ARRT abdomen 5 Flashcards
1
Q
Charcot triad
A
pain, fever, jaundice
2
Q
Clinical symptoms of acute cholangitis include
A
Charcot triad, elevated ALP and bilirubin, nausea/vomiting
3
Q
Sonographic appearance of acute cholangitis
A
thickened bile duct walls >5mm, stones, sludge
4
Q
Chronic complications of acute cholangitis
A
sclerosing cholangitis
5
Q
sclerosis =
A
hardening and thickening
6
Q
Chronic type of fibrotic thickening of bile ducts
A
sclerosing cholangitis
7
Q
What kind of cholangitis increases the risk for cholangiocarcinoma?
A
sclerosing
8
Q
Pneuma =
A
air
9
Q
air or gas formation within the biliary tree
A
pneuomobilia
10
Q
Pneumobilia is caused by:
A
recent surgery or trauma
11
Q
Sonographic appearance of pneumobilia
A
comet-tail or ring down artifacts scattered throughout the liver
12
Q
parasites in bile ducts
A
ascariasis
13
Q
What confirms the presence of ascariasis?
A
movement of worm in real time
14
Q
most common cancer of biliary tract
A
gallbladder carcinoma
15
Q
Gallbladder carcinoma is suspected when polyps measure over
A
1 cm
16
Q
Clinical symptoms of gallbladder carcinoma
A
weight loss
RUQ pain
jaundice if obstructive
17
Q
Sonographic appearance of gallbladder carcinoma
A
non-mobile mass along wall larger than 1 cm
18
Q
cancer within the bile ducts
A
cholangiocarcinoma
19
Q
Most common tumor associated with cholangiocarcinoma
A
Klatskin tumor
20
Q
Where is the Klatskin tumor located?
A
junction of the right and left hepatic ducts
21
Q
Ductal dilatation will occur ___ cholangiocarcinoma
A
above
22
Q
Clinical symptoms of cholangiocarcinoma include
A
weight loss
RUQ pain
jaundice
pruritis
history of sclerosing cholangitis
23
Q
Pruritis
A
excessive itching
24
Q
Sonographic appearance of cholangiocarcinoma
A
dilated intrahepatic ducts the abruptly terminate
25
Most common location of pancreatic carincoma mass
pancreatic head
26
Pancreatic carcinoma causes:
biliary obstruction
27
clinical symptoms of pancreatic carcinoma
jaundice (direct bilirubin)
elevated ALP
dilated ducts: CBD and proximal pancreatic duct
28
"born with it"
congenital
29
narrowing or absence of the biliary tree
biliary atresia
30
Biliary atresia is only seen in ____ and is not compatible with life
newborns/infants
31
Biliary atresia will eventually cause ____ and ___ if not corrected
liver failure
death
32
Clinical symptoms of biliary atresia
neonatal jaundice
liver failure
33
Sonographic appearance of biliary atresia
absent ducts
absent cord appearance at porta hepatis
34
most common type of choledochal cyst
cystic dilatation of CBD
35
Clinical signs of choledochal cyst
biliary obstruction signs
36
Sonographic appearance of choledochal cyst
cystic dilatation of CBD
37
segmental dilatation of intrahepatic ducts
Caroli disease
38
Clinical signs of Caroli disease include:
may eventually have biliary obstruction signs
39
Sonographic appearance of Caroli disease
central dot sign
segmental dilatation located in one part of the liver
40
The pancreas is a ____peritoneal organ
retro
41
The pancreas is located in the:
anterior pararenal space
42
Is the pancreas an endocrine or exocrine gland?
both
43
The exocrine enzymes are produced by the ____ in the pancreas.
acinar
44
The enzymes produced by the acinar cells in the pancreas include ____, _____, _____, and ____.
amylase
lipase
sodium bicarbonate
trypsin
45
The endocrine hormones of the pancreas are made by the:
islets of Langerhaans
46
The islets of Langerhaans consist of ___, ___, and ___ cells
alpha
beta
delta
47
The hormones produced by the islets of Langerhaans include ____, ____, and ____.
insulin
glucagon
somatostatin
48
The main pancreatic duct is also known as:
Duct of Wirsung
49
The main pancreatic duct travels the length of the pancreas and terminates when it meets with the ___ at the ____.
CBD
Ampulla of Vater
50
The Ampulla of Vater empties via the _____
sphincter of Oddi
51
The accessory duct of the pancreas is also known as the:
duct of Santorini
52
The branch of the accessory duct empties via the _____ into the _____
minor sphincter
duodenum
53
The vascular supply to the pancreas is from:
gastroduodenal artery
splenic artery
superior mesenteric artery
54
The gastroduodenal artery is a branch of the _____
common hepatic artery
55
The gastroduodenal artery supplies the_
head of the pancreas
56
The splenic artery and the superior mesenteric artery supply the:
body and tail
57
The sonographic appearance of an adult pancreas
normally echogenic to liver, isoechoic to spleen
58
The sonographic appearance of a pediatric pancreas
normally hypoechoic to the liver
59
The main pancreatic duct should measure less than
2 mm
60
The main pancreatic duct may be seen perpendicular to sound beam to level of
body
61
The gastroduodenal artery is located _____ to the head of the pancreas
anterolateral
62
The common bile duct is located ____ to the head of the pancreas
posterolateral
63
The IVC is located ____ to the head of the pancreas
posterior
64
The duodenum is located ____ to the head of the pancreas
lateral
65
The portal confluence of superior mesenteric vein is located ____ to pancreatic head
medial
66
The portal confluence of superior mesenteric vein is located ____ to uncinate process of the pancreas
anterior
67
The portal confluence or the superior mesenteric vein is located ____ to the neck of the pancreas
posterio
68
The splenic vein is located ____ to the body and tail of the pancreas
posterior
69
The splenic artery is located ____ to body and tail of the pancreas..
superior
70
The superior mesenteric artery is located ____ to the aorta
anterior
71
The superior mesenteric artery is located ____ to pancreas body and splenic vein
posterior
72
The left renal vein is located ____ to superior mesenteric artery
posterior
73
The left renal vein is located ____ to the aorta
anterior
74
The right renal artery is located ____ to IVC
posterior
75
The most common variant of the pancreas
divisum
76
shortened main pancreatic duct, forces accessory duct to become primary drainage
divisum of the pancreas
77
Patients with divisum of the pancreas are at an increased risk of ____ and ____
dilated ducts
pancreatitis
78
Most common cause of acute pancreatitis:
choledocholithiasis
79
Leakage of enzymes into pancreatic tissue causing inflammation
acute pancreatitis
80
In acute pancreatitis, ____ rises first
amylase
81
In acute pancreatitis, ____ rises within 72 hours and is more specific for pancreatitis
lipase
82
Clinical symptoms of acute pancreatitis include
fever
pain
leuko
elevated amylase and lipase
biliary obstruction labs if caused by a stone
83
Sonographic appearance of acute pancreatitis
initially normal
hypoechoic
enlarged
phlegmon (peripancreatic fluid)
pseudocyst
possible ductal dilatation
84
Pancreatic pseudocysts are most commonly found in the:
lesser sac
85
Most common vascular complications of acute pancreatitis:
splenic vein thrombosis
splenic artery pseudocyst
86
peripancreatic fluid
fluid surrounding edematous pancreas
not encapsulated
only found with acute pancreatitis
phlegmon
87
encapsulated fluid collection
most commonly found in lesser sac
can be found with acute and chronic pancreatitis
pseudocyst
88
repeated bouts of acute pancreatitis
chronic pancreatitis
89
Chronic pancreatitis is most commonly found in cases of pancreatitis caused by:
alcoholism
90
clinical symptoms of chronic pancreatitis
pain
jaundice
abnormal labs
weight loss
91
Sonographic appearance of chronic pancreatitis
heterogeneous, hyperechoic with calcs, possible pseudocyst, possible ductal dilatation
92
Pancreatic adenocarcinoma is also known as:
ductal adenocarcinoma
93
Most common location of pancreatic adenocarcinoma
head of pancreas
94
Pancreatic adenocarcinoma is related to:
biliary dilatation
95
enlarged, palpable gallbladder caused by pancreatic head mass
courvoisier gallbladder
96
Clinical symptoms of pancreatic adenocarcinoma include
weight loss
abnormal labs (ALP, conjugated bilirubin)
97
Sonographic appearance of pancreatic adenocarcinoma
hypoechoic mass, dilated ducts, possibly enlarged gallbladder
98
removal of pancreatic head, duodenum, gallbladder, and bile duct
whipple procedure
99
2 types of pancreatic cystadenomas
serous and mucinous
100
Cystadenomas are most commonly found in:
body and tail of pancreas
