Radiology Flashcards
What is the best test for gallstones?
ultrasound!!!
If someone has ovarian/pelvic disease, which imaging??
ultrasound!!
What are the valvulae conniventes?
=plicae circularis of small bowel
What are the causes of small bowel obstruction?
mechanical causes: adhesions hernia crohn's (tumour= very rare!!!)
Which imaging can identify the area of bowel affected in crohn’s? /IBD
contrast MRI!
What are the causes of large bowel obstruction?
mechanical:
ulcerative colitis/IBD stricture, diverticular stricture, cancer is much more common than in small bowel!!!!
What is an important differential for bowel obstruction in elderly?
sigmoid volvulus!
coffee bean sign
Differentials for right iliac fossa pain?
appendicitis
IBD
meckel’s diverticulum
What is meckel’s diverticulum?
outpouching of lower part of small intestine- congenital, leftover from umbilical cord
Differentials for acute non MSK back pain?
pancreatitis
aorta
kidneys- renal colic, pyelonephritis
What percentage of people presenting with acute appendicitis will have the classical history and examination?
50%
Differential diagnosis for acute appendicitis in men?
terminal ileitis, mesenteric adenitis, meckel’s diverticulitis
Differential for acute appendicitis in women?
PID, ectopic pregnancy, ruptured ovarian cyst, mittlechsmertz
Which differential must you consider in older patient presenting with acute right iliac fossa pain?
caecal cancer
Do you need to do an ultrasound in both men and women if you suspect appendicitis?
not necessary in men- clinical diagnosis
BUT
in women you must rule out gynae pathology
How does peptic ulcer disease differ in symptoms from gallstone disease?
peptic ulcer- pain during fasting, relieved by eating
gallstone- pain upon eating, less so when fasting
What are the initial investigations for acute upper abdo pain
WCC/CRP Amylase LFTs CXR (diaphragms) USS (gallstones)
Which imaging modality is first-line in acute lower abdo pain/left iliac fossa pain?
CT abdo pelvis
Differentials for generalised peritonitis?
board like rigidity
- perforated appendicitis, diverticular disease, severe pancreatitis
45 year old woman with severe RUQ pain, vomiting. No fever, normal LFTs, inflammatory markers, what is the likely diagnosis?
peptic ulcer disease, biliary pain, IBS, right sided pneumonia, MI?
Biliary pathology/pain
18 year old male with classical signs and symptoms of appendicitis. What test do you perform/request?
laparoscopy
could do CT abdo pelvis for conservative management
What is the rule of 2’s for meckel’s diverticulum?
2% population
2 years old
2 inches long
2 feet proximal to ileocecal valve
