Exam 3 (GI, Hepatobiliary) Flashcards
The retrograde flow of gastric acid and contents into the esophagus Is called:
gastroesophageal reflux disease
hiatal hernia
gastroenteritis
Hirschsprung disease
gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD): An Incompetent cardiac sphincter allowing the backward flow of gastric acid and contents into the esophagus.
Gastroenteritis: General grouping of a number of inflammatory disorders of the stomach and Intestines.
Hiatal hernia: Protrusion of any structure, especially some portion of the stomach, Into the thoracic cavity through the esophageal hiatus of the diaphragm.
Hirschsprung disease Absence of neurons In the bowel wall, typically in the sigmoid, preventing relaxation of the colon and normal peristalsis; also known as congenital megacolon.
Excessive and chronic alcohol consumption can lead to which of these conditions?
- chronic pancreatitis
- hepatic steatosis
- cancers (esophagus, liver, colon, etc.)
- cirrhosis
4 only
1 and 2 only
1, 3 and 4 only
1,2, 3, and 4
1,2, 3, and 4
chronic pancreatitis
hepatic steatosis
cancers (esophagus, liver, colon, etc.)
cirrhosis
hepatic steatosis- This results in an excess of fatty acids within the liver, which leads to fatty infiltration of the liver
Alcohol-induced liver disease: Liver damage caused by alcohol consumption, resulting in hepatitis, portal venous hypertension, hepatic steatosis (fatty liver), and cirrhosis of the liver. Esophageal varices may also result.
Drinking alcohol raises your risk of getting several kinds of cancer:
-Mouth and throat.
-Voice box (larynx).
-Esophagus.
-Colon and rectum.
-Liver.
-Breast
Chronic pancreatitis does impair the histologic makeup of the pancreas, resulting in irreversible changes in pancreatic function. Its causes include excessive and chronic alcohol consumption, obstruction of the hepatopancreatic ampulla by a gallstone or tumor, trauma, surgery, viral Infections (mumps, cytomegalovirus, and AIDS), steroid use, and even the injection of contrast media during ERCP.
An erosion or ulceration of the mucous membrane of the lower end of the esophagus, stomach, or duodenum; associated with helicobacter pylori.
hiatal hernia
esophageal varices
dilation disease
peptic ulcer
peptic ulcer
A procedure performed in patients with ascites, during which a needle is inserted into the peritoneal cavity to obtain ascitic fluid.
paracentesis
pancreaticoduodenectomy
transjugular intrahepatic portosystemic stent
laparoscopic cholecystectomy
paracentesis
Paracentesis: A procedure performed in patients with ascites, during which a needle Is Inserted into the peritoneal cavity to obtain ascitic fluid.
Transjugular intrahepatic portosystemic stent (TIPSS) An interventional angiography procedure In which a catheter Is used to connect the jugular vein to the portal vein to reduce the flow of blood through a diseased liver.
Laparoscopic cholecystectomy: a surgical technique that allows a less traumatic entry, excision, and removal of the gallbladder, resulting in shortened hospitalization and reduced costs.
Pancreaticoduodenectomy (Whipple’s Procedure): consists of a partial pancreatectomy, duodenectomy, and cholecystectomy, and may or may not include a distal gastrectomy.
Varicose veins are abnormally lengthened, dilated, and superficial veins; those in the esophagus are referred to as:
hematemesis
tracheoesophageal fistula
portal vein hypertension
esophageal varices
esophageal varices
Any disease that comes on slowly and does not have obvious symptoms at first:
insidious onset
diffuse disease
acute onset
focal disease
insidious onset
How does cirrhosis lead to esophageal varices?
Scarring cuts down on blood flowing through the liver. As a result, more blood flows through the veins of the esophagus causing them to bulge.
Lipids accumulate within the hepatocytes, forming free radicals and resulting in an excess of fatty acids within the liver, which leads to fatty infiltration of the liver.
Fluid volume in the peritoneal cavity is decreased due to alcoholism.
A viral Infection causes inflammation of the liver cells.
Scarring cuts down on blood flowing through the liver. As a result, more blood flows through the veins of the esophagus causing them to bulge.
Scarring (cirrhosis) of the liver is the most common cause of esophageal varices. This scarring cuts down on blood flowing through the liver (portal venous hypertension). As a result, more blood flows through the veins of the esophagus. The extra blood flow causes the veins In the esophagus to balloon outward forming esophageal varices.
Viral Hepatitis- A viral Infection causes inflammation of the liver cells.
Ascites: Fluid volume In the peritoneal cavity is increased. Ascites, the accumulation of fluid within the peritoneal cavity, as a result of portal hypertension and the leakage of excessive fluids from the portal capillaries.
Fatty Liver disease (hepatic steatosis) - lipids accumulate within the hepatocytes, forming free radicals. At some point, the liver cannot rid itself of the excessive triglycerides. This results in an excess of fatty acids within the liver, which leads to fatty infiltration of the liver, termed steatosis, and fatty liver disease.
Regional enteritis (Crohn disease) Is considered a inflammatory disease starting in the small intestine affecting all layers of the bowel wall, while ulcerative colitis is an inflammatory disease of the large intestine affecting only the mucosal layer.
True or False
True
Regional enteritis, also known as Crohn disease (CD) Is a chronic IBD of unknown cause. It is a type of chronic inflammatory bowel disease, that causes swelling of the tissues in the digestive tract, affecting all layers of the bowel wall, It usually begins in the terminal ileum and cecum and descends through the bowel, often with skip areas, it rarely produces megacolon or bowel perforations. Radiographic signs include “cobblestone” appearance on barium studies, and “string sign” of the terminal Ileum.
Ulcerative colitis is a chronic, recurrent ulceration of the colon mucosa of unknown cause. It typically involves only the mucosal layer and begins at the rectum and ascends, often resulting in megacolon and bowel perforations and frequently progressing to cancer.
A modified barium swallow study is:
conventional (non-fluoroscopic) imaging that focuses on the motility of the esophagus.
MRI cholecystogram
Sonography examination of the thyroid.
fluoroscopic examination that assesses swallowing safety.
fluoroscopic examination that assesses swallowing safety.
A modified barium swallow study is fluoroscopic examination that assesses swallowing safety.
To evaluate disorder of esophageal motility (achalasia), esophageal manometry and an esophagram are typically ordered.
The esophagus and stomach are distinguished by the difference in the mucosal folds; demonstration of the stomach in the thoracic cavity Is a case of:
gastric reflux
hiatal hernia
esophagitis
Barrett esophagus
hiatal hernia
Abnormal passage between the trachea and esophagus, associated with esophageal atresia.
pylorospasm
hypertrophic pyloric stenosis
tracheoesophageal fistula
hypoplasia
tracheoesophageal fistula
Hypertrophic pyloric stenosis- A congenital anomaly of the stomach in which the pyloric canal is greatly narrowed because of hypertrophy (abnormal enlargement) of the pyloric sphincter.
Hypoplasia- Less than normal development
Pylorospasm- is an incomplete obstruction of fluid flow into the duodenal bulb resulting from spasmodic changes in pyloric muscle tone.
fistula-an abnormal tube-like passage from one structure to another
tracheoesophageal fistula- abnormal passage between the trachea and esophagus, associated with esophageal atresia.
A pedunculated polyp in the bowel is:
attached to the bowel wall by a narrow stalk.
an abnormal passage or opening between two organs.
attached directly to the bowel wall with a wide base. an outpouching of the bowel lumen.
attached to the bowel wall by a narrow stalk.
Colonic polyps are small masses of tissue arising from the bowel wall to project inward within the lumen. Sessile polyps attach directly to the bowel wall with a wide base. Pedunculated polys are attached by a narrow stalk to the bowel wall.
Diverticula/diverticulum are outpouches in the lumen of bowel wall.
A fistula is an abnormal passage or opening between two organs or between an organ and the body’s surface.
Celiac disease is a type of:
tistula.
diverticulum.
hernia
malabsorption syndrome.
malabsorption syndrome.
Gluten-sensitive enteropathy, formally known as celiac sprue or celiac disease, is an autoimmune hereditary disorder involving increased sensitivity to gluten. Gluten is an agent found in wheat, barley, and rye products such as bread, which interferes with normal digestion and absorption of food through the small bowel.
In adults, when ___ is visible in the peritoneal cavity on abdominal radiographs, bowel perforation may be a concern.
string sign
free air
lead pipe sign
fat stranding
free air
The presence of stones within the common bile duct is termed
Cholelithiasis
Cholangitis
Choledocholithiasis
Choleliths
Choledocholithiasis
Choledocholithiasis: Presence of gallstones in the common bile duct
Choleliths- gallstones
Cholangitis: inflammation of the biliary ductal system
Cholelithiasis The presence of gallstones
Cholecystitis: An acute inflammation of the gallbladder most frequently caused by obstruction
This condition Is a strict contraindication for barium enema examinations.
Crohn disease
Meckel diverticulum
toxic megacolon
esophageal strictures
toxic megacolon
Hirschsprung disease Absence of neurons in the bowel wall, typically in the sigmoid, preventing relaxation of the colon and normal peristalsis; also known as congenital megacolon. Toxic megacolon develops from bacterial overgrowth leading to fluid and electrolyte imbalances that could result in death. Barium enema examination Is strictly contraindicated in persons with known or suspected toxic megacolon.
What modality Is preferred for imaging of suspected cholelithiasis?
abdominal radiography
sonography
MRI
computed tomography
sonography
Sonography Is the primary choice for imaging the gallbladder. Sonography has advantages as it is non-invasive, performed without exposure to ionizing radiation, less expensive, and the gallbladder can be imaged in almost all individuals who are fasting regardless of the body habitus or clinical condition of the person. When sonography Is performed by a skilled sonographer, it has been proven to be almost 100% accurate in detecting gallstones, with the capability of detecting stones as small as 2 mm In size.
Benign strictures of the esophagus are often:
unsmooth mucosa and irregular contours with acute or “shouldered” margins.
smooth with tapered or obtuse margins.
ragged and nodular.
abnormally dilated.
smooth with tapered or obtuse margins.
A stricture is an abnormal narrowing. Strictures may be benign or malignant. Benign strictures are often smooth with tapered or obtuse margins. The mucosa of a benign stricture may be normal or abnormal.
Malignant strictures often have unsmooth mucosa and irregular contours with acute or “shouldered” margins.
A “shoulder” sign is when a tumor margin abruptly transitions from the intraluminal component to the adjacent normal mucosa, forming a shouldered edge. For example, shouldered margins on an esophagus in a radiograph can be a sign of a malignant tumor, such as esophageal cancer.
What do these terms all have in common: laparoscopic, fluoroscopic, endoscopic?
all refer to a “surgical connection that is created between tubular structures”
all refer to “through the skin”
all refer to “inspection by a camera”
all refer to “surgical removal of an organ”
all refer to “inspection by a camera”
“-scope, -scopy or-scopic” all refer to “inspection by a camera”, i.e. “endoscopy”: “flouroscopy”, etc
An anastomose is a “surgical connection that is created between tubular structures”.
“-ectomy” which means “surgical removal of…”. l.e., duodenectomy, refers to the surgical removal of the duodenum
“trans”- refers to across- l.e., transhepatic = across the liver.
“per-“ refers to pass through - i.e., percutanous = pass through the skin.
A type of cancer that develops in the flat cells lining the Gl tract (epithelium). AKA: epidermoid carcinoma.
adenocarcinoma
hemangioma
squamous cell carcinoma
cyst
squamous cell carcinoma
Squamous cell carcinoma arises from squamous cells. Squamous cells are flat, thin cells that look like fish scales under a microscope. They are found in the following tissues:
-The surface of the skin
-The lining of the respiratory and digestive tracts
-The lining of hollow organs, such as the bladder, kidney, and uterus
Adenocarcinoma is a type of cancer that originates in glandular cells, also known as adenomatous cells, which produce mucus and digestive juices. Adenocarcinoma can develop in many organs, including the breast lung, prostate, and gastrointestinal tract.
Cysts and Hemangiomas are benign. A hemangioma Is a benign tumor of dilated blood vessels.
This pathology develops as lipids accumulate within the hepatocytes, forming free radicals; also called hepatic steatosis and is classified generally as either alcoholic or non-alcoholic.
hepatocellular carcinoma
hemangioma
fatty liver disease
portal hypertension
fatty liver disease
The recommended initial imaging evaluation in cases of suspected bowel obstruction.
CT
MRI
sonography
acute abdominal series
acute abdominal series
An acute abdominal series is the recommended first radiologic evaluation in cases of suspected bowel obstruction. Abdominal radiographs that are positive for bowel obstruction often direct the subsequent imaging workup
A malignancy of the bile ducts:
cholangitis
cirrhosis
cholangiocarcinoma
pancreatic cancer
cholangiocarcinoma
A rare, serious disorder in which one part of the intestine slides inside an adjacent part. It is the most common cause of Intestinal obstruction In children younger than 3 years old.
paralyte ileus
stricture
intussusception
volvulus
intussusception
Vulvulus: An Intestinal obstruction caused by a twisting of the bowel about its mesenteric base.
Intussusception is a rare, serious disorder in which one part of the intestine slides Inside an adjacent part. Intussusception is the most common cause of intestinal obstruction in children younger than 3 years old. The cause of most cases of intussusception in children is unknown.
