GI Flashcards
DDx esophagitis
GE reflux Infectious (e.g. candida, CMV) Eosinophilic Drugs Caustic ingestion XRT
What is Boerhaave’s Syndrome?
Post-emetic esophageal rupture. If untreated, mortality rate nearly 100%.
What are 3 types of adenomatous polyposis syndromes?
Gardner syndrome
Familial adenomatous polyposis
Turcotte syndrome
What are 3 types of hamartomatous polyposis syndromes?
Peutz-Jegher
Cowden syndrome
Juvenile polyposis
DDx for fat-containing liver masses
HCC Adenoma (micro or macro) Liposarcoma mets Teratoma (primary or secondary) FNH (micro or macro fat) Focal steatosis AML (rare)
DDx for small bowel polypoid mass
GIST
Small bowel adenocarcinoma
Carcinoid
What are symptoms of carcinoid syndrome?
Flushing
Diarrhea
Palpitations
Shortness of breath, wheezing
What blood or urine tests can be used to dx carcinoid syndrome?
- Urine 5-HIAA (related to serotonin)
- Serum chromogranin A
What nuclear medicine scan is most useful for imaging carcinoid tumors?
Octreotide scan
DDx splenic cystic lesions
Simple splenic cyst Epidermoid cyst Echinococcal cyst Pancreatic pseudocyst (lymphangioma?)
What are MRI features of hepatic adenoma?
- Variable T1 (usually mildly hyperintense)
- Mildly T2 hyperintense
- may drop SI on IP/OOP images
- Adenomas show early arterial enh and become nearly isointense relative to liver on delayed images; may show even show washout
- If hemorrhagic, blood products may alter signal characteristics
What are risk factors for hepatic adenoma?
- Young women on OC
- Glycogen storage disease
- Anabolic steroids
What infectious etiologies should you consider in terminal ileitis?
- Yersinia
- TB
- Amebiasis
- Actinomycosis
DDx for micronodularity of the spleen
- Lymphoma/Leukemia
- Fungal infections (Candida, histo)
- TB
- Sarcoidosis
- Mets usually cause larger nodules
What is the risk of malignant degeneration of Barrett esophagus?
10% (adenocarcinoma)
What is considered splenomegaly (measurements)?
Greater than 13 cm in length
Greater than 6 cm in width and 8 cm in breadth
What are radiographic signs of pneumoperitoneum?
Rigler sign Football sign Cupola sign Triangle sign Falciform ligament, umbilical ligament (inverted "V"), ligamentum teres, or urachus signs
What is an amyand hernia?
Inguinal hernia containing the appendix
What is a littre hernia?
Hernia containing a Meckel diverticulum
What is Mirizzi syndrome?
Occurs when a gallstone lodges in the neck of the GB or cystic duct and causes compression of the CBD.
What is a Todani type 1 choledochal cyst?
1A: saccular, majority of the extrahepatic CBD
1B: saccular, limited segment of the CBD
1C: fusiform, majority of the CBD
What is a Todani type 2 choledochal cyst?
isolated diverticulum; often a narrow-necked CBD
What is a Todani type 3 choledochal cyst?
duodenal wall, CBD (aka choledochocele)
What is a Todani type 4 choledochal cyst?
4A: multiple intrahepatic and extrahepatic
4B: multiple extrahepatic