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CORE > GI > Flashcards

GI Flashcards

1
Q

liver –> Couinaud segmts –> sup segmts? inf?

A
  • sup: 2, 4, 8, 7, 1

- inf: 3, 4, 5, 6

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2
Q

liver –> caudate lobe –> draining V?

A

IVC

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3
Q

liver MRI –> steatosis vs hemochromatosis –> inphase/out phase signal?

A
  • out of phase –> low signal –> fat

- in phase –> low signal –> iron

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4
Q

liver –> amyloid –> CT appearance?

A

hypodense –> focal or diffuse

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5
Q

Wilson dz –> copper deposit –> locations? (3)

A
  • basal ganglia
  • cornea
  • liver
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6
Q

Wilson dz –> liver –> CT appearance?

A

mult hyperdense nodules

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7
Q

iron overload –> accum in what cell type? —> hemochromatosis vs hemosiderosis

A
  • hemochromatosis –> hepatocytes

- hemosiderosis –> reticuloendothelial system –> hepatic Kupffer cells

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8
Q

hemochromatosis vs hemosiderosis –> affected organs?

A

hemochromatosis:
- liver
- pancreas
- myocardium
- skin/jt

hemosiderosis:
- liver
- spleen
- BM

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9
Q

hemochromatosis vs hemosiderosis –> MOA?

A
  • hemochromatosis: genetic defect –> inc iron absorb

- hemosiderosis: blood transfusion or defective erythrocytosis

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10
Q

hemochromatosis vs hemosiderosis –> tx?

A
  • hemochromatosis: phlebotomy

- hemosiderosis: iron chelator

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11
Q

what is 2ary hemochromatosis?

A

chronic hemosiderosis –> RES saturated –> hepatic damage

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12
Q

noncontrast CT –> hyperdense liver –> HU?

A

> 75

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13
Q

noncontrast CT –> hyperdense liver –> ddx? (4)

A
  • iron overload
  • med (amiodarone, gold, methotrexate)
  • copper overload (Wilson dz)
  • glycogen excess
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14
Q

mult tiny hypodense liver lesions –> (5)

A
  • candidiasis –> microabscesses
  • mets
  • lymphoma
  • biliary hamartoma
  • Caroli dz
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15
Q

liver abscess –> MC etiology?

A

bowel process:

  • diverticulitis
  • appendicitis
  • Crohn
  • bowel surg
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16
Q

hepatic echinococcus –> hydatid cyst –> CT appearance?

A

well-defined hypodense mass –> floating membrane or assoc daughter cyst

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17
Q

cirrhosis –> early findings? (3)

A
  • preportal space expand
  • caudate lobe enlrg –> caudate to R lobe size ratio >0.65
  • empty gallbladder fossa sign
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18
Q

what is Gamma-Gandy bodies?

A

cirrhosis –> 2nary finding –> splenic microhemorrhage

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19
Q

liver cirrhosis –> regenerative nodule –> arterial phase –> enhance or not?

A

not enhance

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20
Q

liver cirrhosis –> what is siderotic nodule?

A

iron-rich regenerative or dysplastic nodule

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21
Q

cirrhosis –> hypervasc liver mass –> ddx? (1)

A

HCC until proven otherwise

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22
Q

HCC –> classic enhancemt pattern?

A
  • arterial phase –> enhance

- portal venous phase –> washout

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23
Q

cirrhosis –> what is “nodule in a nodule”?

A

enhancing nodule w/in dysplastic nodule –> early HCC

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24
Q

fibrolamellar HCC –> epidemiology?

A

young –> no cirrhosis

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25
Q

fibrolamellar HCC –> MRI findings? (3)

A
  • lrg heterogeneous mass
  • central fibrotic scar –> T1/T2 hypo
  • 10% –> capsular retract
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26
Q

liver mets –> best seen on what phase imaging?

A

most –> hypovasc –> portal venous –> hypodense

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27
Q

hypervasc liver mets? (5)

A
  • neuroendocrine tumor –> pacnreatic, carcinoid
  • RCC
  • thyroid CA
  • melanoma
  • sarcoma
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28
Q

liver mets –> T1/T2 signal?

A
  • T1 hypo

- T2 hyper

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29
Q

what is pseudocirrhosis?

A

mult scirrhous liver mets –> macronodular liver contour

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30
Q

pseudocirrhosis –> MC etiology?

A

treated breast CA

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31
Q

liver –> capsular retraction –> ddx? (6)

A
  • mets –> usu post-tx
  • fibrolamellar HCC
  • HCC
  • epithelioid hemangioendothelioma
  • intrahep cholangioCA
  • confluent hepatic fibrosis
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32
Q

what is epithelioid hemangioendothelioma?

A

liver –> rare vasc malig –> mult round subcapsular mass –> can confluent

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33
Q

epithelioid hemangioendothelioma –> mass appearance?

A

halo or target

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34
Q

what is focal nodular hyperplasia (FNH)?

A

disorganized liver tissue

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35
Q

focal nodular hyperplasia (FNH) –> assoc w OCP –> T/F?

A

F

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36
Q

focal nodular hyperplasia (FNH) –> enhancemt pattern?

A
  • arterial –> avid enhance –> quick washout
  • portal venous –> unenhancing central “scar”
  • delayed –> scar enhance
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37
Q

what is hepatic hemangioma? blood supply?

A

benign mass –> disorg endothelial-lined pockets of blood vessels –> supplied by hep A

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38
Q

liver –> giant hemangioma –> nonenhancing central area –> what is it?

A

cystic degen

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39
Q

hepatic hemangioma –> enhancemt pattern?

A

peripheral nodular enhance –> progress fill-in

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40
Q

hepatic hemangioma –> noncontrast CT –> density?

A

hypo

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41
Q

what is hepatic adenoma?

A

benign neoplasm:

  • hepatocytes
  • scattered Kupffer cells
  • no bile ducts
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42
Q

focal nodular hyperplasia (FNH) –> contain bile ducts –> T/F?

A

T

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43
Q

hepatic adenoma –> assoc RF? (2)

A
  • OCP

- anabolic steroid

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44
Q

mult hepatic adenoma –> synd? (1)

A

von Gierke dz (type 1 glycogen storage dz)

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45
Q

hepatic adenoma –> tx? why?

A

resect –> high risk hemorrhage

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46
Q

hepatic adenoma –> MRI appearance? (3)

A
  • arterial phase –> hypervasc
  • if fatty –> hypo OOP
  • hemorrhage –> T1 hyper
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47
Q

what is Budd-Chiari?

A

hepatic venous outflow obstruct –> thrombotic vs non

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48
Q

acute Budd-Chiari –> clinical triad?

A
  • abd pain
  • hepatomeg
  • ascites
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49
Q

Budd-Chiari –> vascular findings? (3)

A
  • hep V –> no flow
  • hep V/IVC –> thrombus
  • collateral vessels
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50
Q

liver –> what is veno-occlusive dz?

A

patent hep V –> destruction of post-sinusoidal venules

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51
Q

liver –> what is veno-occlusive dz –> epidemiology?

A

BM tx

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52
Q

liver –> what is veno-occlusive dz –> imaging findings? (4)

A

nonspecific:
- hepatomeg
- heterogen enhance
- narrow hep V
- periportal edema

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53
Q

what is cardiac hepatopathy?

A

HF, constrictive pericarditis, R valve dz –> passive hepatic congest –> cirrhosis

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54
Q

cardiac hepatopathy –> imaging findings? (3)

A
  • contrast reflux into IVC/hepV
  • enlrg IVC/hepV
  • enlrg liver –> mottled enhance
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55
Q

what is biliary hamartoma (von Meyenburg complex)?

A

embryology fail normal bile duct formation –> small cystic liver lesions that not comm w biliary tree

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56
Q

liver injury –> MDCT grading system? (5)

A
  • grade I: superficial lac or subcapsular hematoma –> <1cm
  • II: 1-3cm
  • III: >3cm
  • IV: >10cm or 1 hep lobe devasc
  • V: both hep lobes –> devasc
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57
Q

eovist –> excretion? T1 signal?

A

biliary excretion

T1 hyper biliary fluid

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58
Q

choledochal cyst –> Todani classification?

A
  • type I: CBD –> fusiform dilate
  • II: extrahep –> saccular dilation
  • III: intra-duodenal
  • IVA: mult –> intra & extra-hep
  • IVB: mult –> extra-hep only
  • V (Caroli dz): intrahep
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59
Q

choledochal cyst –> tx or no? why?

A

resect –> inc risk cholangioCA

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60
Q

choledochal cyst V (Caroli dz) –> assoc condition?

A

polycystic kidneys

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61
Q

choledochal cyst V (Caroli dz) –> sign?

A

central dot sign

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62
Q

what is Caroli synd?

A
  • Caroli dz

- hep fibrosis

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63
Q

gangrenous cholecystitis –> MOA?

A

inc intralum pressure –> GB wall ischemia

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64
Q

Charcot triad? dx?

A

ascending cholangitis:

  • fever
  • abd pain
  • jaundice
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65
Q

ascending cholangitis –> key imaging finding?

A

biliary wall –> thick & hyperenhance

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66
Q

what is 1ary sclerosing cholangitis (PSC)?

A

idiopathic –> bile duct inflamm –> destroy

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67
Q

1ary sclerosing cholangitis (PSC) –> assoc condition?

A

ulc colitis

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68
Q

1ary sclerosing cholangitis (PSC) –> imaging appearance?

A

CBD & intrahep bile duct –> beaded irreg appearance

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69
Q

1ary sclerosing cholangitis (PSC) –> ddx? (1)

A

HIV cholangitis (cholangiopathy)

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70
Q

1ary sclerosing cholangitis (PSC) –> comp? (3)

A
  • cirrhosis
  • cholangioCA
  • recurrent biliary infx
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71
Q

what is 1ary biliary cirrhosis (PSC)?

A

smaller bile duct –> inflamm –> destroy

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72
Q

1ary biliary cirrhosis (PSC) –> epidemiology?

A

middle age F

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73
Q

1ary biliary cirrhosis (PSC) –> initial ssx? (1)

A

pruritis

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74
Q

HIV cholangitis (cholangiopathy) –> MC org? (2)

A
  • Cryptosporidium

- CMV

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75
Q

HIV cholangitis (cholangiopathy) vs 1ary biliary cirrhosis (PSC) –> differentiating imaging finding?

A

HIV cholangitis –> papillary stenosis

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76
Q

recurrent pyogenic cholangitis (Oriental cholangiohepatitis) –> MC org?

A

parasite Clonorchis sinensis

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77
Q

recurrent pyogenic cholangitis (Oriental cholangiohepatitis) –> imaging triad?

A
  • pneumobilia
  • lamellated bile duct filling defect
  • intra & extra-hep biliary dilate & stricture
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78
Q

what is biliary cystadenoma?

A

benign cystic neoplasm

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79
Q

biliary cystadenoma –> epidemiology?

A

middle age F

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80
Q

biliary cystadenoma –> comm w biliary system –> T/F?

A

F

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81
Q

biliary cystadenoma –> imaging appearance?

A

lrg multiloculated cystic mass

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82
Q

what is cholangioCA?

A

biliary duct epithelium –> malig tumor

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83
Q

what is Klatskin tumor?

A

MC form of cholangioCA –> at hilum

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84
Q

cholangioCA –> imaging appearance?

A
  • intrahep –> confluence of central bile ducts –> mass
  • biliary dil
  • capsular retraction
  • tumor fingers into bile ducts
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85
Q

gallbladder CA –> MC appearance?

A

scirrhous mass –> invade GB wall –> into liver

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86
Q

GB mets –> 1ary CA?

A

melanoma

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87
Q

pancreas neoplasm –> 3 broad types?

A
  • solid epithelial
  • cystic epithelial
  • endocrine
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88
Q

pancreas –> solid epithelial neoplasm –>2 types?

A
  • ductal adenoCA

- acinar cell CA

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89
Q

pancreas –> cystic epithelial neoplasm –> 4 types?

A
  • serous cystic
  • mucinous cystic
  • solid & papillary epithelial neoplasm (SPEN)
  • intraductal papillary mucinous neoplasm (IPMN)
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90
Q

pancreas –> endocrine neoplasm –> 5 types?

A
  • insulinoma
  • gastrinoma
  • glucagonoma
  • VIPoma
  • somatostatinoma
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91
Q

pancreas –> cystic epithelial neoplasm –> epidemiology?

  • serous cystic
  • mucinous cystic
  • solid & papillary epithelial neoplasm
  • intraductal papillary mucinous neoplasm (IPMN)
A
  • serous cystic: old F (grandmother tumor)
  • mucinous cystic: middle age F (mother)
  • solid & papillary epithelial neoplasm: young F (daughter)
  • intraductal papillary mucinous neoplasm: old M (grandfather)
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92
Q

MC pancreatic neoplasm?

A

pancreas adenoCA

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93
Q

pancreas adenoCA –> RF? (3)

A
  • smoke
  • alcohol
  • chronic panc
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94
Q

pancreas adenoCA –> MC location?

A

panc head

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95
Q

CT –> pancreas –> phases?

A
  • noncontrast
  • late art
  • portal venous
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96
Q

pancreas adenoCA –> CT appearance? T1 signal?

A
  • hypodense/T1 hypo –> ill-defined, hypovasc
  • panc duct obstruct –> double duct sign
  • panc tail –> atrophy
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97
Q

pancreas mass –> no duct dil –> ddx? (8)

A
  • autoimmune pancreatitis
  • groove pancreatitis
  • cystic panc tumor
  • neuroendocrine tumor
  • duodenal GIST
  • peripanc LN
  • panc mets
  • lymphoma
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98
Q

double duct sign –> no panc mass –> ddx? (1)

A

panc adenoCA

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99
Q

pancreas –> what is acinar cell CA?

A

panc adenoCA variant –> rare, aggressive

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100
Q

acinar cell CA –> clinical triad? MOA?

A

malig cells –> lipase –> lipase hypersecretion synd:

  • subQ fat necrosis
  • bone infarct –> polyarthralgia
  • eosinophilia
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101
Q

pancreas –> serous cystadenoma –> benign or malig?

A

benign

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102
Q

pancreas –> serous cystadenoma –> imaging features? (3)

A
  • many small cysts –> >6 cysts –> <2cm –> may appear solid
  • hypervasc
  • central stellate calc
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103
Q

pancreas –> mucinous cystic neoplasm –> benign or malig?

A

benign

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104
Q

pancreas –> mucinous cystic neoplasm –> tx? why?

A

resect –> malig potential

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105
Q

pancreas –> mucinous cystic neoplasm –> imaging feature? (1)

A

1 or few lrg cysts –> <6 cysts –> >2cm

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106
Q

pancreas tumor –> capsule –> ddx? (2)

A
  • mucinous cystic

- SPEN

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107
Q

solid & papillary epithelial neoplasm (SPEN) –> imaging feature? (2)

A
  • lrg heterogeneous solid & cystic mass

- hemorrhage

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108
Q

pancreas –> intraductal papillary mucinous neoplasm (IPMN) –> benign or malig?

A

variable:
- benign
- indolent
- agg

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109
Q

pancreas –> intraductal papillary mucinous neoplasm (IPMN) –> main panc duct vs sidebranch –> which is more malig potential?

A

main

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110
Q

pancreas –> intraductal papillary mucinous neoplasm (IPMN) –> classic imaging appearance?

A

intra-pancreas –> cystic lesion –> comm w panc duct or sidebranch

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111
Q

pancreas –> intraductal papillary mucinous neoplasm (IPMN) –> resect –> indication? (3)

A
  • > 3cm
  • mural nodule
  • panc duct >10mm
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112
Q

hypervasc liver mass + assoc pancreatic mass –> ddx? (1)

A

panc endocrine neoplasm –> liver mets

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113
Q

panc endocrine tumor –> hypo- or hypervasc?

A

hyper

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114
Q

panc endocrine tumor –> small vs lrg –> density?

A
  • small –> solid

- lrg –> central necrosis & calc

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115
Q

MC panc endocrine tumor?

A

insulinoma

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116
Q

insulinoma –> clinical triad?

A

Whipple triad:

  • hypoglycemia
  • hypoglycemia ssx
  • improve w glucose admin
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117
Q

2nd MC panc endocrine tumor?

A

gastrinoma

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118
Q

gastrinoma –> assoc synd?

A

mult endocrine neoplasia (MEN) type 1

119
Q

mult endocrine neoplasia (MEN) type 1 –> gastrinoma –> location?

A

duodenum –> mult

120
Q

what is gastrinoma triangle?

A

typical location –> triangle:

  • cystic duct & CBD
  • duodenum
  • panc neck/body
121
Q

gastrinoma –> comp? (1)

A

high gastrin –> stomach –> carcinoid tumor

122
Q

panc divisum –> MOA?

A

fail fusion of ventral & dorsal panc ducts

123
Q

panc divisum –> comp? MOA?

A

Santorinicele –> obstruct minor papilla –> pancreatitis

124
Q

panc divisum –> sign?

A

crossing sign –> CBD cross main duct

125
Q

what is annular panc?

A

ventral panc bud –> incomplete rotate –> panc wrap around duodenum

126
Q

adult –> annular panc –> comp? (3)

A
  • pancreatitis
  • peptic ulcer dz
  • duodenal obstruct
127
Q

neonate –> annular panc –> comp? (1)

A

duodenal obstruct

128
Q

what is common channel synd (pancreaticobiliary maljx)?

A

no septum bw distal CBD & panc duct –> reflux bw 2 systems

129
Q

von Hippel-Lindau –> pancreas neoplasms? (2)

A
  • serous cystadenoma

- neuroendocrine tumor

130
Q

child –> MCC panc atrophy?

A

cystic fibrosis

131
Q

cystic fibrosis –> panc comp? (2)

A
  • fatty atrophy

- pancreatic cystosis –> diffuse replace panc w innum cysts

132
Q

what is Schwachman-Diamond dz?

A

rare –> inherit –> panc –> diffuse fatty replace:

  • panc exocrine insuff
  • neutropenia
  • bone dysplasia
133
Q

child –> 2nd MCC panc atrophy?

A

Schwachman-Diamond dz

134
Q

intra-panc access spleen –> MC location?

135
Q

acute panc –> 2 MCC?

A
  • alcohol

- obstructing gallstone

136
Q

autoimmune pancreatitis –> assoc condition?

137
Q

autoimmune pancreatitis –> typical imaging appearance?

A

diffuse “sausage-shape” enlrgmt of pancreas –> however, can be focal

138
Q

autoimmune pancreatitis –> tx?

139
Q

groove pancreatitis –> epidemiology?

A

young M –> heavy drink

140
Q

groove pancreatitis –> chronic –> duodenal changes? (2)

A
  • duodenal stenosis

- cystic change of duodenal wall

141
Q

polysplenia –> assoc anomaly? (3)

A
  • severe congenital cardiac anomaly
  • venous anomaly –> ie IVC w hemi/azygous continuation
  • preduodenal portal V
142
Q

splenic hemangioma –> assoc synd? (2)

A
  • Kasabach-Merritt

- Klippel-Trenaunay-Weber

143
Q

Kasabach-Merritt synd? (3)

A
  • anemia
  • thrombocytopenia
  • consumptive coagulopathy
144
Q

Klippel-Trenaunay-Weber synd? (3)

A
  • cutaneous hemangioma
  • varicose veins
  • extremity hypertrophy
145
Q

splenic hemangioma –> CT density?

  • noncontrast
  • contrast
A
  • noncontrast: hypo or iso

- contrast: hyperenhance

146
Q

splenic hemangioma –> MR signal?

  • T2
  • contrast
A
  • T2: hyper

- contrast: peripheral or homogenous enhance

147
Q

splenic hemangioma –> Tc-99m RBC scan –> finding?

A

delayed –> inc activity in lesion

148
Q

splenic hemangioma –> Tc-99m sulfur colloid scan –> finding?

A

dec or inc activity

149
Q

what is splenic hamartoma?

A

malformed red pulp –> benign lesion

150
Q

splenic hamartoma –> assoc condition? (1)

A

tuberous sclerosis

151
Q

splenic hamartoma –> CT density?

  • noncontrast
  • contrast
A
  • noncontrast: hypo to iso

- contrast: heterogeneous enhance

152
Q

splenic hamartoma –> MR signal?

  • T2
  • enhance
A
  • T2: iso to slight hyper

- enhance: early heterogeneous enhance –> delayed homogenous enhance

153
Q

spleen –> what is post-traumatic pseudocyst?

A

spleen –> hematoma –> evolution –> end result

154
Q

spleen –> congenital true (epithelial) cyst vs post-traumatic pseudocyst?

  • lining
  • internal septations
  • mural calc
A

congenital true (epithelial) cyst:

  • epithelial lining
  • internal septations
  • no mural calc

post-traumatic pseudocyst:

  • lining –> fibrotic tissue
  • no internal septations
  • mural calc
155
Q

spleen –> lymphangioma –> classic imaging appearance?

A

multilocular cystic structure w thin septations

156
Q

sarcoidosis –> spleen –> MC manifestation? less common?

A
  • # 1 splenomeg

- mult hypodense nodules –> no enhance

157
Q

spleen –> what is inflamm pseudotumor?

A

unclear etiology –> focal collection –> immune cells + inflamm exudate

158
Q

spleen –> MC org?

  • single abscess
  • mult
A
  • single abscess –> bact

- mult –> fungal

159
Q

spleen abscess –> charact US finding?

A

wheel w/in wheel or bull’s eye appearance

160
Q

MC spleen malig?

161
Q

1ary spleen lymphoma –> MC imaging appearance?

A

solitary hypovasc mass

162
Q

systemic lymphoma –> 2ary spleen involve –> 4 imaging presentations?

A
  • miliary mass
  • mult small to mod size mass
  • 1 lrg mass
  • splenomeg –> no mass
163
Q

spleen lymphoma –> MRI –> T1 post-contrast appearance?

A

hypoenhance

164
Q

spleen lymphoma –> US appearance?

A

cystic –> internal flow

165
Q

wandering spleen –> comp?

166
Q

splenic infarct –> classic imaging appearance? less common?

A
  • # 1 peripheral –> wedge –> nonenhance

- heterogenous mass

167
Q

splenic infarct –> acute & hemorrhagic –> T1 signal?

168
Q

splenic infarct –> acute & hemorrhagic –> T1 /T2 signal?

A
  • T1 hypo

- T2 hyper

169
Q

what are Gamna-Gandy bodies?

A

portal HTN –> spleen –> hemosiderin

170
Q

Gamna-Gandy bodies –> MRI signal?

A

all seq –> hypo

171
Q

what is Gaucher dz?

A

AR –> glucocerebrosidase def –> glucocerebrosides accum in RES

172
Q

Gaucher dz –> splenic manifestations? (2)

A
  • splenomeg

- mult nodules

173
Q

spleen trauma –> pseudoaneurysm vs AV fistula –> CT appearance?

A

indistinguishable

174
Q

nasopharynx –> anatomy location?

A

base of skull –> soft palate

175
Q

oropharynx –> anatomy location?

A

uvula –> hyoid bone

176
Q

hypopharynx –> anatomy location?

A

hyoid bone –> cricopharyngeus M

177
Q

what is Schatzki ring?

A

distal esophagus –> focal narrowing of B mucosal ring –> intermittent dysphagia

178
Q

focal narrowing of B mucosal ring –> asx –> dx?

A

lower esophageal ring

179
Q

Schatzki ring –> assoc condition?

A

hiatal hernia

180
Q

chronic esophagitis –> comp?

A

scarring –> smooth tapered stricture above GE jx

181
Q

reflux esophagitis –> imaging finding?

A

thick distal esophageal folds

182
Q

Barrett esophagus –> imaging features? (3)

A
  • distal esophagus –> featureless
  • proximal: reflux esophagitis –> mucosal granularity, superficial erosion
  • stricture –> abnormally high location than peptic stricture
183
Q

esophageal candidiasis –> imaging appearance?

A

variable:
- scattered plaque-like lesions
- shaggy esophagus

184
Q

herpes esophagitis –> imaging appearance?

A

scattered small uclers

185
Q

CMV/HIV esophagitis –> imaging appearance?

A

large flat ovoid ulcer

186
Q

esophagus –> malig stricture –> key imaging finding?

A

shouldered margins

187
Q

esophagus –> long smooth narrow stricture –> ddx? (3)

A
  • caustic stricture
  • NG tube stricture
  • radiation stricture
188
Q

esophagus –> radiation stricture –> how differentiate from other types of stricture?

A

spare GE jx

189
Q

esophagus –> MC submucosal tumor?

A

benign mesenchymal tumor

190
Q

esophagus –> benign mesenchymal tumor –> includes what kind of tumors? (4)

A
  • GIST
  • leiomyoma
  • lipoma
  • hemangioma
191
Q

esophagus –> adenoma –> mucosal or submucosal lesion? benign or malig?

A

mucosal lesion –> benign –> malig potential

192
Q

esophagus –> what is inflamm polyp? assoc condition?

A

enlrg gastric fold –> protrude into esophagus

reflux

193
Q

esophagus –> fibrovasc polyp –> MC location? dx feature?

A

cervical esophagus

CT –> fatty component

194
Q

esophagus –> fibrovasc polyp –> benign or malig?

195
Q

esophagus –> what is “downhill” varices?

A

SVC obstruct –> varices –> prox esophagus

196
Q

esophageal duplication cyst –> location?

A

post mediastinum:

  • esphagus –> submucosa
  • extrinsic to esophagus
197
Q

neurenteric cyst –> assoc anomaly?

A

vertebral body anomaly

198
Q

esophageal vs bronchogenic duplication cyst –> differentiate on imaging?

A

indistinguishable

199
Q

what is achalasia?

A

motility disorder –> Auerbach plexus –> myenteric ganglia abnormal –> distal esophagus –> unable to relax

200
Q

what is vigorous achalasia?

A

less severe form of achalasia –> repetitive nonpropulsive contractions

201
Q

2ary achalasia –> cause?

202
Q

achalasia –> tx?

A

Heller myotomy –> incise lower esophageal muscle fibers

203
Q

what is pseudoachalasia?

A

GE jx –> obstructing cancer

204
Q

what is nutcracker esophagus?

A
  • chest pain
  • normal XR
  • manometry –> high amp contractions
205
Q

esophagus –> pulsion diverticulum –> MOA?

A

inc esophageal pressure

206
Q

esophagus –> traction diverticulum –> MOA?

A

adj struct –> ie TB mediastinal LN –> traction –> diverticulum

207
Q

Zenker diverticulum –> MOA?

A

cricopharyngeus M –> fail to relax –> inc hypopharyngeal pressure –> diverticulum

208
Q

Zenker diverticulum –> location?

209
Q

Zenker diverticulum –> tx? (2)

A
  • cricopharyngeal myotomy & diverticulopexy

- diverticulectomy

210
Q

what is pseudo-Zenker diverticulum?

A

barium trapped in pharyngeal contraction wave

211
Q

Killian-Jamieson diverticulum –> location?

A

below cricopharyngeus M –> ant –> bilat

212
Q

esophagus –> what is pseudodiverticulosis?

A

chronic reflex esophagitis –> dilated submucosal glands –> mult tiny outpouchings

213
Q

esophagus –> what is pseudodiverticulosis –> assoc other finding?

A

upper/mid esophagus –> smooth stricture

214
Q

feline esophagus –> normal variant –> T/F?

215
Q

scleroderma –> esophagus –> manifestaiton?

A

distal 2/3 esophagus –> smooth muscle atrophy & fibrosis –> lack of peristalsis –> marked dilation

216
Q

eosinophilic gastritis –> features? (2)

A
  • h/o allergy

- stomach & SB –> thick folds

217
Q

what is Menetrier dz?

A

prox stomach –> parietal cells –> replace w hyperplastic epithelial cells –> achlorhydria –> protein-losing enteropathy –> dx of exclusion

218
Q

stomach –> what is hyperplastic polyp (inflamm polyp)? benign or malig?

A

chronic inflamm –> gastric gland –> cystic dilate

almost always benign

219
Q

what is fundic gland polyposis synd?

A

familial adenomatous polyposis synd –> variant that involve stomach

220
Q

stomach –> what is adenomatous polyp? benign or malig?

A

neoplastic polyp –> malig potential

221
Q

stomach –> hamartomatous polyp –> benign or malig? assoc synd? (3)

A

benign

  • Peutz-Jeghers
  • juvenile polyposis
  • Cronkhite-Canada
222
Q

MC submucosal gastric tumor?

A

gastrointestinal stromal tumor (GIST)

223
Q

gastrointestinal stromal tumor (GIST) –> cell of origin?

A

interstitial cells of Cajal –> pacemaker cell –> drive peristalsis

224
Q

gastrointestinal stromal tumor (GIST) –> location of occurence?

A

GI tract –> anywhere

225
Q

gastrointestinal stromal tumor (GIST) –> benign or malig?

A

benign or malig

226
Q

gastrointestinal stromal tumor (GIST) –> features that inc risk of malig? (2)

A
  • location not stomach –> ie. small bowel, rectum

- size & #mitoses

227
Q

submucosal gastric mass –> ddx? (3)

A
  • mesenchymal tumor
  • carcinoid
  • ectopic panc rest
228
Q

submucosal gastric mass –> mesenchymal tumor –> types? (4)

A
  • GIST
  • fibroma
  • lipoma
  • neurofibroma
229
Q

ectopic panc rest –> classic imaging appearance?

A

stomach –> submucosal nodule –> umbilicated

230
Q

gastric adenoCA –> manifestation? (2)

A
  • mass

- ulcer

231
Q

gastric adenoCA –> RF? (4)

A
  • # 1 chronic inflamm
  • ingest processed meats
  • atrophic gastritis
  • pernicious anemia
  • post-subtotal gastrectomy
232
Q

what is Krukenberg tumor? (2)

A
  • gastric CA –> mets to ovary

- any mucinous mets to ovary

233
Q

benign gastric ulcer –> typical imaging features? (3)

A
  • radiating gastric folds –> smooth & symm
  • ulcer extend beyond normal contour of gastric lumen
  • Hampton line –> nonulcerated mucosa surrounding ulcer crater
234
Q

benign gastric ulcer vs benign ulcer assoc w ASA –> MC location?

A
  • most benign ulcer –> lesser curvature

- assoc w ASA –> grter curvature, antrum

235
Q

gastric CA –> ulcer –> typical imaging features? (4)

A
  • asymm ulcer crater –> surrounding nodular tissue
  • normal gastric wall & surrounding tissue –> abrupt transition
  • ulcer crater NOT project beyond expected location of gastric wall
  • Carman meniscus sign –> compress –> ulcer splay open
236
Q

Roux-en-Y gastric bypass –> components?

A
  • prox gastric pouch –> gastrojejunostomy

- distal side-to-side jejunojejunostomy –> panc & bile

237
Q

Roux-en-Y gastric bypass –> comp? (6)

A
  • postop leak
  • gastrogastric fistula
  • SBO
  • internal hernia
  • stomal stenosis
  • marginal ulcer
238
Q

Roux-en-Y gastric bypass –> acute postop period –> SBO –> cause?

A

gastrojejunostomy or jejunojejunostomy –> edema or hematoma

239
Q

Roux-en-Y gastric bypass –> late –> SBO –> cause? (2)

A
  • internal hernia

- adhesion

240
Q

Roux-en-Y gastric bypass –> internal hernia –> location? (3)

A
  • # 1 transmesocolic
  • Peterson’s space
  • jejunojejunostomy –> mesenteric defect
241
Q

internal hernia –> imaging features? (3)

A
  • swirling mesentery
  • mesentery –> mushroom shape
  • small bowel loops –> post to SMA
242
Q

SBO –> (impending) ischemia –> imaging findings? (4)

A
  • engorged mesenteric vessels
  • ascites around bowel
  • wall thick
  • lack of bowel wall enhance
  • pneumatosis
243
Q

closed loop obstruct –> cause? (2)

A
  • adhesion

- hernia

244
Q

closed loop obstruct –> comp? (2)

A
  • ischemia

- volvulus –> ischemia

245
Q

inguinal hernia –> indirect vs direct –> location relative to inf epigastric vessels?

A
  • indirect: lat to inf epigastric vessel

- direct: med

246
Q

inguinal hernia –> indirect vs direct –> MOA? go into scrotum?

A

indirect: congenital –> patent processus vaginalis –> go into scrotum
- direct: ant abd wall –> weak area –> not into scrotum

247
Q

obturator hernia –> epidemiology? MOA?

A

elder F –> pelvic floor laxity –> bowel herniate thru obturator canal

248
Q

obturator hernia –> key imaging finding?

A

bowel –> bw pectineus & obturator M

249
Q

internal hernia –> locations? (3)

A
  • transmesenteric
  • paraduodenal
  • Foramen of Winslow
250
Q

transmesenteric internal hernia –> MC type?

A

transmesocolic

251
Q

transmesenteric internal hernia –> imaging findings? (3)

A
  • colon –> post displace
  • SB –> ant to colon
  • SMA/SMV –> displace & engorge
252
Q

child –> MC hernia? MOA?

A

transmesenteric hernia: prenatal intestinal ischemia –> congenital mesenteric defect

253
Q

2nd MC internal hernia?

A

paraduodenal

254
Q

paraduodenal internal hernia –> MOA?

A

embryologic –> mesentery –> fail to fuse –> congenital mesenteric defect

255
Q

paraduodenal internal hernia –> classic clinical presentation?

A

chronic –> postprandial pain –> relieve w massage (reduce hernia)

256
Q

paraduodenal internal hernia –> L vs R –> which more common?

257
Q

left paraduodenal hernia –> key imaging finding?

A

cluster of SB –> bw panc & stomach

258
Q

Foramen of Winslow hernia –> key imaging finding? (2)

A
  • upper abd –> dilated bowel

- mesentery –> bw IVC & main portal V

259
Q

small bowel –> lymphoma –> classic appearance?

A

small bowel wall –> aneurysmal expansion

260
Q

small bowel –> 1ary neoplasm? (3)

A
  • adenoCA
  • GIST
  • carcinoid
261
Q

gallstone ileus –> what is Rigler’s triad?

A
  • pneumobilia
  • SBO
  • gallstone in small bowel
262
Q

scleroderma –> small bowel –> fluoro findings? (2)

A
  • antimesenteric border –> sacculations

- “hidebound” bowel

263
Q

scleroderma –> small bowel –> natural progression?

A

small bowel –> musc layers –> replace w collagen –> impair motility –> slow transit –> bact overgrowth –> progressive dilate –> pseudo-obstruct

264
Q

celiac dz –> charact imaging finding?

A

reversal of jejunal & ileal fold patterns

265
Q

celiac dz –> fluoro findings? (2)

A
  • “flocculations” of barium

- moulage sign

266
Q

celiac dz –> comp? (6)

A
  • small bowel –> T cell lymphoma
  • intussusception
  • pneumatosis
  • spleen atrophy
  • venous thromboembolism
  • cavitating mesenteric LN synd (CMLNS)
267
Q

low density mesenteric LN –> ddx? (4)

A
  • TB
  • Whipple dz
  • trted lymphoma
  • cavitating mesenteric LN synd (CMLNS)
268
Q

SMA & IMA –> watershed region?

A

splenic flexure

269
Q

TB –> colon –> MC location?

A

ileocecal valve

270
Q

pseudomembranous colitis –> key imaging finding?

A

entire colon –> marked thick wall –> accordion sign –> severe colon wall thick w undulating enhancing inner mucosa

271
Q

“lead pipe” colon –> dx?

272
Q

toxic megacolon –> imaging findings? (2)

A
  • colon dilate –> >6cm

- ileus

273
Q

familial adenomatous polyposis (FAP) –> variants? (2)

A
  • Gardner synd

- Turcot synd

274
Q

Gardner synd? (5)

A

DOPE:

  • colon polyps
  • desmoid tumor
  • osteomas
  • papillary thyroid CA
  • epidermoid cyst
275
Q

Turcot synd? (2)

A
  • colon polyps

- CNS tumor –> glioma, medulloblastoma

276
Q

hereditary nonpolyposis colon CA synd (HNPCC, Lynch synd) –> assoc other CA? (5)

A
  • endometrium
  • stomach
  • small bowel
  • liver
  • biliary
277
Q

what is Peutz-Jeghers synd? (3)

A

AD:

  • hamartomatous polyps –> #1 small bowel
  • blue/brown spots –> lips, gums
  • neoplasm –> gyn, GI
278
Q

Peutz-Jeghers synd –> small bowel polyp –> comp?

A

intussusception

279
Q

what is Cowden synd? (2)

A

AD:

  • mult hamartomatous polyps –> skin, external mucus membrane, GI tract
  • CA –> thyroid, skin, oral, breast, uterus
280
Q

small bowel –> polyposis synd? (5)

A
  • familial adenomatous polyposis (FAP)
  • hereditary nonpolyposis colon CA synd (HNPCC, Lynch synd)
  • Peutz-Jeghers synd
  • Cowden synd
  • Cronkhite-Canada
281
Q

“misty” mesentery –> causes? (4)

A
  • fluid
  • inflamm
  • tumor
  • fibrosis
282
Q

tumor –> “misty” mesentery –> MC ddx? (1)

A

non-Hodgkin lymphoma

283
Q

carcinoid –> involve mesentery –> classic imaging appearance?

A

enhance soft tissue mass –> radiating linear bands into mesenteric fat

284
Q

mesenteric mass –> calc –> ddx? (3)

A
  • carcinoid
  • desmoid tumor
  • sclerosing mesenteritis
285
Q

what is desmoid tumor? benign or malig?

A

proliferating fibrous tissue –> mass

benign –> local aggressive

286
Q

what is sclerosing mesenteritis?

A

rare –> inflamm condition –> mesenteric root –> fatty necrosis & fibrosis

287
Q

what is mesenteric panniculitis?

A

sclerosing mesenteritis –> variant –> inflamm predominate –> acute abd pain

288
Q

mesenteric lymphoma –> sign?

A

sandwich sign –> 2 bulky lymphomatous mass –> bw is mesenteric fat & vessels

289
Q

peritoneal carcinomatosis –> MC tumor type?

A

mucinous adenoCA

290
Q

what is pseudomyxoma peritonei?

A

low grade malig –> mucus in peritoneal cavity

291
Q

pseudomyxoma peritonei –> mucin source –> ddx? (3)

A
  • appendix –> adenoma, adenoCA
  • ovary
  • colon
292
Q

pseudomyxoma peritonei –> CT finding? (2)

A
  • lobular ascites

- pathognomic –> scallop liver margin

293
Q

pseudomyxoma peritonei –> tx? (2)

A
  • surg

- hyperthermic intraperitoneal ctx lavage

CORE (33 decks)

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