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GI Challenge Flashcards

1
Q

Case 151

What heterotaxy syndrome is associated with a high risk of congenital heart disease?

A

Situs ambiguous with asplenia (85-95% have CHD)

Situs ambiguous with polysplenia have a lower chance of CHD

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2
Q

Case 151

Right lower lobe bronchiectasis with dextrocardia = ?

A

Kartagener’s syndrome

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2
Q

Case 151

What is the incidence of congenital heart disease in patients with situs inversus?

A

5%

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4
Q

Case 152

What is the MC congenital abnormality of the pancreas?

A

Pancreatic divisum (4-10% of the population)

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5
Q

Case 152

What is the MC clinical scenario associated with pancreas divisum?

A

Most are asymptomatic, although there is a higher incidence of pancreatitis

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6
Q

Case 152

What is the other name of the accessory pancreatic duct?

A

Duct of Santorini

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7
Q

Case 153

What is the MC viscus used for esophageal interposition surgery?

A

Stomach

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8
Q

Case 153

Tumor recurrence is common following esophagectomy for esophageal cancer. Where is the MC site for recurrence?

A

Distant metastases

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9
Q

Case 154

What is the peritoneal space posterior to the stomach and anterior to the pancreas?

A

Lesser sac

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10
Q

Case 154

Which viscus most commonly herniates through the foramen of Winslow?

A

Small bowel

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11
Q

Case 154

What is the MC type of internal hernia?

A

Paraduodenal

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12
Q

Case 155

In what age group is mesenteric volvulus typically seen?

A

Infancy, and is usually associated with congenital abnormalities.

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13
Q

Case 156

Which imaging modality is best for preoperative or pre-interventional planning for uterine fibroids?

A

MRI

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14
Q

Case 157

What postoperative complication is more common following Billroth II compared to Billroth I?

A

Afferent loop syndrome (also seen with Roux-en-Y gastric bypass and pancreaticoduodenectomy)

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15
Q

Case 157

What are some potential causes of gastric bezoar?

A
  1. Hair (trichobezoars)
  2. Persimmon fruit or psyllium fiber taken with too little water (phytobezoar)
  3. Post-gastric surgery (incidence of 5-12%)
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16
Q

Case 158

What histologic component seen in other parts of the GI tract is absent in the esophagus?

A

Serosa

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17
Q

Case 158

Worldwide, what is the MC cause of portal hypertension and varices?

A

Schistosomiasis

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18
Q

Case 158

What are ‘jump’ metastases in esophageal cancer and why do they occur?

A

Mets that spread throughout the length of the esophagus.

Due to extensive lymphatic network in the esophagus.

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19
Q

Case 159

What is the MC surgical complication of lap cholecystectomy?

A

Retained stone

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20
Q

Case 160

In patients with Crohn’s disease, which portion of the stomach is typically involved?

A

Antrum

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21
Q

Case 160

In longstanding Crohn’s disease, what is the name given to a featureless antrum and duodenum?

A

Ram’s horn sign

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22
Q

Case 161

What is the MC pancreatic islet cell tumor?

A

Nonfunctioning islet cell tumor (50% of all pancreatic neuroendocrine tumors)

Conflicting info see on Radiopaedia. They say that 15% are nonfunctional. MC functional pancreatic NET is insulinoma

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23
Q

Case 161

Which pancreatic islet cell tumor would be associated with palpitations, sweating, and headache?

A

Insulinoma

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24
Q

Case 162

What is the MC cause of cirrhosis in caucasians? In Asians?

A

Caucasians - alcohol

Asians - viral hepatitis

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25
Q

Case 162

What serum marker is often used in HCC?

A

Alpha-fetoprotein (AFP), although it is nonspecific

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26
Q

Case 163

What is the definition of a giant duodenal ulcer?

A

A mucosal defect replacing 2/3 of the duodenal bulb

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27
Q

Case 163

Where do perforating duodenal ulcers most commonly occur?

A

Duodenal bulb

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28
Q

Case 163

What is the only duodenal tumor that can specifically diagnosed with CT?

A

Lipoma

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29
Q

Case 164

From where does most of the air come from seen within the GI tract?

A

Swallowed air

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30
Q

Case 164

T or F: Pneumoretroperitoneum is never benign.

A

True. Most commonly represents performation of colon or duodenum.

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31
Q

Case 165
In the setting of a nutmeg liver, what imaging characteristic would be suggestive of Budd-Chiari over right heart failure?

A

Caudate lobe hypertrophy

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32
Q

Case 166

What is the pathophysiology of epiploic appendagitis?

A

Torsion of the epiploic appendage

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33
Q

Case 166

What is the treatment for epiploic appendagitis?

A

Conservative therapy

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34
Q

Case 167

What is the MC presentation of a thyroglossal duct cyst?

A

Palpable mass

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35
Q

Case 167

What is the MC complication of a thyroglossal duct cyst?

A

Infection

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36
Q

Case 167

What is the definitive treatment for a thyroglossal duct cyst?

A

Surgery

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37
Q

Case 168

An abscess due to a retained surgical foreign body is known as what?

A

Gossypiboma

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38
Q

Case 169

What is the MC cause of portal vein thrombosis in adults?

A

Cirrhosis

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39
Q

Case 170

Multiple rim enhancing soft tissue lesions in the liver in a patient without known primary tumor?

A

I would still think metastatic disease first, until proven otherwise.

Epithelioid hemangioendothelioma (EHE) is also a consideration.

40
Q

Case 170

What is the MC site of involvement for epithelioid hemangioendothelioma (EHE)?

A

Soft tissues

41
Q

Case 170

Histologically, what is epithelioid hemangioendothelioma (EHE)?

A

Rare vascular tumor that is clinically and histologically intermediate between angiosarcoma and hemangioma.

Now thought of as a low grade epithelioid angiosarcoma.

42
Q

Case 171

Where in the esophagus are strictures most commonly seen?

A

Distal esophagus

43
Q

Case 171

What is the treatment for esophageal webs?

A

Endoscopy

44
Q

Case 172

What is the clinical significance of colon cancer presenting with perforation?

A

Elevated risk of peritoneal carcinomatosis

45
Q

Case 173

What is the MC predisposing factor in esophageal bolus impaction?

A

There is typically an underlying stricture

46
Q

Case 174

What is the MC predisposing factor in hepatic microabscesses?

A

Immunocompromised state

47
Q

Case 174

What is the MC causative organism in hepatic microabscesses?

A

Candida

48
Q

Case 175

What is the MC benign cause of linitis plastica?

A

Caustic ingestion

49
Q

Case 176

What are the normal lymphoid aggregates in the ileum called?

A

Peyer’s patches

50
Q

Case 176

What disease is most commonly associated with nodular lymphoid hyperplasia of the distal ileum?

A

Viral infection

51
Q

Case 176

What is a potential complication of nodular lymphoid hyperplasia in pediatric patients?

A

Ileocolic intussusception

52
Q

Case 177

What is the underlying pathophysiologic defect in achalasia?

A

Aganglionosis

53
Q

Case 177

What is tylosis and why is it important?

A

Genetic disorder characterized by palmar/plantar hyperkeratosis, oral leukoplakia, and esophageal cancer.

Only genetic syndrome known to predispose to SCC of the esophagus.

54
Q

Case 178

On what CT phase is RCC typically the most conspicuous?

A

Nephrographic phase

55
Q

Case 179

What is the MC causative organism for AIDS-related enteritis?

A

Cryptosporidium parvum

56
Q

Case 179

What is the MC cause of dysphagia/odynophagia in AIDS patients?

A

Candida esophagitis

57
Q

Case 179

What disease occurs in immunocompromised patients following bone marrow transplant but not AIDS patients?

A

GVHD

58
Q

Case 180

What is the CT fat halo sign and what does it suggest?

A

Ring of fat tissue in the submucosa of bowel. Seen in inflammatory bowel disease.

59
Q

Case 181

What is the MC cause of large bowel obstruction?

A

Tumor

60
Q

Case 181

What is the MC type of colonic volvulus?

A

Sigmoid

61
Q

Case 182

What is the MC finding of bowel ischemia?

A

Bowel wall thickening

62
Q

Case 183

What is the MC malignancy of the biliary tract?

A

GB adenocarcinoma

63
Q

Case 183

What is the prognosis for GB adenocarcinoma?

A

Mean survival time of 6 months

64
Q

Case 184

What is the MC site of GI tract involvement in Burkitt’s lymphoma?

A

Terminal ileum

65
Q

Case 184

What is the MC site of presentation in Burkitt’s lymphoma?

A

Facial and mandibular

66
Q

Case 184

What virus is specifically associated with Burkitt’s lymphoma?

A

Epstein-Barr virus

67
Q

Case 185

T or F. Traumatic diaphragmatic injury is typically evident at presentation.

A

False. It is commonly missed at presentation, even with cross-sectional imaging.

68
Q

Case 186

What is the MC systemic disorder that may be associated with esophageal dysmotility?

A

Diabetes mellitus

69
Q

Case 186

What is the most common GI manifestation of a paraneoplastic syndrome?

A

Diarrhea

70
Q

Case 186

What is the MC malignancy to give rise to a paraneoplastic syndrome?

A

Bronchogenic carcinoma

71
Q

Case 187

What is the MC cause of perfusion defects in the spleen?

A

Infarcts

72
Q

Case 187

How common are splenic hematogenous metastases?

A

Rare.

73
Q

Case 187

What is the MC primary splenic neoplasm?

A

Hemangioma

74
Q

Case 188

Bleeding colonic polyps in someone who recently went ‘swimming in the Nile”

A

Colonic schistosomiasis

75
Q

Case 189

What is the MC clinical manifestation of a lymphangioma?

A

Cystic hygroma

76
Q

Case 189

What syndrome is associated with lymphangiomas?

A

CRS says fetal alcohol syndrome

Also, aneuploidy syndromes (Trisomies, Turner syndrome), Noonan syndrome, Cornelia de Lange, among others

77
Q

Case 190

What finding suggests pancreatic lymphoma over adenocarcinoma?

A

Absence of pancreatic ductal dilation

78
Q

Case 191

What is the MC type of esophageal polyp

A

Leiomyoma (stromal cell tumor)

79
Q

Case 191
What is the MC location of an esophageal fibrovascular polyp?

How do they typically present?

A

Proximal esophagus.

Typically present with dysphagia.

80
Q

Case 192

What is the MC complication of peptic ulceration?

A

Bleeding

81
Q

Case 192
What is the eponym of a penetrating ulcer that extends from the gastric antrum to the duodenum (paralleling the pyloric channel)?

A

Dragstedt ulcer (could hardly find anything online about this)

82
Q

Case 193

What is the MC cause of small bowel hemorrhage?

A

Anticoagulant therapy

83
Q

Case 193

What is the ‘stack of coins’ sign on SBFT and what does it suggest?

A

Thickening small bowel folds that remain straight and parallel. Associated with small bowel hemorrhage.

84
Q

Case 194

What are the underlying pathologic changes seen in the bowel as a result of scleroderma?

A

Small vessel vasculitis and fibrosis

85
Q

Case 194

What is meant by ‘hidebound’ appearance of bowel and what does it suggest?

A

Dilated small bowel with crowding of normal thickness valvulae conniventes. Seen in scleroderma.

86
Q

Case 195

What is the MC cause of hepatic infarction secondary to hepatic arterial occlusion?

A

Hepatic transplantation

87
Q

Case 195

What can develop as a result of hepatic arterial occlusion and infarction?

A

Bile lakes

88
Q

Case 196

What is the MC underlying cause of SMV thrombosis?

A

Prothrombotic state

89
Q

Case 196

What part of the GI tract would you expect to be affected with SMV thrombosis?

A

Small bowel and right colon

90
Q

Case 197

Oral and ileocecal aphthous ulcers, skin lesions, uveitis, and genital ulcers. Diagnosis?

A

Behcet’s disease

91
Q

Case 198

What is the typical first line therapy for splenic artery pseudoaneurysm?

A

Endovascular intervention

92
Q

Case 199

What is the typical appearance of gastric GIST?

A

Exophytic mass with extragastric extension

93
Q

Case 199

What is the MC cause of a bulky gastric tumor?

A

Carcinoma

94
Q

Case 200

What imaging finding would suggest biliary cystic neoplasm over a simple hepatic cyst?

A

Ductal dilation

95
Q

Case 200

Do biliary cystadenomas have any malignant potential?

A

Yes.

GI (3 decks)

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