5

Systolic acceleration time >0.1 sec.

18
Q

Primary biliary cholangitis (formerly cirrhosis)

A
  • Middle aged women
  • Present with fatigue, pruritus and cholestasis.
  • Antimitochondrial antibody is highly sensitive and specific.
  • Assoc with:
    • Gallstones, Sjörgrens, AA thyroiditis, ILD and HCC
  • MRI:
    • T2 periportal hyperintensity.
    • caudate lobe hypertrophy
    • hepatic surface nodularity
    • splenomegaly and local lymphadenopathy.
19
Q

Primary sclerosing cholangitis

A
  • Idiopathic inflammatory condition resulting in biliary strictures and eventually cirrhosis
  • Middle aged men.
  • Present with fatigue, pruritus, jaundice and GI bleeding.
  • Assoc with IBD - particularly UC
  • MRCP:
    • multiple short strictures
    • intermittent normal caibre ducts gives beading appearance.
20
Q

Splenic injury scale (AAST)

A

grade I

  • subcapsular haematoma <10% of surface area
  • capsular laceration <1 cm depth

grade II

  • subcapsular haematoma 10-50% of surface area
  • intraparenchymal haematoma <5 cm in diameter
  • laceration 1-3 cm in depth not involving trabecular vessels

grade III

  • subcapsular haematoma >50% of surface area or expanding
  • intraparenchymal haematoma >5 cm or expanding
  • laceration >3 cm in depth or involving trabecular vessels
  • ruptured subcapsular or parenchymal haematoma

grade IV

  • laceration involving segmental or hilar vessels with major devascularisation (>25% of spleen)

grade V

  • shattered spleen
  • hilar vascular injury with splenic devascularisation
21
Q

Turcot syndrome

A
  • Inheritance: AR Ch 10 Age: 20s
  • Features:
    • colonic polyps and diarrhoea
    • develop cancer in 40s
    • seizures
  • Assoc w supratentorial GBM and meduloblastoma
22
Q

Whipple disease

A

Middle aged white men.

Rare multisystem disease

  • SI joints, joint capsule, heart vlaves and jejunum

Imaging:

  • 1-2mm micronodules in jej
  • Nodal mesenteric masses.
  • Sacroiliitis.
23
Q

Lynch syndrome

A
  • Hereditary non-polyposis colorectal cancer (HNPCC)
  • Presentation: Colorectal cancer in 4th and 5th decades.
  • Due to mutation in mismatch repair (MMR) gene.
  • Assoc w other malignancies
    • genitourinary
    • small bowel cancer
    • CNS - commonly gliobastoma.
24
Q

Carney Triad

A

Pulmonary chondroma

Gastric GIST

Multiple extra-adrenal neuroblastomas

Radiology (6 decks)

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