GIT II (stomach)

Question 1

Clinical signs and symptoms that may come to patients with stomach and duodenal problems

Answer 1

Epigastric pain
Vomiting
Hematemesis

Question 2

Some conditions for doing barium study

Answer 2

Fasting patient for at least 6 hours
IV injection of a short acting smooth muscle relaxant

Question 3

Causes of filling defect in the stomach

Answer 3

Carcinoma
Leiomyoma
Polyps
Intraluminal defects

Question 4

Radiology pattern of carcinoma of stomach

Answer 4

Irregular filling defect with alternation of mucosal pettern

Question 5

Radiological description of leiomyoma of stomach

Answer 5

Smooth, round filling defect arising from the wall of the stomach
May has an ulcer on its surface

Question 6

Causes of intraluminal defects in stomach

Answer 6

Food or blood
Hair forming ball or bezoar

Question 7

Filling defects of the gastric polyps

Answer 7

Single or multiple
Sessile or have a stalk

Question 8

Investigation of choice to visualize mucosal disease

Answer 8

Endoscopic ultrasonography

Question 9

Investigation of choice to visualize mucosal disease

Answer 9

Endoscopic ultrasonography

Question 10

Uses of endoscopy with combination of high-frequency US

Answer 10

Visualization of the bowel wall with high spatial resolution
Perform targeted endoscopic biopsy

Question 11

Uses of CT with oral contrast in stomach

Answer 11

Dx and staging of tumors of the stomach and duodenum

Multidetector CT : multiplanar reconstrictions allowing early detection of various disease, (subtle mural abnormalities)

Question 12

Features of congenital hypertrophic pyloric stenosis

Answer 12

Age : usually at 2-8 weeks
Non-bilious projectile vomiting
Palpable olive-shaped mass
Positive family hx
Visible peristalsis
Nasogastric aspirate > 10ml

Question 13

Radiological findings of pyloric stenosis

Answer 13

(measurements)
Pyloric muslce wall thickness > 3mm
Pyloric transverse diameter > 14 mm with pyloric channel closed
Elongated pyloric canal > 17 mm in length
(special signs)
Cervix sign
Antral nippel sign
Target sign
(real time)
Exaggerated peristalsis waves

Question 14

What are the three uss signs of pyloric stenosis

Answer 14

Target sign :transverse uss
Cervix sign: longitudinal
Antral nipple sign : longitudinal

Question 15

Signs of pyloric stenosis on barium meal study

Answer 15

Mushroom sign
Shoulder sign
String sign
Mucosal nipple sign

Question 16

Duodenal atresia

Answer 16

Atresia usually just **distal to ampulla of vater

Main C/F Bilious vomiting in first several hours

Question 17

Prenatal ultrasounds in case of duodenal atresia

Answer 17

Double bubble sign

Question 18

Plain abdominal x-ray in case of duodenal atresia

Answer 18

Larger bubble is air in dilated stomach
Smaller bubblenis air in a dilated duodenum

There is usullay little or no air in the bowel distal to the obstruction

Question 19

Do we need a contrast study to dx duodenal atresia?

Answer 19

No

Question 20

Malrotation with a midgut volvulus

Answer 20

Torsion of entire gut around superior mesenteric artery (SMA) due to a short mesenteric attachment of small intestine

Question 21

Malrotation and midgut vovulus usually occurs which age:

Answer 21

Neonate or young infant

occasionally older child and adult

Question 22

Clinical signs and symptoms of midgut volvulus

Answer 22

Projectile bile-stained vomiting
Intermittent, postprandial abdominal distension
Intermittent obstructive symptoms in older child, recurring attacks of nausea, vomiting, abdominal pain
Failure to thrive

Question 23

Radiological findings in case of midgut volvulus

Answer 23

Plain X-ray: double bubble sign
Barium meal: corkscrew sign (spiral appearance of the distal duodenum and proximal jejunum)

Question 24

Uss midgut volvulus

Answer 24

Whirlpool sign: swirling of the bowel and mesenteric vein around the superior mesenteric artery (SMA)

Question 25

Hiatus hernia

Answer 25

results from the extension of the the stomach into the chest throughout the wide esophagus hiatus

Question 26

some features of hiatus hernia

Answer 26

Acquired
often associated with obesity or pregnancy
frequently are asymptomatic and incidental findings on chest radiographs and CT
usually associated with gastroesophageal reflux

Question 27

examination of choice to hiatus hernia

Answer 27

barium swallow

Question 28

common types of hiatus hernia

Answer 28

sliding : GE junction and gastric cardia
paraesophageal (rolling) hernia: fundus +/- other parts of the stomach

Question 29

how to describe hiatus hernia on CXR

Answer 29

round retrocardiac masses, usually containing air or an air-fluid level

Question 30

CT scan chest for hiatus hernia

Answer 30

Extension of a portion of the proximal stomach into the lower mediastinum

Question 31

diagnosis of hiatus hernia is confirmed by:

Answer 31

barium swallow or CT

Question 32

types of peptic ulcer

Answer 32

gastric ulcer : are open sores on the lining of the stomach
duodenal ulcers: occur in part of the intestine just beyond the stomach

Question 33

common symptoms of peptic ulcer

Answer 33

ingestion
heartburn
nausea

Question 34

gastric ulcer caused by:

Answer 34

an infection with Helicobacter pylori (H. pylori) bacteria
taking NSAIDs

Question 35

complications of peptic ulcer
hint : POB

Answer 35

perforation
gastric obstruction
bleeding

Question 36

90-95% of gastric ulcers are located on:

Answer 36

lesser curvature and posterior stomach wall in the gastric body and antrum

uncommonly seen on the greater curvature