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Radiology Review > GI trivia > Flashcards

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
Q

coffee bean appearance of colon

A

sigmoid volvulous (look for normal right colon)

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26
Q

Colonic pseudoobstruction (Ogilve Syndrome)

A

Chronic form shows decreased intramural ganglion cells

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27
Q

MCL of epiploic appendagitis

A

sigmoid and descending colon

can see central vessel (thrombosed vein)

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28
Q

Omental infarct

A

MCL anterior transverse colon or anteromedial to ascending colon
no central thrombosed vein

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29
Q

MCL for perforation due to sigmoid colonic neoplasm

A

Cecum (if ileocecal valve is competent)

greater risk if cecum >/= 10 cm

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30
Q

Right sided colon infections

A

salmonella
yersinia
TB
amebiasis

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31
Q

Left sided colon infections

A

Shigella
Lymphogranuloma venereum
Gonorrhea
Schistosomiasis

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32
Q

Diffuse colon infections

A

E. coli

CMV

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33
Q

Amyand Hernia

A

appendicitis in an inguinal hernia

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34
Q

Littre hernia

A

meckels in an inguinal hernia

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35
Q

Richter hernia

A

antimesenteric portion of bowel wall goes through abdominal defect

36
Q

MEN 1

A

PPP
parathyroid
pancreatic NETs
Pituitary adenoma

37
Q

MEN 2a

A

MPP
Medullary thyroid
pheo
parathyroid

38
Q

MEN 2b

A

MNP
Medullary thyroid
neuromas
pheo

39
Q

Insulinoma

A

Whipple triad
hypoglycemia
low glucose that symptoms resolve when corrected

40
Q

Gastrinoma

A

ZE syndrome

41
Q

Glucagonoma

A 
4D Syndrome
Dermatitis
Diabetes
DVT
Depression
42
Q

VIPoma

A

WDHA Syndrome
watery diarrhea
hypokalemia
achlorhydria

43
Q

Somatostatinoma

A 
Inhibitory Syndrome
Diabetes
steatorrhea
diarrhea
cholelithiasis
44
Q

Pancreas is usually T1 bright

A

Pathology typically is T1 hypo

45
Q

Duodenal diverticulum

A

oral contrast and gas with connection to duodenum

Change in size and shape from study to study

46
Q

Serous microcystic cystadenoma (pancreas)

A

numerous small cysts clustered together with multilobulated margins

47
Q

Mucinous cystic neoplasm (pancreas)

A

large encapsulated cyst with thick irregular internal septations and mural
90% in body or tail of pancreas

48
Q

Intraductal papillary mucinous neoplasm (pancreas)

A

lobulated cystic mass communicating with pancreatic duct (either directly or on side branches)
> 3 cm and main ductal dilation and nodularity = bad

49
Q

Complete fatty replacement of the pancreas

A

CF

50
Q

Solid pseudopapillary tumor

A

Cystic mass with solid enhancing parts and hemorrhage in young woman

51
Q

Interstitial edematous pancreatitis

A

< 4 weeks Acute peripancreatic fluid collection

> 4 weeks pancreatic pseudocyst

52
Q

Necrotizing pancreatitis

A

< 4 weeks Acute necrotic collection (parenchymal necrosis alone, peripancreatic necrosis alone, pancreatic and peripancreatic necrosis)
> 4 weeks Walled-off necrosis

53
Q

MC mets to pancreas

A

RCC

usually appears as a hypervascular mass

54
Q

Budd-Chiari on CT

A

heterogeneous liver with macronodular contour
enlargement and increased enhancement of the caudate lobe
hepatic veins not seen (venogram has spider web of collaterals)

55
Q

Biliary cystadenoma

A

encapsulated, multiloculated cystic mass in the liver with enhancing septations (possible nodules)
biliary ductal dilation
+/- calcs

56
Q

More than 10 liver cysts are seen

A

consider fibropolycystic liver disease

57
Q

Von Meyenburg Complex

A

AKA - biliary hamartomas

numerous sub cm T2 hyperintense lesions scattered throughout the liver

58
Q

Signs of cirrhosis

A

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
Q

Primary hemochromatosis

A

pancreas (bronzing DM)

60
Q

Secondary Hemochromatosis

A

spleen

61
Q

THID (MRI) and THAD (CT)

A

wedge-shaped or geographic area of enhancement representing altered perfusion
usually only seen on one phase (MC arterial)

62
Q

Cavernous transformation of the portal vein

A

main portal vein not seen, numerous tortuous collaterals = chronic portal vein occlusion

63
Q

Washout of hepatic lesions

A

have to be hypodense to surrounding liver , NOT isodense

64
Q

MC benign hepatic tumor

A

Hemangioma

65
Q

Timing of arterial phase for hypervascular liver lesions

A

Late arterial phase when there is heterogeneous blush in the main portal vein

66
Q

Hypervascular METs (also most likely to bleed)

A 
"MR CT"
Melanoma
Renal Cell carcinoma
Carcinoid (neuroendocrine tumors)/ Choriocarcinoma
Thyroid Carcinoma
67
Q

Pseudocirrhosis after liver mets treatment

A

MCC breast ca

68
Q

Giant cavnerous hemangioma of the liver assoc with what syndrome

A

Kasabach-Merritt syndrome

thrombocytopenia = sequestration/destruction of platelets

69
Q

Peliosis hepatis

A

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
Q

Type I Choledolchal cyst

A

single fusiform of part or entire extrahepatic duct

71
Q

Type II Choledolchal cyst

A

true diverticulum with narrow stalk from extrahepatic duct

72
Q

Type III Choledolchal cyst

A

Dilation of the extrahepatic bile duct within duodenal wall

73
Q

Type IV choledochal cyst

A

IVa - both intra and extra hepatic cysts

IVb - multiple dilatations of extrahepatic ducts only

74
Q

Type V Caroli disease

A

multiple dilatations of intrahepatic ducts only

75
Q

Bouveret’s Syndrome

A

subtype of gallstone ileus with gallstone stuck in duodenum = gastric outlet obstruction

76
Q

Rigler triad

A

pneumobilia, bowel distention, and ectopic gallstones = gallstone ileus

77
Q

causes of pneumobilia

A

Iatrogenic
Trauma
Biliary-enteric fistula
gas forming infection

78
Q

Periportal edema

A 
fluid resuscitation
CHF
acute hepatitis
trauma
liver transplant
79
Q

Portovenous gas

A 
bowel ischemia/obstruction
IBD
hepatic abscess
necrotizing pancreatitis
trauma
caustic ingestion
80
Q

Intrahepatic stones with extensive diease

A

think recurrent pyogenic cholangitis

81
Q

AIDS cholangiopathy

A

looks like PSC with papillary stenosis, MCC = cryptosporidium

82
Q

Lobulated mas with dense calcs and spiculated margins tethering the ileal mesentery

A

Carcinoid tumor or retractile (fibrosing) mesenterities

83
Q

Whipple disease

A

arthralgias and abdominal ss

nodular bowel wall thickening and low-density adenopathy

84
Q

Pseudomyxoma peritonei

A

look for scalloping of the liver and spleen

fluid can return as no malignant cells

85
Q

MCC of mortality in VHL

A

RCC

Radiology Review (9 decks)

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