Stomach And Bowel

Question 1

Where do most gastric ulcers develop?

Answer 1

Lesser curvature of the stomach

Question 2

What is Hamptons line?

Answer 2

It’s is the acid resistant mucosa which surrounds the gastric ulcers

Question 3

What is the characteristic histopathology expression of GIST tumours?

Answer 3

C-KIT

Question 4

What cells do GIST tumours arise from ?

Answer 4

Interstitial cells of Cajal - the pacemaker cells that drive peristalsis

Question 5

What is ectopic pancreatic rest ? where are they usually found?

Answer 5

Presence of pancreatic tissue in the submucosal, muscular is or subserosal layers of the luminal GI tract.
Usually found along the greater curvature of the gastric antrum or in the proximal duodenum.

Question 6

What are the main causes of benign gastric masses?

Answer 6

GIST
Lipoma
Ectopic pancreatic rest

Question 7

What is linitis plastica ?

Answer 7

Diffuse submucosal thickening due to infiltrative Adenocarcinoma of the stomach

Question 8

What is a krukenberg tumour?

Answer 8

Metastatic spread of a gastric carcinoma to the ovary - or any mucinous tumour to the ovary

Question 9

What are the most common primary malignancies that metastasise to the stomach?

Answer 9

Breast, Lung, Melanoma

Question 10

What is the triad associated with Gardners syndrome ?

Answer 10

FAP - colonic polpys
Osteomas of the membranous skull. Skull, maxilla, mandible
Soft tissue tumours - desmoid tumours of the mesentary, lipomas, fibromas, keloid scarrings.

Many people have supranumary teeth and dental caries needing early dental work

Question 11

What is an Amyand hernia

Answer 11

An inguinal hernia that contains the appendix

Question 12

What is a litter hernia

Answer 12

A hernia which contains meckles diverticulum

Question 13

What is the relationship of the inferior epigastric vessels and a direct inguinal hernia

Answer 13

In a direct inguinal hernia, the neck of the hernia is medial to the inferior epigastric vessels

Question 14

Who do obturator wall hernias occur in ?

Answer 14

Elderly women due to lax pelvic floor

Question 15

What is a Forman of Winslow hernia

Answer 15

Small bowel contents then go through the former of Winslow into the lesser sac. You can see mesenteary and bowel loops between the IVC and portal vein .

Question 16

Causes of low attenuation mesenteric lymph nodes

Answer 16

TB
Whipples disease
Treated lymphoma
CMLNS - cavitating mesenteric lymph node syndrome secondary to coeliac disease

Question 17

What is scleroderma ?

Answer 17

Collagen deposition within the muscular layers

Question 18

What bacteria/virus most commonly cause right sided colitis

Answer 18

STaY on the right
Salmonella
TB
a
Yersinnea

Question 19

What infections typically cause pancolitis ?

Answer 19

All the C’s
C.diff
CMV
E.Coli

Question 20

What conditions are patients with UC at increased risk of ?

Answer 20

Cholangiocarinoma
Primary Sclerosing Cholangitis
Colon cancer

Question 21

What are the extra-abdominal manifestations of UC ?

Answer 21

PIES
Pyoderma gangrenosum - inflammatory skin disorder
Iritis
Erythema nodosum - painful red dots on legs
Sacroilitis - bilateral and symmetrical

Question 22

What are the most common immune drugs to cause colitis

Answer 22

Ipilimumab and Pembrolizumab

Question 23

What is Typhilitis ?

Answer 23

Intramural bacterial invasion without inflammatory reaction in patients with poor immune systems

Necrotising Colitis - seen in the right/terminal ileum
Occurs in neutropenic patients
Imaging features - cecal thickening, fat stranding, ileus , SBO

Question 24

What is sterocoral colitis

Answer 24

Focal inflammatory colitis caused by lots of poo in the rectum

Question 25

What are the additional findings in ‘Complicated Diverticulitis’

Answer 25

Pericolonic /hepatic abscess Mesenteric venous thrombosis / septic thrombophlebitis Colonic Fistula - seen as gas in the bladder Extraluminal air Bowel obstruction

Question 26

What is Gardner syndrome?

Answer 26

A subtype of FAP, in addition to colonic polyps patients also have : DOPE Gardner Desmoid tumours - growth in the Connective tissue Osteomas - bone growths in the head Papillary thyroid cancer Epidermoid cysts

Question 27

What is Turcot Syndrome

Answer 27

FAP plus CNS tumours - gliomas, medulloblastomas -TURbans go over your head.

Question 28

Which cancers are people with COWDENS syndrome at increased risk of ?

Answer 28

thyroid cancer (follicular) Skin Oral Breast Uterine malignancies

Question 29

What is cronkhite-Canada

Answer 29

Non-inherited disorder, consisting of harmatomatous polyps throughout the GI tract, with Rash, allopecia, watery diarrhoea and weird nails

Question 30

Which ring, when pathological is known as the shatzi-ring?

Answer 30

The SHATZ-B-ring, is the muscosal B ring on barium

Question 31

What is the HU of fresh blood ?

Answer 31

30-45

Question 32

What is the HU of fresh blood ?

Answer 32

30-45

Question 33

What is the HU of clotted blood ?

Answer 33

60-100

Question 34

which part of the bowel is usually affeceted in Toxic megacolon ?

Answer 34

Transverse colon

Question 35

What is Turcot syndrome ?

Answer 35

Autosomal Recessive disease causing polyps in the colon / rectum and brain tumours - usually supratentorial glioblastoma

Question 36

Which organisms commonly affect the right hemicolon in colitis ?

Answer 36

Shigella and salmonella

Question 37

What is Whipples disease?

Answer 37

Tropheryma whipplei infection of the duodenum and jejunum Causes thickened irregular folds and sand like nodules on the fluoroscopy Large retroperioneal lymph nodes - almost fat density

Question 38

What are the causes of increased density of the liver pre contrast ?

Answer 38

Haemochromatosis Iron overload Glycogen storage disease Haemosiderosis

Question 39

Which tropical infection causes a cirrhotic liver with hyperechoic septa and a ‘turtle back appearance ?

Answer 39

Schistosomiasis

Question 40

Which is the most common malignancy to metastasis to the spleen ?

Answer 40

Malignant melanoma

Question 41

What are most gallstones made up of ?

Answer 41

Cholesterol

Question 42

What is the most sensitive way to check for splenosis ?

Answer 42

Nuclear medicine scan - 99mRBC or 99mTc sulphur colloid studies

Question 43

what is a rare complication of salmonella infection ?

Answer 43

acute acalculous choleysystitis

Question 44

what ducts are also at risk of injury during a laparoscopic choleycysteomy ?

Answer 44

ducts of lushka

Question 45

what is a klatskin tumour

Answer 45

a tumour at the hilar of the billary tree may have normal CBD

Question 46

What does candidiasis oesophagus look like ?

Answer 46

Long linear lines affecting the upper 3rd of the oesophagus

Question 47

What does CMV or HIV oesophagitis look like ?

Answer 47

One bit ulcer

Question 48

What does herpes simplex of the oesophagus look like ?

Answer 48

Multiple small ulcers with a small halo of oedema

Question 49

Which is the only oesophageal lesion to calcify ?

Answer 49

Leiomyoma

Question 50

Which nuclear medicine scan is used to detect carcinoid tumours

Answer 50

Octreotide has the highest sensitivity for detecting carcinoid tumours It is taken up by both the primary lesion and any hepatic metastasis

Question 51

What is the most common cause of pancreatic lipomatosis in children ?

Answer 51

Cystic fibrosis

Question 52

What is the only anti mesenteric divericulum of the small bowel?

Answer 52

Meckles diverticulum

Question 53

What is Ménétrier disease ?

Answer 53

Gastric hypertrophy resulting in low protein, chloride and oedema Thickened gastric mucosal folds that look like the brain maybe seen On barium, the excess mucus means that the barium doesn’t over the walls of the stomach well