GI Flashcards
1
Q
Where are cholesterol deposits located in GB adenomyomatosis?
A
Rokitanksy aschoff sinuses
2
Q
Where is cholesterol in GB cholesterolosis?
A
Lamina propria
3
Q
What is Mirizzi Syndrome?
A
Common hepatic duct is obstructed secondary to impacted cystic stone
4
Q
Direct signs of stenosis Within vessel (2)
A
Elevated peak systolic velocity
Spectral broadening
5
Q
Indirect signs of vessel stenosis (3)
A
Tardus parvus downstream
Low RI downstream
High RI upstream
6
Q
Two causes of pulsatile hepatic vein
A
TR
Right chf
7
Q
D vs s
TR
RHF
A
D deeper
S deeper
8
Q
Decreased hv pulsatility 2
A
Cirrhosis
Hepatic venous outflow obstruction
9
Q
Two causes of lipomatous pseudohypertrophy of the pancreas
A
Shwachman diamond
CF adult
10
Q
Larger calculi in dilated pancreatic duct
A
Tropic pancreatitis
11
Q
Sausage shaped pancreas
A
Autoimmune pancreatitis
12
Q
True simple cysts are associated with what three syndromes?
A
VHL
CF
PCKD
13
Q
Microcystuc mutilocular lobulated lesion with central calcification in the pancreatic head
A
Serous cyst adenoma
14
Q
Mucinous cystic neoplasm
A
Unilocular lesion with peripheral calcs in body/tail
Mother
15
Q
SPEN
A
Daughter lesion
Large lesion in tail with thick capsule
16
Q
Two signs seen in pancreatic adenocarcinoma
A
Frostburg inverted 3
Wide duodenal sweep
17
Q
Increases risk of pancreatic ampullary carcinoma in what syndrome
A
Gardeners
18
Q
What are the three borders of the gastrinoma triangle
A
Superior: junction of cystic and CBD
Inferior: start of the third portion of the duodenum
Medial: start of the body of the pancreas
19
Q
Two sources of blood supply in pancreatic transplant and what they supply
A
Sma: inferior pancreaticoduodenal artery and donor splenic artery to head
Donor splenic artery to body and tail
20
Q
What are the two Venous drainage in pancreatic transplant
A
Donor portal vein and recipient smv
21
Q
What are gamma gandy bodies
A
Hemorrhagic foci in spleen associated with portal hypertension
22
Q
What is peliosis?
A
Multiple blood filled spaces in spleen and liver
23
Q
What is the triad of felty syndrome?
A
Smg
RA
Neutropenia
24
Q
What’s the most common splenic infection in the us and what does it look like
A
Histoplasmosis
Multiple rounded calcs
25
What does splenic brucellosis look like on ct
Bulls eye calcification
26
What is the muscular ring above the vestibule?
A ring
27
What is the muscular ring below the vestibule?
B ring
28
Where does a Zenker diverticulum occur?
hypopharynx
29
Where does a killian jamieson diverticulum occur?
cervical esophagus
30
reticular mucosal esophageal pattern
Barretts
31
Ringed Esophagus
eosinophilc esophagitis
32
What defines T3 vs T4 esophageal cancer?
Adventitia vs invasion into adjacent structures
33
Shaggy Esophagus
Candidiasis
34
Multiple elevated benign nodules in an asymptomatic patient
Glycogenic Acanthoses
35
multiple small esophageal ulcers with halo of edema
herpes
36
large flat esophageal ulcer (2)
CMV HIV
37
What is the site of weakness where zenker diverticula arise?
killian triangle (posterior)
38
Multiple small esophageal outpouchings
chronic reflux- esophageal pseudodiverticulosis
39
What is dysphagia lusoria?
compression of esophagus from aberrant right subclavian artery
40
What three things are seen in Scleroderma?
lower 2/3 esophageal dysmotility, NSIP, small bowel with hide bound valvulae conniventes
41
What four things are seen in Gardner Syndrome?
FAP, desmoid tumors, osteomas, papillary thyroid cancer
42
What three things are associated with Turcots
FAP gliomas medulloblastomas
43
What is associated with Peutz Jeghers? (3)
small/large bowel CA, pancreatic CA, GYN CA
44
What three things are seen in Cowden?
Breast CA, Thyroid CA, Lhermitte Duclos
45
What two things are seen in Cronkhite Canada?
Stomach/SB/LB CA, Ectodermal disease
46
WHat is Carneys triad?
Extra adrenal pheo, GIST, Pulmonary chondroma
47
What is done in Billroth 1?
pylorus removed, proximal stomach sewed directly to the duodenum
48
carmen meniscus sign=
malignant stomach ulcer
49
hamptons line=
benign stomach ulcer
50
Linitis plastica can be the result of what three things?
scirrhous adenocarcinoma, breast or lung mets
51
What is the most common met to the stomach?
melanoma
52
What is Menetrier's Disease?
idiopathic gastropathy with rugal thickening involving fundus, sparing antrum
53
What is a rams horn deformity?
tapering of the antrum
54
What is the differential for a rams horn deformity?
peptic ulcer scarring, granuloamtous disease, scirrhous carcinoma
55
What is the most common GI tract location for sarcoid?
stomach
56
What is done in billroth 2?
partial gastrectomy, stomach attached to duodenum
57
What is done in roux en y?
gastric pouch attaced to jejunum, excluded stomach to duodenum, jejunum attached to other jejunum to form bottom of Y
58
Clover leaf sign=
healed peptic ulcer of duodenal bulb
59
Sand like jejunal nodules=
Whipples
60
Pseudo whipples is caused by?
MAI
61
What is Lane Hamilton Syndrome?
celiac sprue + idiopathic pulmonary hemosiderosis
62
What are the CT findings of Celiac Sprue? (2)
fold reversal and cavitary lymph nodes
63
Moulage sign=
dilated bowel with effaced folds seen in Celiac sprue
64
ribbon bowel=
graft vs host
65
Chronic dialysis patients may have what finding?
thickened dudodenal folds
66
Most common primary location of GI carcinoid?
distal ileum
67
NM for carcinoid?
MIBG or octreotide
68
Which hernia is medial to inferior epigastric artery?
direct
69
What causes a direct inguinal hernia?
defect in hesselbachs triangle
70
Which hernia is covered by internal spermatic fascia?
direct
71
What causes an indirect hernia?
failure of processus vaginalis to close
72
What is a superior lumbar hernia called?
Grynfeltt lesshaft
73
What is an inferior lumbar hernia called?
Petit
74
WHere is a spigelian hernia located?
along semilunar line through transversus abdominis aponeurosis
75
What does a littre hernia contain?
meckels diverticulum
76
What does an amyand hernia contain?
appendix
77
Which hernia is at a very high risk of strangulation?
Richter due to only one bowel wall involved
78
What is a Petersen hernia?
behind roux limb mesentery may be retro or antecolic
79
What and where is hte most common type of internal hernia?
paraduodenal, on the left at the duodenojejunal junction/fossa of landzert
80
Where are right sided paraduodenal hernias located?
fossa of waldeyer
81
What is an onion sign?
on ultrasound, layering within a cystic mass= mucocele
82
What two signs are seen in sigmoid volvulus?
coffee bean, inverted 3
83
What is the buzzword for sigmoid volvulus?
frimann dahl sign
84
Cecal volvulus points where?
LUQ
85
What is Behcet's
penile and oral ulcers with pulmonary artery aneurysms
86
What is colitis cystica?
Cystic dilation of the mucous glands
87
What two syndromes are associated with rectal cavernous hemangioma?
Klippel Trenaunay-Weber and Blue Rubber Bleb
88
What three findings are seen in Entamoeba Histolytica?
conced cecum, flask shaped ulcers, spares terminal ileum
89
What three findings are seen in colonic TB?
coned cecum, fleishcner sign (enlarged gaping IC valve), stierlin sign (TI narrowing)
90
accordion sign=
c diff, contrast trapped inside mucosal folds
91
Where does typhilitis occur?
cecum
92
What ic McKittrick Wheelock Syndrome?
Villous adenoma leading to mucous diarrhea
93
What is stage T3 rectal CA?
breaks out of rectum into perirectal fat
94
sandwich sign=
mesenteric lymphoma
95
What is Cantlie's line?
right and left hepatic lobes (functioning)
96
What is the most common hepatic vascular variant?
replaced right hepatic from SMA
97
What ist he most common biliary variant?
right posterior segmental branch emptying into the left hepatic duct
98
What are the MRI characteristics of a regenerative nodule?
T1 and T2 Dark, no enhancement
99
What are the MRI characteristics of a dysplastic nodule?
T1 bright, T2 dark, no enhancement
100
What are the MRI characteristics of a HCC?
T2 bright, enhances
101
NM for FNH?
sulfur colloid
102
Characteristics of FNH scar?
T2 Bright, delayed enhancement
103
When multiple hepatic adenomas think...
Liver adenomatosis or von gierke
104
What is the most common location for hepatic adenoma?
right hepatic lobe
105
NM for fibrolamellar HCC?
gallium
106
Fibrolamellar HCC characteristics
T2 dark, no enhancement
107
What encases the portal vein?
cholangio
108
What are the four classic features of cholangio?
Delayed enhancement, peripheral biliary dilation, liver capsule retraction, no tumor capsule
109
In what two diseases may hepatic angiosarcoma be seen?
NF, hemochormatosis
110
What feature does hepatic Kaposi Sarcoma have?
diffuse periportal hypoechoic infiltration
111
What is Kasabach Merritt?
sequestration of platelets from giant cavernous hemangioma
112
What disease is hepatic angiomyolipoma associated with?
Tuberous sclerosis
113
What defines a Type I Hiatal hernia
sliding. GEJ above diaphgram
114
What defines a type II hiatal hernia?
paraesophageal, fundus above diaphragm. GEJ normal position
115
What defines a Type III hiatal hernia?
elevation of GEJ with herniation of fundus
116
What defines a type IV hiatal hernia?
Large with other organs herniated
117
What is an inflammatory eosphagogastric polyp?
fixed thickened gastric fold at GE junction seen in GERD
118
At what diameter do patients become symptomatic to esophageal stenosis?
< 13mm
119
EBV esophageal ulcers look like what?
deep linear
120
What is Macklin Phenomenon?
alveolar rupture in PIE
121
Where does an esophageal tear most commonly occur?
Left posterolateral wall
122
What does the esophagus look like in caustic ingestion?
Long stricture
123
What is best positioning to view esophageal varices on upper GI?
RAO semiprone collapsed esophagus
124
Three causes of high esophageal web formation
Plummer vinson, bullous pemphigoid, ectopic gastric mucosa
125
Normal angle in gastric lap band
4-58
126
What is the Borchardt triad?
sudden epigastric pain, retching, cant pass NG, seen in gastric volvulus
127
What are the findings on SBFT of celiac?
widened thin folds, transient jejunojenual intussecption
128
What is the most common malignancy in untreated Celiac?
T cell lymphoma
129
What is cavitary lymph node syndrome?
in celiac, villous atrophy, nodal masses, splenic atrophy
130
What worm causes cholangitis/pancreatitis?
ascaris
131
What worm causes anemia?
hookworm
132
What work comes from sushi?
Anisakis
133
What worm causes rectal prolapse?
trichuris
134
What are the borders of hesselbachs triangle?
inguinal ligament inferiorly, IEV superolaterally, conjoined tendon medially
135
Duodenal windsock sign
=intraluminal duodenal diverticulum
136
What is Griffiths critical point?
anastomsis between left colic and marginal artery of drummond
137
What is Sudeck point?
Watershed area at anastomosis between superior rectal artery and last sigmoid branch of IMA
138
De Garengeot hernia?
appendix in a femoral hernia
139
Collar button ulcer=
ulcerative colitis
140
What is the enhancement pattern in peliosis hepatitis?
centrifugal
141
What bacteria is associated with peliosis hepatitis?
bartonella
142
What is the triad of Klippel Trenaunay?
port wine, limb hemihypertrophy, hemagiomatosis
143
Typical splenic angiosarcoma appearance?
complex cystic with central necrosis and enhancing nodularity
