CTC GI Flashcards
what is nutcracker esophagus?
manometric findings more than 180 mmHg
what cancer is esophageal web a risk factor for?
esophageal and hypopharyngeal ca
what is plummer vinson syndrome?
esophageal web, iton def anemia, thyroid issues (spoon shaped nails)
what is a complication of chemo with gastric lymphoma?
rupture of the mass
what is the most common type of gastric ca?
adenoca
what is seen with barretts esophagus?
mid esophageal stricture and a hiatal hernia, reticular mucosal pattern
what do herpes ulcers in the esophagus look like?
have a HALO of edema around them, multiple, small
what does CMV and AIDS esophagitis look like?
large, flat ulcers ulcers with no halo
what are the imaging features of esophageal adenoca?
distal esophageal stricture/mass/ulcer
what are the imaging features of esoph sq cell ca?
upper-mid esophageal stricutre/mass/ulcer
what does achalasia predispose to?
increased risk of sq cell ca (20 years later) and increased risk of candida
what is carneys triad
chrodoma (pulmonary), extraadrenal pheo, GIST
how often does scleroderma involve the esophagus?
80 percent
what is the most common location for a GIST?
stomach (70 percent)
what is seen with malignant GIST?
large mass, makes a 90 degree angle with the gastric wall, does NOT cause LN enlargement
what syndromes are assoc with GIST?
Carneys and NF1
what are the causes of linitis plastica?
schirrous adenoca, mets from breast or lung cancer
what does chronic ASA therapy cause?
multiple gastric ulcers
what do u see in zollinger ellison syndrome?
multiple duodenal ulcers
what is rams horn deformity of the stomach? what causes it?
tapered antrum. caused by scarring, schrrious ca, granulomatous disease
what is the difference btw a traction and pulsion diverticulum?
traction is triangular and empties contrast, pulsion holds on to contrast
what is a paraesophageal hernia? what is a sliding hernia?
PE (rolling) hernia: GE junction below the diaphragm, stomach is herniated into chest. Sliding: GE junction is above diaphragm, both GE junction and and stomach are herniated into chest
what causes isolated gastric varices?
splenic vein thrombus
what syndromes are assoc with rectal cavernous hemangioma?
klipper trenauney, blue rubber bleb
what is cystic peritoneal mesothelioma?
NOT associated with asbestos, seen in a young woman in her 30s
when is primary peritoneal mesothelioma seen after asbestos exposure?
30-40 years after
what is hypertensive colopathy?
colonic edema due to venous stasis/portal HTN (usually on the right), resolves after liver transplant
what is the order from left to right on a TV view at the porta hepatis (mickey mouse sign)
common bile duct, hepatic artery, portal vein
what are the MRI signal characterisitics of dysplastic liver nodules?
T1 bright, T2 dark
what is the organism if u see a single abcess in the liver? what if u see multiple abcesses?
klebsiella. e. coli.
what is the mgmt for amebic abcess in the left hepatic lobe?
drained bc it can rupture into the pericardium
how do u biopsy a hepatic hemangioma?
core biopsy, FNA does not get enough tissue
what is the ultrasound appearance of a hemangioma?
no internal color flow, hyperechoic with increased thru transmission
what is the ultrasound appearance of FNH?
spoke wheel appearance on US doppler
what diseases are assoc with multiple hepatic adenomas?
glycogen storage disease (von gierke) or liver adenomatosis
what is the most common location for a hepatic adenoma?
right lobe of the liver
what is the mgmt for hepatic adenomas?
less than 5 cm watch and wait, more than 5 cm resect bc it can bleed or degenerate into HCC
what patients get hepatic angiosarcoma?
NF, hemochromatosis
what is pesudocirrhosis?
cirrhosis like picture due to treated breast cancer
what are contraindications to liver transplantation?
extrahepatic malignancy, advanced cardiac disease, advanced pulmonary disease, active substance abuse,
what are the causes of pancreatic lipomatosis
CF, schwan diamond, cushings, chronic steroid use, hyperlipidemia
what is annular pancreas? what are the subdivisions?
failure of ventral bud to rotate with the duodenum. Can be complete or incomplete, extramural or intramural
if u suspect pancreatic duct injury on a CT what is the best next step?
MRCP or ERCP
where are pseudoaneurysms seen as a result of pancreatitis?
GDA and splenic artery pseudoaneurysms
what must be present to classify pancreatitis as “severe?”
necrosis (not necessarily infection)
what is the risk of pancreatic ca with chronic pancreatitis?
20 yrs of chronic panc, leads to 6 percent increased risk in ca
in what percent of chronic pancreatitis is there pseudocyst formation?
30 percent
what are the imaging features of autoimmune pancreatitis?
sausage shaped, capsule like delayed rim enhancement, no ductal dilation or calcifications
what are the imaging features of tropic pancreatitis?
young age at onset, large stones in a dilated pancreatic duct, increased risk of panc adenoca (also an increased risk of adenoa ca with hereditary pancreatitis)
what is the arterial and venous supply for pancreatic grafts?
arterial: donor SMA and splenic artery. venous: donor portal vein and recipient SMV
when is splenic v thrombosis seen most commonly after placement of graft pancreas?
within 6 weeks
what is feltys syndrome?
big spleen, rheumatoid arthritis, neurtopenia
what are the cuases of a small spleen? big spleen?
small: radiation, thorotrast, sickle cell, UC/Crohns big spleen: Gauchers, leukemia lymphoma, passive congestion (herat failure, splenic v thromobsis, portal HTN)
what percent of women with unilateral renal agenesis have genital anomalies? what percent of men with unilateral renal agenesis have genital anomalies?
70 percent of women, 20 percent of men (absence of ipsi vas def or epidydmis, or an ipsi seminal vesicle cyst)
what subtype of RCC is assoc with birt higg dube?
chromophobe
what is the most common subtype of RCC?
clear cell, assoc with VHL
what are the imaging features of oncocytoma on CT/MRI, US and PET?
CT/MRI: solid mass with a central scar, US: spoke wheel vascular pattern, PET: hot
in what syndrome do u get bilateral oncocytomas?
Birt Hogg Dube
what is the enhancement pattern of bosniak class 4 cysts?
any enhancement more than 15HU
what percent of VHL patients get RCC?
25-50% get RCC (clear cell)
what are the imaging features of lithium induced nephropathy?
multiple small cysts, kidneys are normal to small in size
when do u drain a renal abcess?
if larger than 3 cm
what are the imaging features of pyonephrosis on US?
fluid fluid level in collecting system
what are the renal findings of disseminated PCP?
multiple punctate cortical calcifications
what are the cuases of a persistent nephrogram?
ATN, hypotension/shock
what are the causes of a delayed nephrogram?
obstruction, or extrinsic pressure on one kidney
what disorders is medullary sponge kidney associated with?
sickle cell, carolis, ehlers danlos, beckwith wiedmann
what is a fractured kidney?
severe laceration extending the whole length of the kidney
what percent of renal transplants get renal artery thrombosis?
1 percent
what are the signs of renal artery stenosis after transplant?
PSV more than 200, PSV ratio more than 3 (external iliac artery/renal artery), tardus parvus (slowed systolic upstroke and decreased systolic velocity)
what is the difference between ureteritis cystica and ureteral pseudodiverticulosis? which has arisk for malignancy?
both are due to chronic inflammation of the ureter. ureteritis cystica is many small fluid filled cysts in the ureteral wall, often in diabetics with recurrent UTIs. ureteral pseudodiverticulosis is multiple small OUTpouchings (75% bilateral), usually in upper or middle ureter - there is an increased risk of TCC with pseudodiverticulosis.
what is leukoplakia vs malakoplakia?
leuko: multiple mural filling defects, PREMALIGNANT and assoc wih sq cell ca, malakoplakia is asso with E coli and see plque like or nodular intramulral lesions, Rx with Abx (not premalignant)
what are the nuc med findings of metabolically active retroperitoneal fibrosis? what percent of RP fibrosis is assoc with malignancy?
hot on gallium and FDG PET. 10% of RP fibrosis is assoc with malignancy
how often is ureteral TCC bilateral?
5%
what part of the ureter is the most common for TCC?
75% are in the bottom 1/3 of the ureter
what is balkan nephropathy?
TCC in the upper ureter or renal pelvis due to aristolochic acid
what is the most common TCC subtype in the bladder?
superficial pappillary
what are the findings of bladder schistosomiasis?
heavily calcified bladder wall, assoc with sq cell ca
what part of the GU tract is affected in TB?
upper GU tract, may see calcs
in what conditions do u see a “pear shaped” bladder?
pelvic lipomatosis, hematoma
what does eosinophilic esophagitis look like on barium?
stricutre with concentric rings, or small esophagus
what is the imaging appearnace of varicoid esopahgeal ca?
thick longitudinal folds, fixed serpiginous defects
what are the CT findings of neutropenic colitis?
isolated right colonic thickening
what are the plain film findings of toxic megacolon?
dilated colon, loss of haustral markings, see “pseudopolyps” which represent denuded colon wall
what are the mucinous mets to the liver?
ovarian and colon
where is focal iron sparing seen in the liver?
posterior segment 4
what does nutmeg liver represent?
hepatic venous congestion, see engorged IVC and hepatic veins
what are the findings of primary biliary cirrhosis? what cancer are patients at risk for?
portal HTN, cirrhosis, periportal halo. patients are at risk for HCC
what cancer are patients with PSC at risk for?
cholangiocarcinoma (5-10%)
what does a tailgut cyst look like?
multilocular cystic lesion, bones intact
how does frame rate affect dose
higher pulse rate -> higher dose
what does INR have to be before paracentesis?
dont need to check INR before paracentesis or thoracentesis
