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GI trivia Flashcards

1
Q

Type I HH

A

GEJ above the diaphragm, no paraesophageal componet

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2
Q

Type II HH

A

anterolateral phrenoesophageal membrane defect
Gastric cardia and GEJ remain subdiaphragmatic
Fundus usually first part herniated

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3
Q

Type III HH

A

MCC of paraesophageal with Type I and II features
gastric rotation
usually large

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4
Q

Type IV HH

A

Marked widening of the diaphragmatic hiatus that contains other organs

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5
Q

GERD findings

A 
abn motility
mucosal filling defects
Ulceration
Sacculations
thick logitudinal folds
Transverse folds
Intramural pseudodiverticula
Inflammatory polyp
Stricture
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6
Q

Chagas Disease can look like what on esophagram

A

Achalasia

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7
Q

Epiphrenic diverticulum of esophagus assoc with what

A

motility disorders like achalasia

pulsion type

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8
Q

MCL for esophageal tear from Boerhaave

A

left posterior lateral distal esophagus

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9
Q

Long esophageal strictures

A

severe GERD
NG tube
ZE syndrome
Caustic ingestion = liquifactive necrosis

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10
Q

Downhill varicies

A

SVC obstruction

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11
Q

Multiple short concentric rings in esophagus (not feline)

A 
Eosinophilic esphagitis (usually upper and mid)
hx of asthma/atopy
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12
Q

Major risk factors for esophageal adenocarcinoma

A

Obesity
GERD
smoking

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13
Q

Benign stomach ulcer findings

A

Extends beyond stomach contour
regular ovoid shape
folds radiating to the edge of the crater
smooth ulcer collar
more common in antrum and lesser curvature

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14
Q

Organoaxial rotation of stomach

A

stomach rotates along the long axis with the greater curvature located cephalad to the lesser

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15
Q

Mesenteroaxial rotation of the stomach

A

rotates around the short axis

displacement of the antrum above the GEJ (stomach looks upside down with the antrum and pylorus superior to the fundus)

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16
Q

Right paraduodenal hernia (25% of PDH)

A

through fossa of Waldeyer (1st part of jejunal mesentery)

bowel goes behind the SMA and diplaced anterior and inferior to transverse duodenum

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17
Q

Left paraduodenal hernia (75%)

A

fossa of Landzert
between pancreas and stomach
IMV displaced superiorly and anteriorly

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18
Q

Duodenal hematoma/injury with blunt trauma as usually have what injuires

A

Pancreatic trauma
Left hepatic lobe
spleen

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19
Q

direct inguinal hernia

A

medial to inferior epigastrics

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20
Q

indirect inguinal hernia

A

lateral to inferior epigastrics

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21
Q

femoral hernia

A

medial to inferior epigastrics and compress the femoral vein (medial to the vein)

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22
Q

median arcuate ligaments compresses what artery

A

Celiac

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23
Q

Colonic diverticula form where

A

weakness area where the vasa recta penetrate the bowel wall

pulsion type

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24
Q

Griffiths point

A

watershed area near splenic flexure

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25
coffee bean appearance of colon
sigmoid volvulous (look for normal right colon)
26
Colonic pseudoobstruction (Ogilve Syndrome)
Chronic form shows decreased intramural ganglion cells
27
MCL of epiploic appendagitis
sigmoid and descending colon | can see central vessel (thrombosed vein)
28
Omental infarct
MCL anterior transverse colon or anteromedial to ascending colon no central thrombosed vein
29
MCL for perforation due to sigmoid colonic neoplasm
Cecum (if ileocecal valve is competent) | greater risk if cecum >/= 10 cm
30
Right sided colon infections
salmonella yersinia TB amebiasis
31
Left sided colon infections
Shigella Lymphogranuloma venereum Gonorrhea Schistosomiasis
32
Diffuse colon infections
E. coli | CMV
33
Amyand Hernia
appendicitis in an inguinal hernia
34
Littre hernia
meckels in an inguinal hernia
35
Richter hernia
antimesenteric portion of bowel wall goes through abdominal defect
36
MEN 1
PPP parathyroid pancreatic NETs Pituitary adenoma
37
MEN 2a
MPP Medullary thyroid pheo parathyroid
38
MEN 2b
MNP Medullary thyroid neuromas pheo
39
Insulinoma
Whipple triad hypoglycemia low glucose that symptoms resolve when corrected
40
Gastrinoma
ZE syndrome
41
Glucagonoma
``` 4D Syndrome Dermatitis Diabetes DVT Depression ```
42
VIPoma
WDHA Syndrome watery diarrhea hypokalemia achlorhydria
43
Somatostatinoma
``` Inhibitory Syndrome Diabetes steatorrhea diarrhea cholelithiasis ```
44
Pancreas is usually T1 bright
Pathology typically is T1 hypo
45
Duodenal diverticulum
oral contrast and gas with connection to duodenum | Change in size and shape from study to study
46
Serous microcystic cystadenoma (pancreas)
numerous small cysts clustered together with multilobulated margins
47
Mucinous cystic neoplasm (pancreas)
large encapsulated cyst with thick irregular internal septations and mural 90% in body or tail of pancreas
48
Intraductal papillary mucinous neoplasm (pancreas)
lobulated cystic mass communicating with pancreatic duct (either directly or on side branches) > 3 cm and main ductal dilation and nodularity = bad
49
Complete fatty replacement of the pancreas
CF
50
Solid pseudopapillary tumor
Cystic mass with solid enhancing parts and hemorrhage in young woman
51
Interstitial edematous pancreatitis
< 4 weeks Acute peripancreatic fluid collection | > 4 weeks pancreatic pseudocyst
52
Necrotizing pancreatitis
< 4 weeks Acute necrotic collection (parenchymal necrosis alone, peripancreatic necrosis alone, pancreatic and peripancreatic necrosis) > 4 weeks Walled-off necrosis
53
MC mets to pancreas
RCC | usually appears as a hypervascular mass
54
Budd-Chiari on CT
heterogeneous liver with macronodular contour enlargement and increased enhancement of the caudate lobe hepatic veins not seen (venogram has spider web of collaterals)
55
Biliary cystadenoma
encapsulated, multiloculated cystic mass in the liver with enhancing septations (possible nodules) biliary ductal dilation +/- calcs
56
More than 10 liver cysts are seen
consider fibropolycystic liver disease
57
Von Meyenburg Complex
AKA - biliary hamartomas | numerous sub cm T2 hyperintense lesions scattered throughout the liver
58
Signs of cirrhosis
Micronodular regenerating nodules segmental atrophy (right lobe and medial left lobe) Segmental hypertrophy (caudate and lateral left) Right posterior hepatic notch sign Expanded GB fossa sign (increased fat in the pericholecystic area)
59
Primary hemochromatosis
pancreas (bronzing DM)
60
Secondary Hemochromatosis
spleen
61
THID (MRI) and THAD (CT)
wedge-shaped or geographic area of enhancement representing altered perfusion usually only seen on one phase (MC arterial)
62
Cavernous transformation of the portal vein
main portal vein not seen, numerous tortuous collaterals = chronic portal vein occlusion
63
Washout of hepatic lesions
have to be hypodense to surrounding liver , NOT isodense
64
MC benign hepatic tumor
Hemangioma
65
Timing of arterial phase for hypervascular liver lesions
Late arterial phase when there is heterogeneous blush in the main portal vein
66
Hypervascular METs (also most likely to bleed)
``` "MR CT" Melanoma Renal Cell carcinoma Carcinoid (neuroendocrine tumors)/ Choriocarcinoma Thyroid Carcinoma ```
67
Pseudocirrhosis after liver mets treatment
MCC breast ca
68
Giant cavnerous hemangioma of the liver assoc with what syndrome
Kasabach-Merritt syndrome | thrombocytopenia = sequestration/destruction of platelets
69
Peliosis hepatis
benign vascular disorder with dialted sinusoids and blood filled cavities fills in central to peripheral (opposite hemangiomas) delayed enhancement over surrounding liver (mets less likely) assoc with Bartonella species
70
Type I Choledolchal cyst
single fusiform of part or entire extrahepatic duct
71
Type II Choledolchal cyst
true diverticulum with narrow stalk from extrahepatic duct
72
Type III Choledolchal cyst
Dilation of the extrahepatic bile duct within duodenal wall
73
Type IV choledochal cyst
IVa - both intra and extra hepatic cysts IVb - multiple dilatations of extrahepatic ducts only
74
Type V Caroli disease
multiple dilatations of intrahepatic ducts only
75
Bouveret's Syndrome
subtype of gallstone ileus with gallstone stuck in duodenum = gastric outlet obstruction
76
Rigler triad
pneumobilia, bowel distention, and ectopic gallstones = gallstone ileus
77
causes of pneumobilia
Iatrogenic Trauma Biliary-enteric fistula gas forming infection
78
Periportal edema
``` fluid resuscitation CHF acute hepatitis trauma liver transplant ```
79
Portovenous gas
``` bowel ischemia/obstruction IBD hepatic abscess necrotizing pancreatitis trauma caustic ingestion ```
80
Intrahepatic stones with extensive diease
think recurrent pyogenic cholangitis
81
AIDS cholangiopathy
looks like PSC with papillary stenosis, MCC = cryptosporidium
82
Lobulated mas with dense calcs and spiculated margins tethering the ileal mesentery
Carcinoid tumor or retractile (fibrosing) mesenterities
83
Whipple disease
arthralgias and abdominal ss | nodular bowel wall thickening and low-density adenopathy
84
Pseudomyxoma peritonei
look for scalloping of the liver and spleen | fluid can return as no malignant cells
85
MCC of mortality in VHL
RCC

Radiology Review (9 decks)

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