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ARDMS ABD PATHOLOGY > GI Tract Pathology > Flashcards

GI Tract Pathology Flashcards

1
Q

intestinal pathology creates a sonographic pattern “gut signature” known as the ____ or ____ sign

A

“target” or “pseudokidney” sign

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2
Q

ultrasound appearance of the “target” or “pseudokidney” sign (2)

A

hypoechoic external rim = thickened wall
hyperechoic center = mucosal ulceration

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3
Q

most common cause of an acutely painful abdomen

A

acute appendicitis

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4
Q

acute appendicitis is caused by the obstruction of the

A

appendiceal lumen

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5
Q

acute appendicitis criteria (5)

A

non-compressible
> 6mm diameter
appendicolith
periappendiceal fluid
“thyroid in the belly” sign

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6
Q

what is appendicolith?

A

echogenic structure within the appendix lumen

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7
Q

signs/symptoms of acute appendicitis (4)

A

periumbilical pain shifting to the RLQ
anorexia
leukocytosis
rebound tenderness

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8
Q

what is mesenteric adenitis?

A

inflammation of the mesenteric lymph nodes in the RLQ
clinical presentation mimics acute appendicitis

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9
Q

what is hypertrophic pyloric stenosis (HPS)?

A

enlargement or hypertrophy of the pyloric sphincter muscles cause gastric outlet obstruction

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10
Q

HPS is most common in

A

infants 2 to 6 weeks old

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11
Q

signs/symptoms of HPS (3)

A

nonbilious projectile vomiting
palpable “olive-shaped” pylorus
visible peristalsis

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12
Q

most accurate measurement for HPS

A

muscle wall thickness

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13
Q

measurements of HPS

A

muscle wall thickness > 3mm
pyloric channel length > 17mm

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14
Q

most common cause of gastric outlet obstruction in premature infants and neonates younger than 4 weeks

A

pylorospasm

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15
Q

unlike HPS, pylorospasm measurements tend to be

A

normal

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16
Q

another cause of nonbilious projectile vomiting in infants where gas bubbles can be observed traveling retrograde up the esophagus

A

gastroesophageal reflux

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17
Q

clinical presentation is similar to HPS, but with bilious vomiting

A

midgut malrotation (volvulus)

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18
Q

what is midgut malrotation?

A

small bowel mesenteric rotate around the SMA

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19
Q

normally the SMA is to the ___ of the SMV
with malrotation the SMA is to the ___ of the SMV

A

normal = SMA to the LEFT of the SMV
malrotation = SMA to the RIGHT of the SMV

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20
Q

what is intussusception?

A

telescoping of one segment of bowel into another

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21
Q

intussusceptum = _____ segment, _____ loop
intussiscipiens = _____ segment, ____ loop

A

intussusceptum = proximal segment, interior loop
intussuscipiens = distal segment, exterior loop

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22
Q

most common type of intussusceptum

A

ileocolic intussusception

RLQ - ileum to ascending colon

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23
Q

most common cause of intestinal obstruction in children less than 2 years old

A

intussusception

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24
Q

intussusception rarely occurs in those under ____ and over ____

A

under 3 months old
over 3 years old

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25
Q

ultrasound appearance of intussusception (4)

A

target mass in TRV plane
“cinnamon bun sign” in TRV plane
pseudokidney in longitudinal plane
diameter > 3cm

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26
Q

signs/symptoms of intussusception (4)

A

red currant jelly stool *
acute ABD pain
palpable abdominal mass
vomiting

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27
Q

lab values of intussusception (3)

A

anemia
dehydration
leukocytosis

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28
Q

what are the two types of bowel obstruction?

A

mechanical
nonmechanical / paralytic ileus

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29
Q

what is mechanical bowel obstruction?

A

bowel being blocked by something

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30
Q

what can cause mechanical bowel obstruction? (4)

A

intraluminal - food bolus
bowel wall lesion - tumor, Crohn disease
extrinsic - adhesions, hernia ** MOST COMMON**
volvulus - twisting of the intestines

31
Q

what is nonmechanical / paralytic ileus bowel obstruction?

A

bowel lacks normal peristalsis

32
Q

what causes nonmechanical / paralytic ileus bowel obstruction? (4)

A

peritonitis
bowel ischemia
surgery
medications

33
Q

what are bezoars?

A

masses of various ingested materials that may cause intestinal obstruction

34
Q

what do trichobezoars consist of?

A

ingested hair

35
Q

what do lactobezoars consist of?

A

powdered milk

36
Q

what do phytobezoars consist of?

A

vegetable material

37
Q

what types of bezoars are common in pediatric patients?

A

trichobezoars
lactobezoars

38
Q

what type of bezoar is common in older patients?

A

phytobezoars

39
Q

ultrasound appearance of bowel obstruction (3)

A

distended fluid-filled loops of bowel

acute = thin walls with hyperperistalsis, back and forth movement of intraluminal contents

progression = aperistaltic with thick, edematous walls

40
Q

signs/symptoms of bowel obstruction (4)

A

abdominal distention
intermittent ABD pain
constipation
nausea and vomiting

41
Q

what is Crohn’s disease?

A

autoimmune disorder
periods of inflammation of the GI tract, cause is unknown

42
Q

most common inflammatory disease of the small intestines

A

crohn’s

43
Q

crohn’s usually involves the ____ or ____

A

terminal ileum or proximal colon

44
Q

ultrasound appearance of Crohn’s (4)

A

bowel wall thickening
hyperemia
noncompressible > 5 mm
“target” appearance

45
Q

signs/symptoms of Crohn’s (4)

A

episodes of diarrhea
ABD pain
weight loss
rectal bleeding

46
Q

what is diverticulitis?

A

inflammation of the diverticuli

47
Q

diverticulitis most often involves the

A

sigmoid colon

48
Q

ultrasound appearance of diverticulitis (4)

A

thick-walled outpouchings
hypoechoic thickening of adjacent bowel (perienteric fat)
projections will produce shadowing or ring-down artifact
hyperemia

49
Q

signs/symptoms of diverticulitis (4)

A

LLQ pain
fever
constipation or diarrhea
nausea and vomiting

50
Q

what is colitis?

A

inflammation of the colon

51
Q

4 types of colitis

A

pseudomembranous
ulcerative
ischemic
infectious

52
Q

ultrasound appearance of colitis (2)

A

thickened, hypoechoic colon wall
hyperemia

53
Q

signs/symptoms of colitis (3)

A

watery or bloody diarrhea
pain
fever

54
Q

previous antibiotic therapy that destroys the healthy flora of the intestines leads to subsequent proliferation of _______

A

Clostridium difficile (C. Diff)

55
Q

most common benign tumor of the small and large intestines

A

leiomyomas

56
Q

leiomyomas appear as

A

hypoechoic masses continuous with the muscular layer

57
Q

gastric carcinoma most often is in the form of

A

adenocarcinoma (80%)

58
Q

adenocarcinoma of the appendix can lead to ___ with subsequent development of ____

A

rupture with subsequent development of pseudomyxoma peritonei

59
Q

what is pseudomyxoma peritonei?

A

gelatinous ascites that may appear as a multiseptated cystic pelvic mass

60
Q

most common metastatic tumors to the bowel (3)

A

malignant melanoma
lungs
breast

61
Q

ultrasound appearance of gastric carcinoma (3)

A

hypoechoic, irregular-shaped, bulky mass
up to 10 cm in size
“target” or “pseudokidney”

62
Q

signs/symptoms of gastric carcinoma (4)

A

weight loss
ABD pain
anorexia
vomiting

63
Q

rectus sheath hematoma is the result of

A

abdominal trauma or may occur spontaneously

64
Q

signs/symptoms of rectus sheath hematoma (4)

A

ABD pain
palpable abdominal mass
skin discoloration at the area
decrease hematocrit

65
Q

most common site for endometriosis of the abdominal wall

A

anterior abdominal wall

66
Q

what is scar endometriosis?

A

endometriosis that is located within the scar of a previous C-section

67
Q

ultrasound appearance of endometriosis of the abdominal wall (4)

A

well-defined
lobulated
infiltrative
hypoechoic or heterogenous

68
Q

signs/symptoms of scar endometriosis (2)

A

palpable mass
cyclical pain

69
Q

what is an inguinal hernia?

A

bowel protrudes into the groin

70
Q

what is an incisional hernia?

A

bowel protrudes into a surgical incision site

71
Q

what is a linea alba hernia?

A

bowel protrudes through the fascia of the linea alba

72
Q

what is an umbilical hernia?

A

bowel protrudes into the umbilicus

73
Q

what is a spigelian hernia?

A

bowel protrudes into a weakened area in the lower 1/4th of the rectus muscle

ARDMS ABD PATHOLOGY (13 decks)

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