Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

[PBR] Oral boards > GI > Flashcards

GI Flashcards

1
Q

posterior impression on esophagus

A

aberrant subclavian
vascular ring (double aortic arch)
(if high, DISHphagia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what’s the liver disease associated with ulcerative colitis? What are the risks?

A

Primary sclerosing cholangitis. May lead to cirrhosis, increased risk of cholangiocarcinoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What’s the anatomy of Bilroth I? Bilroth II? What are complications?

A

Bilroth 1: antrectomy anastomosis to duodenum
Bilroth 2: antrectomy anastomosis to jejunum, risk for aferent loop syndrome
Done for gastric carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What’s afferent loop syndrome?

A

uncommon complication following a Billroth II
Most are mechanical obstruction of the afferent loop from adhesions, kinking at the anastomosis, internal hernia, stomal stenosis, malignancy, or inflammation surrounding the anastomosis
Obstruction -> back pressure from dilated -> bil dil and acute pancreatitis.
Dx: hepatobiliary nucs study

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ddx of desmoplastic reaction in mesentary

A

Retractile mesenteritis
desmoid tumor
(desmoplastic) carcinoid (met)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ascites with scalloping of organs (liver, spleen, etc.)

A

Pseudomyxoma peritonei: intraperitoneal accumulation of a gelatinous ascites secondary to rupture of a mucinous tumour. The most common cause is a ruptured mucinous tumour of the appendix / appendiceal mucocoele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ddx hypervascular splenic lesions

A 
Mets: Melanoma, RCC, endometrial, carcinoid
Lymphoma
angiosarcoma
hemangioma, hamartoma, sarcoid
Fungal infxn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ddx hepatic lesion with central scar

A 
FNH (benign hamartomarous - central scar is AVM)
Hepatic adenoma
Giant cavernous hemangioma
Fibrolamellar HCC
Mets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Causes of pneumatosis intestinalis

A

primary (15%)
ischemia, trauma, infection, pulmonary (COPD), colonic obstruction, artificial ventilation, collagen disease, steroid therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Portal venous gas in adult Ddx

A

mesenteric ischemia (eg occlusion), diabetes, mesenteric vein thrombosis, hemorrhagic pancreatitis, diverticulitis, pelvic abscess, perforated gastric ulcer, necrotic colon cancer, ingestion of corrosive substances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ddx for solid pancreatic masses

A 
adenocarcinoma
islet cell tumor
SPEN (young women)
lymphoma
microcystic (serous) adenoma
mets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ddx echogenic liver masses

A

Hemangioma (70%)
mets
HCC
fatty change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What liver mass is associated with hormonal contraceptives? What do we do when it’s diagnosed?

A

Hepatic adenoma
common in young women
remove them - risk of rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ddx hepatic cysts

A 
simple cyst
traumatic cyst
echinococcal
abscess
biliary cystadenoma (septa may calcify)
(cystadenoma, mesenchymal hamartoma, emryonal sarcoma)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ddx cystic pancreatic masses

A 
pseudocyst
abscess
congenital (PCKD, VHL)
microcystic adenoma (grandmother)
mucinous cystic adenoma/carcinoma (mother)
SPEN (daughter)
IPMT (grandfather)
islet cell
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what MRI contrast agent to look for FNH

A

eovist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Ddx Gastric mass: intramural/extramucosal

A

GIST, leiomyoma/sarcoma, neurogenic tumor, heterotopic pancreas, carcinoid, fibrous tumor, granuloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Ddx thickened gastric folds

A 
Gastritis-Hypertrophic, H. Pylori
Menetrier’s disease
Zollinger Ellison syndrome
Varices
Lymphoma
(post-radiation, Crohn, sarcoid, gastric, mets, eosinophilic gastritis, amyloid)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What’s Zollinger-Ellison?

What syndrome is it associated with?

A

Gastrinoma with excessive secretion of acid into the stomach, initial manifestations is with peptic ulcer disease (PUD) with multiple recurrent and intractable ulcers, often in unusual locations
Also get diarrhea
assoc. with MEN I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What’s menetrier disease?

A

a form of rare idiopathic hypertrophic gastropathy, most commonly affecting fundus with massively thickened folds -
it causes protein loss
*increased risk of gastric cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Ddx pancreatic lipomatosis

A

CF, obesity, malnutrition, steroids/Cushing syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Gastric polyps - what types and what would each be associated with?

A

adenomatous (usually antral)
Hyperplastic (gastritis)
Hamartomatous (Peutz-Jeghers)
Fundic Gland (FAP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What’s Peutz–Jeghers syndrome?

A

multiple hamartomatous polyps, most commonly involving the small intestine, but also colon and stomach
mucocutaneous pigmentation involving the mouth, fingers and toes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Ddx for mid-esophageal stricture

A 
caustic injestion
reflux esophagitis
radiation
prolonged tube
eosinophilic esophagitis
carcinoma (primary or mets)
pill esophagitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Ddx thickened bowel wall / bowel wall thickening
enteritis, radiation, ischemia (including shock bowel), hemorrhage, ACE angioedema
26
Ddx for aneurysmal dilatation prior to small bowel stricture
lymphoma, Crohn's dz, TB
27
Ddx gastric antral stenosis
TB, sarcoid, caustic, gastric cancer, mets, lymphoma, eosinophilic gastroenteritis, radiation
28
Ddx multiple gastric antral ulcers
erosive gastritis (meds, H. pylori), mets (melanoma, breast, Kaposi's, lymphoma), Crohn's dz
29
Ddx colonic "thumbprinting"
C. diff colitis, Crohn's, UC, ischemic bowel, (if also in small bowel, graft-vs-host)
30
Organs involved in primary hemachromatosis:
Liver, pancreas, heart
31
GE junction polyps are associated with what?
reflux
32
Ddx for large gas-filled cyst in the lower abdomen on plain film:
cecal or sigmoid volvulus | giant sigmoid diverticulum
33
What are the types of groin hernias? How do you distinguish them?
Inguinal hernia - anterior to pubic tubercle Indirect is lateral to the inferior epigastric vessels and congenital direct is medial and found in adults Lateral to pubic tubercle: Femoral hernia - anterior to pectineus Obturator hernia - posterior to pectineus (characteristic in old ladies)
34
What hernia are gastric bypass patients prone to?
internal hernia through the mesocolic window created during surgery
35
Small bowel tapeworm is called
Ascaris lumbricoides
36
Ddx small esophageal ulcers
Herpes, Crohn's, medication
37
Ddx large esophageal ulcers
CMV (late HIV), HIV (at seroconversion)
38
Ddx for multiple calcifications in the liver and spleen
Treated systemic PCP, treated granulomatous disease
39
Ddx "target" lesions in small bowel
Mets (melanoma, breast, lung) | Immunocompromised: Kaposi, lymphoma
40
What's a "carpet lesion" in the colon?
Villous adenoma
41
Posterior esophageal diverticulum =
Zenker's
42
Lateral esophageal diverticulum =
Killian-Jamieson
43
Pseudopolyps in the colon indicate
Chronic IBD/colitis (look at distribution for Crohns vs UC)
44
Ddx for intramural bowel fistula
Crohns (especially if long), diverticulitis, cancer
45
Ddx numerous small esophageal outpouchings
Esophageal pseudodiverticulosis (Aunt Minnie)
46
Describe flouro findings of Barrett's esophagus
may be normal ulcer stricture reticular mucosa
47
Ddx large / mega esophagus
achalasia, scleroderma, Chagas disease (Tripanosoma cruzi), pseudoachalasia (ca/mets)
48
Esophageal ulcers tracking longitudinally into the wall
TB
49
What's Hampton's line (relating to the stomach)?
Line of intact mucosa around a benign ulcer
50
Ddx for double pyloric channel
Ulcer/peptic ulcer disease Crohns Cancer with ulceration
51
Duodenal adenoca - what should you think of/look for?
FAP - look for a stoma or absence of colon from prior total colectomy
52
Reduced/absent gastric folds:
Atrophic gastritis: causes vitamin B12 deficiency, and megaloblastic anemia can be caused by persistent infection with Helicobacter pylori, or can be autoimmune in origin
53
What's Cowden syndrome?
multiple hamartoma syndrome large and small bowel hamartomatous polyps associated with Lhermitte-Duclos (hamartoma in cerebellum) increased risk of breast cancer
54
Imaging features of cholangiocarcinoma
Central (Klatskin) or peripheral, masslike or infiltrating slow enhancement, retains contrast capsular retraction distal bile duct dilatation
55
Imaging features of recurrent pyogenic cholangitis
Infection with chlonorchis ("Oriental") strictures, especially (98%) in LEFT lobe with atropy Ducts get strictures and *stones, sludge increased risk for cholangioca
56
What are the types of bile duct cysts? What's the classification called?
``` Todani classification 1 - CBD - fusiform 2 - CBD diverticulum 3 - choledochocele 4 - multiple extrahepatic +/- intrahepatic (type A) 5 - Caroli's disease ```
57
Features of Crohn's dz
``` ulcers - apthous or deep cobble stone mucosa comb sign wall thickening and enhancement strictures LAN fat separating bowel loops ("fat halo") pseudodiverticula ("omega sign") on anti-mesenteric border fistula and abscess formation ram's horn sign (antrum-duodenum) ```
58
Features of Scleroderma in the small bowel:
hidebound/saran-wrapped: crowded, sharp folds pseudosacculations along the mesenteric border with more folds along the antimesenteric border (check lung bases for fibrosis and esophagus for dilatation)
59
Features of celiac disease
reversal of jejunal and ileal fold pattern delayed transit duodenitis mesenteric LAN
60
Features of small bowel lymphoma
aneurysmal dilatation - no obstruction! wall thickening without luminal narrowing splenomegaly LAN
61
Ddx small bowel stricture
NSAID enterocolitis, Crohn's, ischemia, radiation, lymphoma, TB, eosinophilic enteritis
62
Ddx for fatty/low density LAN
Whipple disease, TB or fungal, mets (incl lymphoma)
63
Ddx for pancolitis
Infectious, IBD | not ischemic
64
Ddx for proctitis
Herpes, CMV, Crohn's, UC, chlamydia (lymphogranuloma venereum)
65
Locations in the colon prone to ischemia:
Splenic flexure, sigmoid
66
What are filiform colonic polyps and what are they caused by?
Small islands of residual mucosa which appear as thin, worm-like structures UC, Crohn's, TB
67
What's the term for colitis caused by fecal impaction?
Stercoral colitis | can rupture
68
What are some things to consider if the patient has no colon?
Total colectomy: UC (look for liver lesion eg missed metastatic lesion from colon ca, PSC and/or cholangioca) FAP - look for duodenal mass or desmoid in mesentery Occasionally 2/2 Crohn's or C. diff colitis
69
What's a tail gut duplication cyst?
aka retrorectal cystic hamartoma seen in adults (~30-60 yo) discrete, well-marginated, pre-sacral mass with water or soft-tissue density, depending on the contents of the cyst. Calcifications may be seen
70
What's a Spigelian hernia?
Lateral to the rectus femoris m. | tends to cause bowel strangulation
71
What other issue is associated with wandering spleen?
Gastric volvulus
72
Describe the types of gastric volvulus
organoaxial - along long axis, so greater curvature is now superior and to the right mesenteroaxial - across short axis, so GE jctn on right and pylorus on left - more severe both can cause ischemia
73
What is a waterlily sign and what does it mean? What are other features of this disease?
``` detachment of the endocyst membrane which results in floating membranes within the pericyst Hydatid cyst (Echinococcal infection) Daughter cysts are also diagnostic ```
74
Ddx dense liver
defined as >70 HU | Amiodarone, hemosiderosis, hemochromatosis, Wilson's
75
Liver lesions that can contain calcium:
Mets (mucinous GI, osteosarcoma, treated lymphoma)
76
Low density lesions in the spleen
Fungal infxn, lymphoma, mets, TB, hemangioma (fills in post contrast)
77
What's the name for complications resulting from foreign objects / material left inside a patient's body, usually following surgery
Gossypiboma
78
Ddx varioliform gastric ulcers
NSAIDS, Crohns, EtOH, infxn (CMV, candida) | Note - these are smaller than target lesions, which are >1 cm
79
What are Gamna gandy bodies? What do they look like? What organ? What does it mean?
``` aka siderotic nodules = microhemorrhages + fibroblastic rxn in the spleen Dark on T2 / heterogeneous on US Portal HTN (rarely other causes) ```
80
What's cavernous transformation of the portal vein?
portal vein thrombosis and is the replacement of the normal single channel portal vein with numerous tortuous venous channels. (there's portal HTN)
81
Ddx massive gallbladder wall thickening
(acute cholecystitis) hepatitis hypoproteinuria CHF

[PBR] Oral boards (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions