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Abdo > Practise viva > Flashcards

Practise viva Flashcards

1
Q

Budd-Chairi

A 
Nodular liver contour
Idiopathic, congenital (venous web), thrombosis (pregnant, OC, polycythaemia, antiphospholipid, sickle cell disease, other)
Phlebitis - BMT, chemo
Autoimmune
Tumour invasion - RCC, HCC, adrenal Ca
Leiomyosarc of IVC
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2
Q

Calcific mets

A 
BOTOM
Breast
Osteosarc
Papillary thyroid
Ovary
Mucinous adenocarcinoma (esp colorectal)
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3
Q

Random points

A

Second unrelated sign
Common condition on uncommon exam
Talk about findings being persistent or not with fluoroscopy

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4
Q

Random cases

A

Aspiration on barium swallow

Double cystic duct and other anatomical variants

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5
Q

Renal scarring

A

Reflux nephropathy
Infarct
Chronic infection

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6
Q

Sigmoid volvulus

A

Large bowel obstruction
Ahaustral wall, lower end points to pelvis
More common in elderly - associated with chronic neuro conditions, meds for psych conditions, Chagas, chronic laxatives or constipation, fibre rich diet
Rectal tube insertion succesful in treating 90%

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7
Q

Caecal volvulus

A

Younger patients than sigmoid

Laparotomy for reduction, may need caecoplexy, or hemicolectomy if ischaemic

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8
Q

Emphysematous pyelonephritis

A 
Diabetes
E coli, klebsiella, proteus.
Retroperitoneal air or air over renal shadow
High mortality
Drain collections and IV antibiotics
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9
Q

Emphysematous cholecystitis

A

Diabetes
More common in men
50% acalculous
High rate of perforation

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10
Q

Biliary gas v portal venous gas

A

Biliary central, portal venous peripheral

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11
Q

Small bowel obstruction radiograph

A

Herniae
Appendicoliths
Gallstones

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12
Q

Staghorn calculi

A

Struvite stone
Setting of recurrent infection with urease producing organisms
Proteus, klebsiella, pseudomonas, enterobacter
More common in women, cord injury, renal tract anamoly, reflux
May progress to xanthogranulomatous pyelonephritis

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13
Q

Xanthogranulomatous pyelonephritis

A

Associated with staghorn calculi
Chronic granulomatous pyelonephritis
E coli, proteus
Surgical nephrectomy

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14
Q

Sclerosing encapsulating peritonitis

A

Rare benign cause of acute or subacute bowel obstruction
Total or partial encasement of small bowel by thick fibrocollagenous membrane
Idiopathic or secondary to peritoneal dialysis, shunts e.g. VP
And rarely other causes e.g. TB, sarcoid
Wall may calcify

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15
Q

Relative washout

A

PV - delayed / PV

>40% suggests adenoma

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16
Q

Absolute washout

A

PV - delayed / PV - unenhanced

>60% suggests adenoma

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17
Q

Abdominal calcification

A

Don’t forger aneurysm as possible cause

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18
Q

Hypervascular liver mets

A

Renal, thyroid, breast, lung, melanoma, carcinoid, chodiocarcinoma, other

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19
Q

Central scar

A

FNH, large haemangioma, fibrolamellar HCC

May also be seen in normal HCC, some mets, cholangiocarc

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20
Q

Hypervascular liver lesion

A

HCC, haemangioma, FNH, adenoma, mets

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21
Q

FNH

A 
T2 hyperintense scar
Delayed enhancement of central scar
Takes up hepatobiliary contrast agent - iso cf adenoma hypo
Spoke wheel on doppler, DSA
Usually soitary, subcapsular mass
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22
Q

Fibrolamellar HCC

A

May resemble FNH
Will not take up sulphur colloid (Kuppfer cells)
Young adults without cirrhosis
FNH has T2 scar and has less calcs and is less heterogeneous
Better prognosis - 60% 5yr

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23
Q

Washout of hypervascular liver lesion

A

Malignancy until proven otherwise

24
Q

Pancreatic trauma

A

Treat duct injuries with stenting
Complications of pseudocyst, pancreatitis
Duct injury makes grade 3 AAST or above
MRCP can image the duct

25
Q

Horseshoe kidney associations

A

Turners, and trisomies (esp 18)
VACTERL

PUJ obstruction
Susceptibility to trauma
Calculi
Wilms, TCC, renal carcinoid
Infection
Renovascular hypertension
26
Q

Bilateral renal fossa clips and calcification in pelvis

A

Bilateral ureteronephrectomy and failed trasplant kidney

27
Q

Small bowel ischaemia

A

With embolus in SMA ileocolic

28
Q

Retroperitoneal tumour

A

Outside major organs
90% sarcomas
40-50
Extragonadal GCT, and primary retroperitoneal adeno much rarer
Liposarc, PUS, leiomyosarc, rhabdoymyosarc
Radiotherapy increases risk (e.g. to neuroblastoma as a child)

29
Q

AMLs and TS

A

Previous plain film with nephrectomy one side, embolisation coils the other
Multiple commonly with TS
TS get RCC at same rate as general population but at a younger age. Also associated with renal cysts
Can have retroperitoneal LAM

30
Q

Testicular epidermoid

A 
Also known as keratocyst
Benign, germ cell origin
Most common benign testicular neoplasm
Painless
Keratinous debris lined by squamous epithelium, layers
Non-vascular, onion skin appearance
Treatment controversial
31
Q

Bile duct injury in hepatic trauma

A

May lead to bile peritonitis or biloma

32
Q

Retroperitoneal colletion, large bowel obstruction, bone and lung mets

A

Colon ca

33
Q

Colon ca location

A

Recotsigmoid - 55%
Caecum and ascendeing - 20%
Transverse - 10%
Descending - 5%

34
Q

Small bowel dilatations and strictures with intervening normal bowel

A

Crohns

35
Q

Haemoperitoneum

A

Layering dense fluid

Cause may be hepatic mass e.g. adenoma (usually surgically removed to take away risk and confirm diagnsis)

36
Q

FMD

A

Renal arteries most common, then carotids
Can affect mesenterics and coeliacs
Saw viva case with occluded SMA with supply by marginal artery of Drummond or arc of Riolan

37
Q

SMA IMA anastomoses

A

Marginal artery of Drummond, arc or Riolan

38
Q

Retrocaval ureter

A

On right
May have obstruction or infection secondary to stasis
Saw viva case with stone posterior to IVC

39
Q

Spina bifida

A

May lead to neurogenic bladder

Therefor increased risk of stones (may see both on same plain radiograph)

40
Q

Malignant v benign gastric ulcer - barium

A

Benign: exoluminal, smooth folds to edge, Hamptons line (radiolucent normal mucosa at neck)
Malignant: endoluminal, nodular folds don’t reach edge,, Carman meniscus sign - inner margin convex towards gastric lumen, “Heaped edged”

41
Q

Herniae causing small bowel obstruction

A

CT and x-ray appearance

42
Q

Splenic cysts

A 
Epidermoid cyst (most common)
Haemangioma (second most common)
Lymphangioma
Cystic mets
Hydatic cyst
Bacterial abscess
Pancreatic pseudocyst
43
Q

Fat containing liver lesion

A 
If Cirrhosis, most likely HCC
Other differentials:
Focal fat
Adenoma
Lipoma
Hepatic AML and other rarer causes
44
Q

Liver trauma grading

A

.

45
Q

Renal trauma grading

A

.

46
Q

Splenic trauma grading

A

.

47
Q

Pancreatic trauma grading

A

.

48
Q

Hyperechoic liver met

A

CRC
RCC
Neuroendocrine (pancreatic or carcinoid)
Choriocarcinoma

49
Q

Hypoechoic liver met

A 
Most common (65%)
Lung
Breast
Pancreatic
Lymphoma
50
Q

ADPKD

A 
Associated with:
Berry anuerysms
HTN
Liver cysts
Multiple biliary hamartomas
Bicuspid aortic valve 
Aortic dissection
Intracranial dolichoectasia
Cr 16 or 4
51
Q

Striated nephrogram

A

Ureteric obstruction
Pyelonephritis
Renal vein thrombosis
ATN (bilateral)

52
Q

Renal vein thrombosis

A

.

53
Q

Cortical nephrocalcinosis

A

.

54
Q

Medullary nephrocalcinosis

A

.

55
Q

Renal papillary necrosis

A

.

56
Q

Polycystic kidneys

A

On plain film, may see fairly diffuse abdominal calcs (in calcified cysts), and masses displacing bowel

57
Q

Linitis plastica

A

Distorted folds or thickened or nodular, and indistensible stomach
Most commonly scirrhous adeno
Also mets (breast, lung), or lymphoma
Infiltrative diseases (/ granulomatous e.g. Crohn’s, TB, sarcoid) or scarring (e.g. caustic) also in diffential

Abdo (7 decks)

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