Gas Patterns I

Question 1

ABCs of abdomen patterns

Answer 1

assess gas patterns (distension/displacement)

Check for calcifications (patterns/loc)

Question 2

xray signs of liver enlargement

Answer 2

• liver projects below costal margin (not too reliable)
• downward displacement of hepatic flexure
• stomach displaced to left + post
• R kidney displaced down
• Lpwer edge cross psaos shadow (most useful sign)
• +/- elevated r diaphragm

Question 3

What is a riddle lobe and how to differentiate it

Answer 3

normal varient (elongated liver)
-extends below iliac crest

Key: R kidney will not be displaced
No clinical sig

Question 4

common causes of hepatomegaly

Answer 4

fatty liver
malignancy
Congestive heart failure
Hepatitis
hemolytic anemia
metabolic storage disease

Question 5

dx tests for hepatomegaly

Answer 5

physical exam
lab (CBC, liver function tests)
US or CT

Question 6

Splenomegaly clinical pres

Answer 6

asymptomatic (+/- pain in LUQ, L shoulder)
fullness w/o eating
anemia/fatigue
frequent infections
easy bleeding

Question 7

abnormal signs for spenomegaly

Answer 7

-extends below 12th rib to ulbilicus, into the pelvis or across the midline

check for:

• medial displacement of magenblase
• splenic flexure displaced down
• left kidney pushed down _ medial

Question 8

common causes of splenomegaly

Answer 8

• tumors
• anemias
• connective tissue diseases
• inf
• cirrhosis
• trauma

Question 9

What is hepatosplenomegaly and imaging signs

Answer 9

-simultaneous enlargement of both spleen/liver

• airless upper quadrents
• inf displacement of bowel gas
• outline of the organs

Question 10

common causes of unilateral kidney enlargement

Answer 10

congenital (hyperplasia, genesis, duplicated pelvicaval system)

obstructive hydronephrosis (mc stones)

Inf (acute pyelonephritis)

Neoplasm

Question 11

what is acute pyelonephritis and who is it mc in

Answer 11

bac inf of renal pelvis + parenchyma

mc= young women

Question 12

clinical pres of acute pyelonephritis

Answer 12

fever
flank pain
CVA tenderness
nausea
vommiting etc

Question 13

common causes of bilateral kidney enlargement

Answer 13

diabetic neuropathy
acute polynephritis
acute glomerulonephritis
lymphoma/leukemia
polycystic disease
sickle cell disease

(all present w smooth pres)

Question 14

anomalies of kidney and mc

Answer 14

Horseshoe (mc)

Ectopic (pelvic mc (too low), crossed, thoracic)

Malrotation

Question 15

imaging signs of horseshoe kidney

Answer 15

midline soft tissue mass
dilation of renal calyces system on both sides
lower poles of kidneys point midline
horseshoe kidney w bilateral caliectasis

Question 16

horseshoe kidney complications (potential)

Answer 16

hydronephrosis
renal calculi
susceptible to trauma
inf
increased malignant

Question 17

mc pres of ectopic kidney

Answer 17

unilateral
Pelvic>crossed>thoracic

most asymptomatic