GI3

Question 1

Cholelithiasis

Answer 1

Gallstones

Question 2

What are radiolucent stones made of

Answer 2

cholesterol

Question 3

what are radioopaque stones made of

Answer 3

calcium

Question 4

Acute Cholecystitis

Answer 4

Inflammation of the gallbladder

Question 5

When does cholecystitis usually occur

Answer 5

after an impacted gallstone obstructs the cystic duct

Question 6

Emphysematous cholecystitis

Answer 6

when gallstones injure mucosal wall and bacteria enters… creating an acute infection of gallbladder wall by gas forming organisms

Question 7

Does emphysematous cholecystitis require surgery

Answer 7

yes it is a surgical emergency

Question 8

Choledocholithiasis

Answer 8

Presence of at least one gallstone within common bile duct

Question 9

Cholangitis

Answer 9

Inflammation of entire bile duct system

Question 10

List in order of most to least severe:
Cholecystitis
Cholangitis
Cholelithiasis
Choledocolthiasis

Answer 10

Least
1)Cholelithiasis
2)Cholecystitis
3)Choledocholithiasis
4)Cholangitis
Most

Question 11

Hepatitis

Answer 11

Inflammation of the liver

Question 12

What is hepatitis usually from

Answer 12

viral infection

Question 13

What types of hepatitis is from fecal-oral route

Answer 13

Hep A (HAV) and Hep E (HEV)

Question 14

What type of hepatitis is contracted from exposure to contaminated blood or sexual contact

Answer 14

Hep B (HBV)

Question 15

What type of hepatitis is the common cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Contracted via blood transfusion or through sexual contact

Answer 15

Hep C (HCV)

Question 16

Is early hepatitis seen on imaging

Answer 16

no

Question 17

What may an enlarged liver be indicative of on images

Answer 17

advancing hepatitis

Question 18

What complications of Hepatitis show up on imaging

Answer 18

Cirrhosis and hepatocellular carcinoma/liver cancer show up on US, CT, MRI

Question 19

What condition is Cirrhosis indicative of

Answer 19

End stage liver disease

Question 20

What is a major cause of liver cirrhosis

Answer 20

Chronic alcoholism (10-20yrs+)
OR viral hepatitis

Question 21

What type of tissue will cirrhosis have

Answer 21

Scar tissue

Question 22

What causes edema of lower limbs when in conjunction with cirrhosis

Answer 22

Decreased albumin production which causes fluid to leak out of circulation

Question 23

What condition can cirrhosis cause dues to increased venous pressure

Answer 23

Ascites

Question 24

Portal vein obstruction in cirrhosis can lead to what

Answer 24

Collateral circulation

Question 25

What common indication of cirrhosis is from destruction of liver cells and blockage of bile ducts

Answer 25

Jaundice

Question 26

How may cirrhosis appear radiographically

Answer 26

Fatty liver, portal veins may stand out more, enlarged spleen

Question 27

Ascites

Answer 27

Accumulation of fluid in peritoneal cavity

Question 28

Along abdominal distention, what other symptoms may ascites produce

Answer 28

Tight hard abdomen

Question 29

What may you need to change about technical factors in a patient with ascites

Answer 29

Increase technical factors to penetrate through the fluid

Question 30

How may ascites look on images

Answer 30

Haziness/graying, fluid will pool as gravity moves, "dog ear" on supine images as fluid collects on both sides of bladder

Question 31

Hepatocellular carcinoma

Answer 31

Liver cancer

Question 32

How does hepatocellular carcinoma appear on images

Answer 32

Large mass on CT, with contrast it may be dense or diffuse enhancment (usually non uniform)

Question 33

Hemangioma

Answer 33

Benign Vascular tumor

Question 34

Are Liver Hemangiomas usually symptomatic

Answer 34

no

Question 35

What makes a liver hemangioma "giant"

Answer 35

being 10cm or greater in size

Question 36

What can Liver hemangiomas cause symptomatically

Answer 36

Edema and jaundice

Question 37

How may liver hemangiomas appear on images

Answer 37

As hypodense lesions on unenhanced images, may also have persistent enhancement on delayed phase

Question 38

Pancreatitis

Answer 38

Inflammation of the pancreas

Question 39

What makes it ACUTE pancreatitis

Answer 39

When enzymes within the pancreas begin to digest the organ itself

Question 40

What is a common resultant of chronic pancreatitis to the tissue

Answer 40

Scar tissue

Question 41

In chronic pancreatitis what is the consequence to its enzymes

Answer 41

It cannot produce the digestive enzymes insulin and glucagon

Question 42

What may appear on an image of acute pancreatitis

Answer 42

Sentinel loop of bowel from an adynamic ileus...but mostly non specific on plain xray ON CT may have enlarged pancreas and obscured peripancreatic soft tissue

Question 43

What may appear on an image of acute pancreatitis

Answer 43

Calcification of the pancreas

Question 44

What is the most common type of pancreatic carcinoma

Answer 44

adenocarcinoma (or cancer that starts in the glands)

Question 45

How may the pancreas' shape alter when there is cancer

Answer 45

the head may enlarge, the bile duct may be blocked, and there may be jaundice

Question 46

What is the most effective modality to diagnose pancreatic carcinoma

Answer 46

CT

Question 47

What will a BE study show for pancreatic carcinoma

Answer 47

Distortion of mucosal pattern and duodenal configuration

Question 48

What type of disorder is diabetes mellitus

Answer 48

an endocrine disorder

Question 49

What is diabetes mellitus

Answer 49

When the pancreas fails to secrete insulin/when target cells fail to respond to the hormone

Question 50

What can diabetes mellitus lead to

Answer 50

hyperglycemia since the glucose is staying in the blood. Also acidosis and dehydration

Question 51

Symptoms of diabetes mellitus

Answer 51

polyuria, polydipsia, glycosuria

Question 52

What can diabetes mellitus lead to (think about the feet)

Answer 52

Peripheral vessel calcification, severe osteomyelitis, neuropathic joints, gas gangrene, ischemic gangrene

Question 53

Hypoglycemia

Answer 53

Low blood sugar

Question 54

Symptoms of hypoglycemia

Answer 54

lightheaded/faint, shaky, sweaty

Question 55

Should you give insulin to someone with hypoglycemia?

Answer 55

No, give them sugar

Question 56

Pneumoperitoneum

Answer 56

Free air in the peritoneal cavity

Question 57

What is often the cause of pneumoperitoneum

Answer 57

A perforation of the GI tract (like from a peptic ulcer)

Question 58

Does pneumoperitoneum resolve on its own?

Answer 58

No, it is a surgical emergency

Question 59

Can you image pneumoperitoneum in a supine position

Answer 59

No, upright or decubitus is needed

Question 60

How long do you let a patient sit when evaluating for pneumoperitoneum

Answer 60

10min (though in practice often only 5)

Question 61

How may air appear radiographically in pneumoperitoneum

Answer 61

air under diaphragm may appear as a sickle shaped lucency