GI from CTC Flashcards by Lane Stafford

Esophageal 1-4

critical = 3 vs 4

1 vs 2 endoscopic dx

Stage 3 = adventitia

Stage 4 = invasion in to adjacent structures

4a resectable (pleura, pericardium diphragm)

4b NOT (trachea, aorta)

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esoph candida

early vs late

old person mimic

MC = discrete plaque like lesions

later shaggy

older person mimic with multiple elevated nodules = glycogenic acanthosis

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esoph ulcers

herp vs HIV/CMV

herp small and multiple with halo

HIV/CMV large and flat

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MC sites for dup cysts

1 ileum

2 gus

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scleroderma small bowel

hidebound, stack of coins, narrowly separated valvulae conniventes

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achalasia cancer risk type

squam

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ZE ulcers MC spot

bulb

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Gardner syndrome

(FAP)

multiple osteomas especially of the mandible, skull and long bones

desmoid tumours of mesentery and anterior abdominal wall

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Cowden’s

HAMARTOMAS

Breast cancer

Lhermitte Duclos

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GIST

where and who

70% stomach

over 40y

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benign ulcer features

deeper than wide

lesser curvature

folds radiate to ulcer

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gastric vs duodenal ulcers

duey

never cancer

“increased peptic acid”

solitary

stomach

“altered mucosal resistance”

5% cancer, 2/2 h pylori

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MC extranodal site for NON hodgkin lymphoma

Stomach

vs primary stomach lymphoma, MALT

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Linitus plastica primary and mets

Primary = scirrhous adenocarcinoma

or breast or lung mets

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ram’s horn ddx

ulcer scarring

Granulomatous

Crohns

Sarcoid

Scirrhous Cancer

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“Isolated gastric varices”

Splenic vein thrombosis

(panc cancer or itis —> splenic thrombus —> isolated gastric varices)

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area gastricea enlarged by?

obliterated by?

elarged in elderly and H pylori, enlarges next to an ulcer

obliterated cancer or atrophic gastritis

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fold density jej vs il

jejunum more packed (4-7 per inch)

2-4 per inch in ileum

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contrast % weight by vol

smal bowel

double barium

CT = 2% wt/vol

Small bowel = 20-30% wt/vol

double barium = 98% wt/vol

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Whipples

strippers - old men in 50’s

thickened folds and nodules

Duoy and Jej

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MC small bowel adeno

duoy

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which side

epiploic append

omental infarct

ROI

RIGHT = omental infarct

Epiploic appendagitis on LEFT

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appendix mucocele

MC mucinous tumor of the appendix

gets big, looks like cystadenoma

rupture = pseudomyxoma peritoneii

“onion sign”

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toxic megacolon causes and must

UC, Crohns (less) and Cdiff

NO haustra

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rectal phleboliths

rectal cavernous hemangioma klippel trenaunay weber Blue Rubber Bleb

entamoeba histolytica site

cecum and ascending colon MC "coned cecum" spares TI

colonic TB

INVOLVES TI also coned cecum ulcers and areas of narrowing

pseudomyxoma peritoneii causes

ruptured mucocele MC = appendix mucinous neoplasm (ovary, colon, appendix and panc) leads to obstructions

cause of atrophy hypertrophy in cirrhosis

Right portal vein takes a longer course

placenta circulation

PULI PUDI splits. placenta umb LIVER IVC placenta umb DUCTUS IVC

regenerative vs dysplastic vs hcc

regen T1 and T2 dark dysplastic T1 bright HCC T2 bright and enhancing

Liver window

Center = 100 Width = 200

OWR liver

cirrhosis with massively enlarged hepatic artery

Single liver abscess = multiple =

single = kleb multiple = e coli

ddx for CT enhancement patterns washout - iso - persist-

**washout = HCC, mets, adenoma, abscess** **iso = FNH** **persists = hemangioma**

FNH trivia scar looks like nucs study

Scar has delayed enhancement (fibrolamellar HCC doesn't) Sulfur colloid FNH is MRI stealth, T1 and T2 iso

Hepatic adenoma on MRI feature

microscopic fat drop out on out of phase (out of phase has india ink)

Fibrolamellar scar and nucs stuff

T2 dark scar that doesn't enhance HOT ON GALLIUM

MRI liver phase timing CT

arterial = 30 seconds PV = 70 seconds hep vein = 90 sec - 5 mins CT 30sec 80 sec 3-5 minutes

Cholangio T4 =?

main vein/artery secondary biliary radicles lead to desmo reaction and delayed enhancement

hepatic angiosarc a/w?

toxic exposure - arsenic, PVC, radiation, thorotrast multifocal, bleeds

cystic liver lesion in middle aged female

biliary cystadenoma can't distinguish from carcinoma

calcified liver mets

colon, ovary, pancreatic (mucinous tumors)

Gallium hot liver thing

**HCC or abscess**

T1/T2 bright liver thing, gross fat on CT

liver AML (TS)

Budd chiari look

large regenerative nodules in a dysmorphic liver (huge caudate) acute flip flop with high attenuation peripherally

massive caudate ddx

Budd PSC PBC

pseudocirrhosis

treated breast (or colon) mets can mimic with retraction and caudate enlargement

liver transplant US normal HA velocity

\<200

bil dil rare in all types of cirrhosis except?

PSC

multifocal strictures/ PSC mimic in HIV

AIDS cholangiopathy CRYPTO

left dominant, recurrent dilated ducts full of stones

Oriental/recurrent pyogenic cholangitis

Caroli's a/w

PcKD medullary sponge

% with synchronous polyps (ie chance someone with an adenomatous polyp cut out has another one)

30-50%

normal PV vel

20-40 cm/s

complication of enzyme replacement therapy in CF

fibrosing colonopathy wall thickening of proximal colon

young pancreatitis with dilated, stone filled duct

hereditary or tropical increased adenoCa risk

IPMN a/w malig = ?

MAIN BRANCH all considered malignant and should be resected diffuse dilatation, calcs, atrophy (mimics chronic itis)

SPEN b9 or malig?

low grade malignant tumor thick capsule may have progressive fill in

unresectable panc cancer = ?

involvement of SMA/celiac axis GDA comes out anyway

Panc NET MC overall MC with MEN Highest malig potential

MC overall = insulinoma MC with MEN = Gastrinoma Highest malig potential = glucagonoma nonfunctional = big, malignant, metastatic

T2 dark things in spleen

GG bodies, foci of hemorrhage ## Footnote **a/w portal HTN**

MC GI sites for sarcoid

antrum MC in GI tract spleen in 50-80% (usually just big)

splenic aneurysms who gets more when to treat

preggos 2-3 cm

classic bug and setting for splenic abscess

salmonella