Radiology

Question 1

What is the best test for gallstones?

Answer 1

ultrasound!!!

Question 2

If someone has ovarian/pelvic disease, which imaging??

Answer 2

ultrasound!!

Question 3

What are the valvulae conniventes?

Answer 3

=plicae circularis of small bowel

Question 4

What are the causes of small bowel obstruction?

Answer 4

mechanical causes:
adhesions
hernia
crohn's
(tumour= very rare!!!)

Question 5

Which imaging can identify the area of bowel affected in crohn’s? /IBD

Answer 5

contrast MRI!

Question 6

What are the causes of large bowel obstruction?

Answer 6

mechanical:

ulcerative colitis/IBD stricture, diverticular stricture, cancer is much more common than in small bowel!!!!

Question 7

What is an important differential for bowel obstruction in elderly?

Answer 7

sigmoid volvulus!

coffee bean sign

Question 8

Differentials for right iliac fossa pain?

Answer 8

appendicitis
IBD
meckel’s diverticulum

Question 9

What is meckel’s diverticulum?

Answer 9

outpouching of lower part of small intestine- congenital, leftover from umbilical cord

Question 10

Differentials for acute non MSK back pain?

Answer 10

pancreatitis
aorta
kidneys- renal colic, pyelonephritis

Question 11

What percentage of people presenting with acute appendicitis will have the classical history and examination?

Answer 11

50%

Question 12

Differential diagnosis for acute appendicitis in men?

Answer 12

terminal ileitis, mesenteric adenitis, meckel’s diverticulitis

Question 13

Differential for acute appendicitis in women?

Answer 13

PID, ectopic pregnancy, ruptured ovarian cyst, mittlechsmertz

Question 14

Which differential must you consider in older patient presenting with acute right iliac fossa pain?

Answer 14

caecal cancer

Question 15

Do you need to do an ultrasound in both men and women if you suspect appendicitis?

Answer 15

not necessary in men- clinical diagnosis
BUT
in women you must rule out gynae pathology

Question 16

How does peptic ulcer disease differ in symptoms from gallstone disease?

Answer 16

peptic ulcer- pain during fasting, relieved by eating

gallstone- pain upon eating, less so when fasting

Question 17

What are the initial investigations for acute upper abdo pain

Answer 17

WCC/CRP
Amylase
LFTs
CXR (diaphragms)
USS (gallstones)

Question 18

Which imaging modality is first-line in acute lower abdo pain/left iliac fossa pain?

Answer 18

CT abdo pelvis

Question 19

Differentials for generalised peritonitis?

Answer 19

board like rigidity

- perforated appendicitis, diverticular disease, severe pancreatitis

Question 20

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?

Answer 20

Biliary pathology/pain

Question 21

18 year old male with classical signs and symptoms of appendicitis. What test do you perform/request?

Answer 21

laparoscopy

could do CT abdo pelvis for conservative management

Question 22

What is the rule of 2’s for meckel’s diverticulum?

Answer 22

2% population
2 years old
2 inches long
2 feet proximal to ileocecal valve