FRCR

Question 1

Candida oesophagitis risk factors

Answer 1

Inhaled steroid, prolonged ABs, HIV, immunocompromised / elderly, stasis secondary to achalasia, scleroderma, post fundoplication

Question 2

Candida oesophagitis appearance

Answer 2

Plaque like lesions, cobblestone appearance, grossly irregular or shaggy appearance

Question 3

Oesophagitis in AIDS

Answer 3

HIV, CMV, HSV, Candida. The non-candida ones tend to form larger ulcers
TB and atypical mycobacteria can also cause

Question 4

Oesophageal pseudodiverticulosis

Answer 4

Uncertain aetiology
May cause dysphagia
Stasis, inflammation believe to be involved
The diverticula are in fact dilater dubmucosal glands
Often associated with dysmotility and strictures
No association with cancer established

Question 5

Booerhave syndrome

Answer 5

Oesophageal rupture secondary to vomiting
Pneumomediastinum, left pneumothorax (dissects from mediastinum into pleural space) and pleural effusion
Can lead to mediastinitis
Surgery treatment
CT most useful imaging

Question 6

Cirrhosis causes

Answer 6

Alcohol, viral hepatitis, haemachromatosis, PSC, BPC, CF, steatosis

Question 7

CT features of cirrhosis

Answer 7

Nodular contour, change in liver shape with enlarged caudate and reduced right lobe, widening of fissurs, fatty infiltration
Portal HTN - splenomegaly, recanalised umbilical vein, portosystemic collaterals, increased portla vein size, ascites

Question 8

Cirrhosis definition

Answer 8

End stage of variety of chornic liver diseases characterised by diffused hepatic fibrosis and regenerating nodules

Question 9

Bezoar definition and risk factors

Answer 9

Ball of hair or fibrous material trapped within stomach
Prevalence greater among those with learning difficulties and in emotionally disturbed children. Greatest in females 10-20

Question 10

Gastric adenocarcinoma appearance and risk factors

Answer 10

Ulcerating mass, intramural mass, or diffuse infiltrating (linitis plastica)
Risk factors: smoking, ingestion of nitries, H pylori, atrophic gastritis, hereditary factors

Question 11

Gastric lymphoma, type

Answer 11

Tend to be MALTomas
Inflammatory disease (Crohns, coeliacs, autoimmune, H pylori) and immunosuppression (HIV, drugs) are risk factors

Question 12

Hyperplastic gastric polyp

Answer 12

Associated with atrophic gastritis, which is a risk factor for malignancy. The gastritis is most commonly autoimmune or H pylori.
Hyperplastic polyps <1cm. Adenomas tend to be >1cm
Minority of polyps are adenomas, which are usually solitary, unless in a familial polyposis
Multiple polyps are usually hyperplastic
Half solitary, half multiple
Usually in antrum or body
Other differentials - GIST, ectopic pancreas, met

Question 13

GIST location

Answer 13

Stomach (2/3), small bowel (1/3). Rarely oesophagus or rectum
The commonest mesenchymal tumour

Question 14

Up to case 11 GI

Answer 14

.

Question 15

Bladder rupture

Answer 15

Extraperitoneal 85%, conservative unless persistent

Intraperitoneal blunt trauma to full bladder

Question 16

Bell-clapper deformity

Answer 16

Tunica vaginalis joins high on spermatic cord, leaving testis free to rotate

Question 17

Torsion differential

Answer 17

Testicular appendage torsion, epididymoorchitis, tumour inc lymphoma, hydrocele.
20% viability at 24 hours

Question 18

Ureteral pseudodiverticulosis

Answer 18

Hyperplastic epithelial cells in submucosa, forming crypts, do not extend past lamina propria
Associated with chronic inflammation
Association with TCC proposed but not confirmed - warrant cytology and cystoscopy to rule out
Men 40-60, upper 2/3 of ureter
(Cf. ureteritis cystica, old female diabetics with recurrent infection, multiple filling defects rather than multiple outpouchings)

Question 19

Cortical nephrocalcinosis

Answer 19

Acute cortical necrosis, transplant rejection, chronic glomerulonephritis.
Oxalosis (autosomal recessive), Alports (X-linked recessive, leiomyomas, sensorineural hearing loss)

Question 20

Medullary nephrocalcinosis

Answer 20

MSK - tends to be normal size or enlarged kidneys, unlike other causes
RTA
Renal papillary necrosis - NSAID, sickle cell, infection, diabetes, dehydration,
Hypercalcuria (may or may not be hypercalcaemic) e.g. HPT (comment on bones), sarcoid
Furosemide abuse