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Radiology courses > Gastrointestinal System Section 3 > Flashcards

Gastrointestinal System Section 3 Flashcards

1
Q

Gallstones (Cholelithiasis)

A

Two major types of gallstones

  • Cholesterol- predominant type in the united states
  • Pigment

Can be caused by family history, being over the age of 40, being overweight, and being a female

Ultrasound is the imaging modality of choice

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2
Q

Acute Cholecystitis

A

Inflammation of the gallbladder

Caused by cystic duct obstruction by a gallstone

Ultrasound and nuclear medicine

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3
Q

Emphysematous Cholecystitis

A

Is rare

Occurs when stasis, ischemia, and cystic duct obstruction allow the growth of gas forming organisms of the gallbladder

Occurs most in elderly men and patients with poor diabetes melitus

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4
Q

Porcelain gallbladder

A

Calcifications of the gallbladder walls

Causes cholecystitis- walls become fibrous, then calcified

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5
Q

Emphysematous Cholecystitis

A

Is rare

Occurs when stasis, ischemia, and cystic duct obstruction allow the growth of gas forming organisms of the gallbladder

Occurs most in elderly men and patients with poor diabetes Mellitus

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6
Q

Porcelain gallbladder

A

Calcifications of the gallbladder walls

Causes cholecystitis- walls become fibrous, then calcified

Called porcelain gallbladder because they become very brittle and hard

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7
Q

What is the most common cause of acute cholecystitis

A

Cystic duct obstruction by gallstones

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8
Q

Hepatitis

A

Most prevelent inflammation disease of the liver

Causes-viral infections, reaction to drugs and toxins

Viral types of hepatitis are

  • Hep A (HAV)
  • Hep B (HBV)
  • Hep C (HCV)-most common cause-sex and blood transfusions. 50% of people will develop cirrhosis
  • Hep E (HEV)-food and water
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9
Q

Cirrhosis of the liver

A

Chronic destruction of the liver cells and structure, with nodular regeneration of liver parenchyma and fibrosis

An end-stage liver disease

A major cause is a chronic alcoholism, 10 to 20 years of abuse

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10
Q

Cirrhosis of the liver

A

Chronic destruction of the liver cells and structure, with nodular regeneration of liver parenchyma and fibrosis

An end-stage liver disease, turning hard and losing function

A major cause is a chronic alcoholism, 10 to 20 years of abuse

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11
Q

Cirrhosis can also cause

A

Ascites-Fluid accumulation in the abdomen.

Can become Johndus

Incurable and irreversible

Ultrasound and CT

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12
Q

Hepatocellular Carcinoma

A

Primary liver cell carcinoma

Most common in those with cirrhosis

Common cause of death could be from bleeding

CT is the modality of choice

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13
Q

Hepatic Metastasis

A

Most common malignancy of the liver

Diagnosed by CT, ultrasound, MRI, NM

CT is the gold standard

Prognosis is poor

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14
Q

Hepatic Metastasis

A

Most common malignancy of the liver

Diagnosed by CT, ultrasound, MRI, NM

CT is the gold standard

Prognosis is poor

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15
Q

What is the most common malignancy of the liver

A

Liver metastasis

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16
Q

Which type of viral hepatitis is of most concern to healthcare workers

A

Hep B (HBV)

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17
Q

Acute Pancreatitis

A

Inflammation process in which protein and lipid digesting enzymes become activated within the pancreas and begin to digest the organ itself

Most common cause is alcohol

Another cause is gallstones obstruction bile flow

Ultrasound and CT

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18
Q

Chronic Pancreatitis

A

frequent injury to the pancrease and causes scar tissue

Recurring episodes are from chronic alcohol abuse

Causes the gland to lose its ability to produce digestive enzymes, insulin and glucagon

Causes pain, malabsorption causing weight loss, and diabetes

Can see on x-ray

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19
Q

Pancreatic Pseudocyst

A

Walled off fluid collections

Occurs due to inflammation, necrosis, or hemorrhage

Causes are acute pancreatitis and trauma

CT and ultrasound unless very large then it can be seen on a plane radiograph

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20
Q

Pancreatic Pseudocyst

A

Walled off fluid collections

Occurs due to inflammation, necrosis, or hemorrhage

Causes are acute pancreatitis and trauma

CT and ultrasound unless very large than can be seen on a plain radiograph

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21
Q

Cancer of the pancreas

A

Most common type is an adenocarcinoma, 90%

Usually advanced at the time of diagnosis

60% are found in the head of the pancreas.

Other common tumors

  • Insulinoma-To much insulin
  • Gastrinoma-To much gastrin
  • Diarrheagenic islet cell tumors

Ultrasound, then use CT to see better

22
Q

Pneumoperitoneum

A

Free air in the peritoneal cavity, would be seen above the domes of the diaphragm

Caused by
Perforation of a gas containing viscus
Abdominal, gynecologic, intrathoracic, or iatrogenic causes.

Can see on radiograph.

23
Q

What is the most common site of pancreatic cancer

A

Head of the pancreas

24
Q

What is the most common cause of acute pancreatitis

A

Excessive alcohol consumption

25
Q

Pathology of the spleen

A

Enlargement and rupture

26
Q

Enlargement of spleen

A

Splenomegaly is an enlargement of the spleen.

CT is the modality of choice

27
Q

Rupture of the spleen

A

Most common cause of rupture is trauma

Rapid blood loss requires immediate surgery

May also be a complication of the palpation of a spleen enlarged by infection (especially infectious mononucleosis) or leukemia.

CT is the modality of choice

28
Q

Gallstones develop when

A

Bile contains insufficient bile salts and lecithin in proportion to cholesterol to maintain the cholesterol in solution.

29
Q

Gallstones look like

A

Radiolucent and visible only on contrast exams or Ultrasound

Large numbers of gallstones can have sand or gravel-like consistency and be visible only when they layer out on radiographs.

30
Q

Gallstones can also look like

A

A nonopaque stone may contain gas-filled fissures that produce the “Mercedes-Benz” sign which is a characteristic triradiate pattern

oral cholecystography was the traditional technique for diagnosis of gallstones

Gallstones appear freely movable filling defects in the opacified gallbladder

31
Q

Acute Cholecystitis occurs

A

After obstruction of the cystic duct by an impacted gallstone.

Gallstones may injure the mucosal wall allowing bacteria to enter

32
Q

Emphysematous Cholecystitis

A

Is a rare condition in which the growth of gas-forming organisms in the gall bladder is facilitated by stasis and ischemia caused by cystic duct obstruction (most often by stones).

33
Q

Emphysematous Cholecystitis looks like

A

Gas in the gallbladder lumen that dissects into the wall or pericholecystic tissues

34
Q

Porcelain gallbladder

A

Extensive calcifications in the wall of the gallbladder.

Forms an oval density corresponding to the size and shape of the organ.

Produces a loss of wall function, so the gallbladder becomes fibrotic and calcified.

35
Q

Porcelain gallbladder looks like

A

Blue discoloration and brittle consistency of the gallbladder wall.

36
Q

Hepatitis (liver)

A

is the most prevelant inflammatory disease of the liver

HAV is transmitted via the digestive tract from oral of fecal contact.

HBV previously known as serum hep. is contracted by exposure to contaminated blood or blood products or through sexual contact. Healthcare workers are particularly likely to be exposed to this virus and are usually required to have been vaccinated

37
Q

Cirrhosis of the liver

A

Chronic destruction of the liver cells and structure, with nodular regeneration of liver parenchyma and fibrosis

An end-stage liver disease

Major cause is 10 to 20 years of alcohol abuse

Fibrous connective tissue replaces the destroyed liver cells with cells that have no liver cell function

38
Q

Cirrhosis may lead to

A

The development of jaundice, due either to the destruction of liver cells or the obstruction of bile ducts.

39
Q

Hepatocelluar Carcinoma

A

Most commonly occurs in patients with underlying diffuse hepatocellular disease, especially alcoholic or postnecroticcirrhosis

CT is the modality of choice

The tumor appears as a large mass with an attenuation value close to that of normal parenchyma, that tends to alter the contour of the liver by projecting beyond its outer margin

40
Q

Hepatic Metastases

A

The most common malignant tumors of the liver

Usually requires CT, US, MRI, or NM

Once diagnosed with Hepatic Metastases most patients face imminent death within months

41
Q

Acute Pancreatitis

A

Inflammatory process in which protein and lipid digesting enzymes become activated within the pancreas and begin to digest the organ. Can cause bleeding.

Most common cause is excessive alcohol.

Acute pancreatitis is related to gallstones, which may enter the common bile duct and obstruct the ampulla of Vater, forcing bile to reflux into the pancreas and causing inflammation

US and CT

42
Q

Acute pancreatitis can cause

A

Pain, nausea, vomiting, and Jaundice

43
Q

Chronic Pancreatitis

A

Frequent intermittent injury to the pancreas causes increasing damage that produces scar tissue.

Results from Chronic alcohol abuse, which may cause the gland to lose its ability to produce digestive enzymes, insulin, and glucagon.

44
Q

Pancreatic Pseudocyst

A

Are loculated (walled off) fluid collections arising from inflammation, necrosis, or hemorrhage associated with acute pancreatitis or trauma.

Has a shaggy lining surrounded by dense white scar tissue and may or may not connect with the pancreatic duct

CT is choice

45
Q

Cancer of the pancreas

A

The most common pancreatic malignancy is adenocarcinoma (90%). (60%) occur in the head of the pancreas.

46
Q

Insulinoma

A

Can lower the blood glucose level, leading to attacks of weakness, unconsciousness, and insulin shock.

47
Q

Cancer of the pancreas is seen best with

A

US is often the initial screening, but then CT is used and is the most effective modality

48
Q

Pneumoperitoneum is

A

Free air in the peritoneal cavity

Caused by the perforation of a gas containing viscus.

As little at 1 mL of free intraperitoneal gas can be seen.

Best demonstrated with the patient in an upright position

49
Q

Enlargement of the spleen

A

Splenomegaly is associated with tons of infections and disorders.

Plain abdominal radiographs can demonstrate the inferior border of the enlarged spleen will be below the costal margin.

Can elevate the left hemidiaphragm.

50
Q

Rupture of the spleen

A

Is usually caused by trauma. It may be complications of the palpation of a spleen enlarged by infections.

CT is the best for imaging.

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