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CTC GI Flashcards

1
Q

what is nutcracker esophagus?

A

manometric findings more than 180 mmHg

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2
Q

what cancer is esophageal web a risk factor for?

A

esophageal and hypopharyngeal ca

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3
Q

what is plummer vinson syndrome?

A

esophageal web, iton def anemia, thyroid issues (spoon shaped nails)

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4
Q

what is a complication of chemo with gastric lymphoma?

A

rupture of the mass

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5
Q

what is the most common type of gastric ca?

A

adenoca

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6
Q

what is seen with barretts esophagus?

A

mid esophageal stricture and a hiatal hernia, reticular mucosal pattern

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7
Q

what do herpes ulcers in the esophagus look like?

A

have a HALO of edema around them, multiple, small

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8
Q

what does CMV and AIDS esophagitis look like?

A

large, flat ulcers ulcers with no halo

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9
Q

what are the imaging features of esophageal adenoca?

A

distal esophageal stricture/mass/ulcer

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10
Q

what are the imaging features of esoph sq cell ca?

A

upper-mid esophageal stricutre/mass/ulcer

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11
Q

what does achalasia predispose to?

A

increased risk of sq cell ca (20 years later) and increased risk of candida

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12
Q

what is carneys triad

A

chrodoma (pulmonary), extraadrenal pheo, GIST

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13
Q

how often does scleroderma involve the esophagus?

A

80 percent

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14
Q

what is the most common location for a GIST?

A

stomach (70 percent)

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15
Q

what is seen with malignant GIST?

A

large mass, makes a 90 degree angle with the gastric wall, does NOT cause LN enlargement

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16
Q

what syndromes are assoc with GIST?

A

Carneys and NF1

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17
Q

what are the causes of linitis plastica?

A

schirrous adenoca, mets from breast or lung cancer

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18
Q

what does chronic ASA therapy cause?

A

multiple gastric ulcers

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19
Q

what do u see in zollinger ellison syndrome?

A

multiple duodenal ulcers

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20
Q

what is rams horn deformity of the stomach? what causes it?

A

tapered antrum. caused by scarring, schrrious ca, granulomatous disease

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21
Q

what is the difference btw a traction and pulsion diverticulum?

A

traction is triangular and empties contrast, pulsion holds on to contrast

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22
Q

what is a paraesophageal hernia? what is a sliding hernia?

A

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

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23
Q

what causes isolated gastric varices?

A

splenic vein thrombus

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24
Q

what syndromes are assoc with rectal cavernous hemangioma?

A

klipper trenauney, blue rubber bleb

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25
Q

what is cystic peritoneal mesothelioma?

A

NOT associated with asbestos, seen in a young woman in her 30s

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26
Q

when is primary peritoneal mesothelioma seen after asbestos exposure?

A

30-40 years after

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27
Q

what is hypertensive colopathy?

A

colonic edema due to venous stasis/portal HTN (usually on the right), resolves after liver transplant

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28
Q

what is the order from left to right on a TV view at the porta hepatis (mickey mouse sign)

A

common bile duct, hepatic artery, portal vein

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29
Q

what are the MRI signal characterisitics of dysplastic liver nodules?

A

T1 bright, T2 dark

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30
Q

what is the organism if u see a single abcess in the liver? what if u see multiple abcesses?

A

klebsiella. e. coli.

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31
Q

what is the mgmt for amebic abcess in the left hepatic lobe?

A

drained bc it can rupture into the pericardium

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32
Q

how do u biopsy a hepatic hemangioma?

A

core biopsy, FNA does not get enough tissue

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33
Q

what is the ultrasound appearance of a hemangioma?

A

no internal color flow, hyperechoic with increased thru transmission

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34
Q

what is the ultrasound appearance of FNH?

A

spoke wheel appearance on US doppler

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35
Q

what diseases are assoc with multiple hepatic adenomas?

A

glycogen storage disease (von gierke) or liver adenomatosis

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36
Q

what is the most common location for a hepatic adenoma?

A

right lobe of the liver

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37
Q

what is the mgmt for hepatic adenomas?

A

less than 5 cm watch and wait, more than 5 cm resect bc it can bleed or degenerate into HCC

38
Q

what patients get hepatic angiosarcoma?

A

NF, hemochromatosis

39
Q

what is pesudocirrhosis?

A

cirrhosis like picture due to treated breast cancer

40
Q

what are contraindications to liver transplantation?

A

extrahepatic malignancy, advanced cardiac disease, advanced pulmonary disease, active substance abuse,

41
Q

what are the causes of pancreatic lipomatosis

A

CF, schwan diamond, cushings, chronic steroid use, hyperlipidemia

42
Q

what is annular pancreas? what are the subdivisions?

A

failure of ventral bud to rotate with the duodenum. Can be complete or incomplete, extramural or intramural

43
Q

if u suspect pancreatic duct injury on a CT what is the best next step?

A

MRCP or ERCP

44
Q

where are pseudoaneurysms seen as a result of pancreatitis?

A

GDA and splenic artery pseudoaneurysms

45
Q

what must be present to classify pancreatitis as “severe?”

A

necrosis (not necessarily infection)

46
Q

what is the risk of pancreatic ca with chronic pancreatitis?

A

20 yrs of chronic panc, leads to 6 percent increased risk in ca

47
Q

in what percent of chronic pancreatitis is there pseudocyst formation?

A

30 percent

48
Q

what are the imaging features of autoimmune pancreatitis?

A

sausage shaped, capsule like delayed rim enhancement, no ductal dilation or calcifications

49
Q

what are the imaging features of tropic pancreatitis?

A

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)

50
Q

what is the arterial and venous supply for pancreatic grafts?

A

arterial: donor SMA and splenic artery. venous: donor portal vein and recipient SMV

51
Q

when is splenic v thrombosis seen most commonly after placement of graft pancreas?

A

within 6 weeks

52
Q

what is feltys syndrome?

A

big spleen, rheumatoid arthritis, neurtopenia

53
Q

what are the cuases of a small spleen? big spleen?

A

small: radiation, thorotrast, sickle cell, UC/Crohns big spleen: Gauchers, leukemia lymphoma, passive congestion (herat failure, splenic v thromobsis, portal HTN)

54
Q

what percent of women with unilateral renal agenesis have genital anomalies? what percent of men with unilateral renal agenesis have genital anomalies?

A

70 percent of women, 20 percent of men (absence of ipsi vas def or epidydmis, or an ipsi seminal vesicle cyst)

55
Q

what subtype of RCC is assoc with birt higg dube?

A

chromophobe

56
Q

what is the most common subtype of RCC?

A

clear cell, assoc with VHL

57
Q

what are the imaging features of oncocytoma on CT/MRI, US and PET?

A

CT/MRI: solid mass with a central scar, US: spoke wheel vascular pattern, PET: hot

58
Q

in what syndrome do u get bilateral oncocytomas?

A

Birt Hogg Dube

59
Q

what is the enhancement pattern of bosniak class 4 cysts?

A

any enhancement more than 15HU

60
Q

what percent of VHL patients get RCC?

A

25-50% get RCC (clear cell)

61
Q

what are the imaging features of lithium induced nephropathy?

A

multiple small cysts, kidneys are normal to small in size

62
Q

when do u drain a renal abcess?

A

if larger than 3 cm

63
Q

what are the imaging features of pyonephrosis on US?

A

fluid fluid level in collecting system

64
Q

what are the renal findings of disseminated PCP?

A

multiple punctate cortical calcifications

65
Q

what are the cuases of a persistent nephrogram?

A

ATN, hypotension/shock

66
Q

what are the causes of a delayed nephrogram?

A

obstruction, or extrinsic pressure on one kidney

67
Q

what disorders is medullary sponge kidney associated with?

A

sickle cell, carolis, ehlers danlos, beckwith wiedmann

68
Q

what is a fractured kidney?

A

severe laceration extending the whole length of the kidney

69
Q

what percent of renal transplants get renal artery thrombosis?

A

1 percent

70
Q

what are the signs of renal artery stenosis after transplant?

A

PSV more than 200, PSV ratio more than 3 (external iliac artery/renal artery), tardus parvus (slowed systolic upstroke and decreased systolic velocity)

71
Q

what is the difference between ureteritis cystica and ureteral pseudodiverticulosis? which has arisk for malignancy?

A

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.

72
Q

what is leukoplakia vs malakoplakia?

A

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)

73
Q

what are the nuc med findings of metabolically active retroperitoneal fibrosis? what percent of RP fibrosis is assoc with malignancy?

A

hot on gallium and FDG PET. 10% of RP fibrosis is assoc with malignancy

74
Q

how often is ureteral TCC bilateral?

A

5%

75
Q

what part of the ureter is the most common for TCC?

A

75% are in the bottom 1/3 of the ureter

76
Q

what is balkan nephropathy?

A

TCC in the upper ureter or renal pelvis due to aristolochic acid

77
Q

what is the most common TCC subtype in the bladder?

A

superficial pappillary

78
Q

what are the findings of bladder schistosomiasis?

A

heavily calcified bladder wall, assoc with sq cell ca

79
Q

what part of the GU tract is affected in TB?

A

upper GU tract, may see calcs

80
Q

in what conditions do u see a “pear shaped” bladder?

A

pelvic lipomatosis, hematoma

81
Q

what does eosinophilic esophagitis look like on barium?

A

stricutre with concentric rings, or small esophagus

82
Q

what is the imaging appearnace of varicoid esopahgeal ca?

A

thick longitudinal folds, fixed serpiginous defects

83
Q

what are the CT findings of neutropenic colitis?

A

isolated right colonic thickening

84
Q

what are the plain film findings of toxic megacolon?

A

dilated colon, loss of haustral markings, see “pseudopolyps” which represent denuded colon wall

85
Q

what are the mucinous mets to the liver?

A

ovarian and colon

86
Q

where is focal iron sparing seen in the liver?

A

posterior segment 4

87
Q

what does nutmeg liver represent?

A

hepatic venous congestion, see engorged IVC and hepatic veins

88
Q

what are the findings of primary biliary cirrhosis? what cancer are patients at risk for?

A

portal HTN, cirrhosis, periportal halo. patients are at risk for HCC

89
Q

what cancer are patients with PSC at risk for?

A

cholangiocarcinoma (5-10%)

90
Q

what does a tailgut cyst look like?

A

multilocular cystic lesion, bones intact

91
Q

how does frame rate affect dose

A

higher pulse rate -> higher dose

92
Q

what does INR have to be before paracentesis?

A

dont need to check INR before paracentesis or thoracentesis

GI (1 decks)

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