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DD FRCR2A > GI > Flashcards

GI Flashcards

1
Q

Where is the A ring in the oesophagus ?

A

Above the vestibule (muscular)

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2
Q

Where is the B ring in the oesophagus?

A

Below vestibule, mucosal
Is called a Schatzki ring if narrowed (<13mm)

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3
Q

Barretts

A

Precursor to Adenocarcinoma 2° to reflux
Shown as high stricture with associated hiatal hernia
Reticular mucosal pattern

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4
Q

Oesophagus Ca buzzwords

A

Irregular contour
Abrupt/shouldered edges

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5
Q

Squamous oesophageal Ca

A

Stricture/ulcer/ mass is mid oesophagus

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6
Q

Oesophageal adenocarcinoma

A

Previous barretts
Stricture/ulcer/mass is in the lower oesophagus

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7
Q

Turcot syndrome

A

Autosomal recessive
Colonic polyposis and CNS tumours - supratentorial glioblastoma and medulloblastomas

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8
Q

Right sided colitis causes

A

Shigella
Salmonella

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9
Q

Haemochromatosis mri findings

A

Low T2
Hepatomegaly

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10
Q

Duodenum

A

4 parts :
D1 superior
D2 descending
D3 horizontal/transverse
D4 ascending

Ligament of treitz at junction of duodenum and jejenum
Bleed proximal to this is an upper GI bleed.

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11
Q

Signs of bowel ischaemia ( or impending ischaemia )

A

Engorged mesenteric vessels
Mesenteric oedema
Ascites
Wall thickening
Lack of bowel wall enhancement
Pneumatosis

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12
Q

Indirect inguinal hernia

A

Lateral to inferior epigastric vessels
Travels with spermatic cord and often into the scrotum

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13
Q

Direct inguinal hernia

A

Medial to inferior epigastric vessels
Contents do not go into the scrotum

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14
Q

Amyand hernia

A

Inguinal hernia containing appendix

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15
Q

Littre hernia

A

Inguinal hernia containing Meckel’s diverticulum

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16
Q

Obturator hernia

A

Usually In elderly due to weak pelvic floor muscles
Bowel located between pectineus and obturator muscles

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17
Q

Femoral hernia

A

Posterior and inferior to inguinal ligament.
If contains appendix is called De Gaarengeot hernia
Compresses femoral vein

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18
Q

Aneurysmal dilatation of the small bowel wall with no obstruction

A

Think lymphoma

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19
Q

Intussusception

A

Transient small bowel - short segment without wall thickening
Malignant - longer segments with associated thickening and upstream obstruction

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20
Q

Chrons

A

Affects mouth to anus
Usually terminal ileum
Discontinuous skip lesions
Early changes - aphthous ulcers

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21
Q

Chrons active inflammation

A

Mural hyperenhancement
Intramural oedema
Mural ulcerations

22
Q

Chrons stricturing disease

A

Luminal narrowing with upstream dilatation

23
Q

Chrons penetrating disease

A

Sinus tracts, simple fistula,complex fistula, inflammatory mass, abscess

24
Q

Celiac disease

A

Reversal of jejunal and ideal fold patterns.
Featureless jejunum due to villous atrophy.

Mesenteric adenopathy
Engorgement of mesenteric vessels

Complication - small bowel t cell lymphoma

25
Q

Terminal ileum infectious enteritis

A

Yersinia and TB

26
Q

Segmental distal small bowel thickening and thickened folds due to infection

A

Salmonella

27
Q

Low attenuation mesenteric adenopathy

A

Whipples disease
Celiac - cavitating mesenteric lymph node syndrome

28
Q

Radiation enteritis

A

Mural thickening
Mucosal hyperenhancement and luminal narrowing later on.

29
Q

Hidebound bowel

A

In scleroderma
Thin, straight bowel folds stacked together due to replacement of muscular layers with collagen

30
Q

Most common primary appendiceal neoplasm

A

Carcinoid

31
Q

Ischaemic colitis

A

Splenic flexure most susceptible as it is a watershed area
Segmental thickening

32
Q

Infectious colitis

A

Pericolonic stranding
Ascites
Colonic wall thickening

Yersinia and salmonella - right colon
E.coli,cmv and c diff. Cause pancolitis

33
Q

Accordian sign

A

Severe Colonic wall thickening and enhancing inner mucosa.can be seen in pseudomembranous colitis

34
Q

Ulcerative colitis

A

Begins distally in rectum and spreads proximally.
Increased risk of PSC, cholangiocarcinoma and colon cancer.
Assoc. Sacroiliitis, iritis, erythema nodosum, pyoderma gangrenosum.
Can have backwash ileitis.
Circumferential wall thickening with granular mucosal pattern.
Featureless and foreshortened lead pipe colon.
Toxic mega colon - >6cm, risk of perforation.

35
Q

Typhlitis

A

Necrotising inflammatory colitis seen in right colon/ terminal ileum in neutropenic patients.

36
Q

Stercoral colitis

A

Focal inflammatory colitis due to increased bowel wall pressure from impacted faeces .
Can lead to bowel wall ischaemia, pressure ulceration and perforation.

37
Q

FAP

A

Autosomal dominant
Innumerable pre-malignant polyps.
Prophylactic colectomy

Gardner syndrome is a variant with Desmoid tumours, osteomas, papillary thyroid cancer and epidermoid cysts.

Turcot syndrome is another variant with CNS tumours - glioma and medulloblastoma

38
Q

Most common tumour involving mesentry

A

Non-Hodgkin lymphoma
Also causes bulky adenopathy

39
Q

Peritoneal carcinomatosis

A

Disseminated Mets to peritoneal surface.
Most commonly caused by mucinous adenocarcinoma

40
Q

Pseudomyxoma peritonei

A

Due to mucin producing adenoma or adenocarcinoma of appendix
Also seen in ovarian, gallbladder and pancreatic ca

41
Q

Necrotising panc imaging

A

Cg 72-96 hrs after onset of symptoms

42
Q

Retroperitoneal

A

Descending and ascending colon

43
Q

Hyperechoic liver lesion

A

Mets
Cholangio
Some HCCs

44
Q

Acute UC presentation

A

AXR as 1st line

45
Q

CI to liver biopsy

A

Echinococcus / hydatid cyst

46
Q

Abnormal uptake on mibg scan

A

Pancreas

(Mibg goes into cells metabolically active for adrenaline )

47
Q

Detect spleen/splenules

A

RBCs

48
Q

Zollinger ellison

A

Multiple gastrinomas
Octreotide scan

49
Q

Mass obstructing smv that calcifies

A

Neuroendocrine tumour

50
Q

Heamachromatosis

A

In and out of phase reversal of signal
GRE to quantify degree

DD FRCR2A (6 decks)

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