GI CORE - Sheet1 Flashcards by Tom Kesler

dilated esophagus + ground glass in lung bases (+/- subpleural sparing)

scleroderma + NSIP

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upper GI location: H pylori gastritis

antrum

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upper GI location: zollinger ellison

ulcerations in stomach, duodenal bulb is most common location for ulcers (jejunal ulcer is buzzword)

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upper GI location: crohns

uncommon in stomach, but when it is, it likes the antrum

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upper GI location: menetrier

usually fundus (classically spares the antrum)

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upper GI location: lymphoma

“crosses the pylorus”

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infection location: giardia

duodenum

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infection location: stronglyoides

duodenum

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infection location: TB

terminal ileum

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infection location: yersinia

terminal ileum

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size of ulcers: herpes esophagitis vs. CMV + AIDS

Herpes Esophagitis = Multiple Small Ulcers

CMV and AIDS = Solitary Large Ulcer

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squamous vs. adenocarcinoma esophageal cancer

Squamous Cell = Black Guy who drinks and smokes- mid esophagus
Adenocarcinoma = White Guy with reflux (history of PPls) - lower esophagus

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uphill vs. downhill varices

uphill: portal HTN, bottom half of esophagus; downhill: SVC syndrome, top half of esophagus

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traction vs. pulsion diverticulum

traction: triangular, will empty; pulsion: round, will NOT empty (no muscle in walls)

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sliding vs. rolling esophageal hernias

sliding: GE junction above the diaphragm; rolling: GE junction below the diaphragm

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Carney’s Triad vs. Carney’s Complex

Carney’s triad: extra-adrenal pheo, GIST, pulmonary chondroma; Carney’s complex: Cardiac myxoma, skin stuff, endocrine stuff

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direct vs. indirect inguinal hernia: most common?

indirect is more common

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direct vs. indirect inguinal hernia: location relative to inferior epigastric?

direct: medial to inferior epigastric, indirect: lateral to inferior epigastric

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direct vs. indirect inguinal hernia: what went wrong?

direct: defect in Hesselbach triangle, indirect: failure of processus vaginalis to close

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direct vs. indirect inguinal hernia: covered by spermatic fascia?

direct: NOT covered by internal spermatic fascia, indirect: covered by internal spermatic fascia

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sigmoid vs. cecal volvulus:

sigmoid: old constipated person, points to RUQ; cecal: younger (mass, surgery, 3rd trimester), points to LUQ

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regenerative vs dysplastic liver nodules contents

regenerative: contains iron, dysplastic: contains fat, glycoprotein

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regenerative vs dysplastic liver nodules vs HCC: MRI signal

regen: T1 dark, T2 bright; dysplastic: T1 bright, T2 dark; HCC: T2 bright

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regenerative vs dysplastic liver nodules vs HCC: enhancement

HCC enhances, regen + dysplastic do NOT enhance

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FNH vs. fibrolamellar HCC central scars: T2 signal

FNH: T2 bright; FL HCC: T2 dark (usually)

FNH vs. fibrolamellar HCC central scars: enhancement

FNH: enhances on delays; FL HCC: does NOT enhance

FNH vs. fibrolamellar HCC: nucs

FNH: mass is SC avid (sometimes); FL HCC: mass is gallium avid

HCC vs. fibrolamellar HCC: cirrhosis?

no cirrhosis in FL HCC

HCC vs. fibrolamellar HCC: demographics

HCC: older (50-60s) vs. FL HCC: younger (30s)

HCC vs. fibrolamellar HCC: calcification?

HCC: rarely calcifies vs. FL HCC: sometimes calcifies

HCC vs. fibrolamellar HCC: AFP?

HCC: elevated AFP vs. FL HCC: normal

primary vs. secondary hemochromatosis: organs

primary: liver + Pancreas (heart, thyroid, pituitary) vs. secondary: liver + Spleen (RES)

primary vs. secondary hemochromatosis: what went wrong

primary: genetic, increased absportion vs. secondary: acquired, multiple transfusions

When I say "narrowed B Ring," You say

Schatzki

When I say "esophageal concentric rings," You say

Eosinophilic Esophagitis

When I say "shaggy" or "plaque like" esophagus, You say

Candidiasis

When I say " looks like candida, but an asymptomatic old lady," you say

glycogen acanthosis

When I say "reticular mucosal pattern," you say

Barretts

When I say "high stricture with an associated hiatal hernia," you say

Barretts

When I say "abrupt shoulders," you say

cancer

When I say "Killian Dehiscence," you say

Zenker Diverticulum

When I say "transient, fine transverse folds across the esophagus," you say

Feline esophagus

When I say "bird's beak," you say

Achalasia

When I say "solitary esophageal ulcer," you say

CMV or AIDS

When I say "ulcers at the level of the arch or distal esophagus," you say

medication induced

When I say "Breast Cancer + Bowel Hamartomas," you say

Cowdens

When I say "Desmoid Tumors + Bowel Polyps," you say

Gardners

When I say "Brain Tumors + Bowel Polyps," you say

Turcots

When I say "enlarged left supraclavicular node," you say

Virchow Node (GI Cancer)

When I say "crosses the pylorus," you say

Gastric Lymphoma

When I say " isolated gastric varices," you say

splenic vein thrombus

When I say "multiple gastric ulcers," you say

Chronic Aspirin Therapy.

When I say "multiple duodenal (or jejunal) ulcers," you say

Zollinger-Elision

When I say "pancreatitis after Billroth 2," you say

Afferent Loop Syndrome

When I say "Weight gain years after Roux-en-Y," you say

Gastro-Gastro Fistula

When I say "Clover Leak Sign - Duodenum," you say

healed peptic ulcer.

When I say "Sand Like Nodules in the Jejunum," you say

Whipples

When I say "Sand Like Nodules in the Jejunum + CD4 < 100," you say

MAl

When I say "Ribbon-like bowel," you say

Graft vs Host

When I say "Ribbon like Jejunum," you say

Long Standing Celiac

When I say "Moulage Pattern," you say

Celiac

When I say "Fold Reversal - of jejunum and ileum," you say

Celiac

When I say "Cavitary (low density) Lymph nodes," you say

Celiac

When I say "hide bound" or "Stack or coins," you say

Scleroderma

When I say "Megaduodenum," you say

Scleroderma

When I say "Duodenal obstruction, with recent weight loss," you say

SMA Syndrome

When I say "Coned shaped cecum," you say

Amebiasis

When I say "Lead Pipe," you say

Ulcerative Colitis

When I say "String Sign," you say

Crohns

When I say "Massive circumferential thickening, without obstruction," you say

Lymphoma

When I say "Multiple small bowel target signs," you say

Melanoma

When I say "Obstructing Old Lady Hernia," you say

Femoral Hernia

When I say "sac of bowel," you say

Paraduodenal hernia.

When I say "scalloped appearance of the liver," you say

Pseudomyxoma Peritonei

When I say "HCC without cirrhosis," you say

Hepatitis B

When I say "Capsular retraction," you say

Cholangiocarcinoma

When I say "Periportal hypocchoic infiltration + AIDS," you say

Kaposi's

When I say "sparing of the caudate lobe," you say

Budd Chiari

When I say " large T2 bright nodes+ Budd Chiari," you say

Hyperplastic nodules

When I say "liver high signal in phase, low signal out phase," you say

fatty liver

When I say "liver low signal in phase, and high signal out phase," you say

hemochromatosis

When I say "multi focal intrahepatic and extrahepatic stricture," you say

PSC

When I say "multi focal intrahepatic and extrahepatic strictures + papillary stenosis," you

say AIDS Cholangiopathy.

When I say "bile ducts full of stones," you say

Recurrent Pyogenic Cholangitis

When I say "Gallbladder Comet Tail Artifact," you say

Adenomyomatosis

When I say "lipomatous pseudohypertrophy of the pancreas," you say

When I say "sausage shaped pancreas," you say

autoimmune pancreatitis

When I say "autoimmune pancreatitis," you say

IgG4

When I say " IgG4" you say

RP Fibrosis, Sclerosing Cholangitis, Fibrosing Medianstinitis, Inflammatory Pseudotumor

When I say "Wide duodenal Sweep," you say

Pancreatic Cancer

most common benign mucosal lesion of the esophagus

papilloma

esophageal webs have increased risk for (2)?

cancer and plummer-vinson syndrome (anemia + web)

achalasia has an increased risk of what kind of cancer?

squamous (20 years later)

most common mesenchymal tumor of the GI tract

GIST

most common location for GIST

stomach

what's a krukenberg tumor?

Stomach (GI) met to the ovary

most common location for sarcoid in the GI tract

stomach

most common internal hernia?

left sided paraduodenal

Most common site of peritoneal carcinomatosis

retrovesical space

An injury to the bare area of the liver can cause a

retroperitoneal bleed

what antibodies are positive in PBC

antimitochondrial

Mirizzi Syndrome

the stone in the cystic duct obstructs the CBD.

Mirizzi Syndrome has a 5 x increased risk of?

GB cancer

dorsal pancreatic agenesis is associated with these 2 random things

diabetes and polysplenia

When I say "Grandmother Pancreatic Cyst" you say

Serous Cystadenoma

When I say "Mother Pancreatic Cyst" you say

Mucinous

When I say "Daughter Pancreatic Cyst," you say

Solid Pseudopapillary

Felty's Syndrome

Big Spleen, RA, and Neutropenia

most common islet cell tumor

insulinoma

most common islet cell tumor with MEN

gastrinoma

NSAID erosive gastritis - finding in fluoro

"shallow"/aphthoid/erosive, multiple ulcers (hole with central dot)