VIQ - GIT - Warm Up

Question 1

@# Regarding hepatocellular carcinoma: (T/F)

a) It is the commonest primary visceral malignancy in the world

b) Haemochromatosis is a recognized cause

c) Elevated alpha-fetoprotein is found in 50-60% of cases

d) Has a higher incidence in macronodular than micronodular cirrhosis

e) On MR, hepatoma has a well defined, hypointense capsule on T1 weighted images

Answer 1

a) True

b) True - other causes are cirrhosis, hepatitis, alpha-1 antitrypsin deficiency, Wilson’s disease, aflatoxin, thorotrast

c) False-90%

d) True

e) False - increased signal intensity on a T2 weighted image. Peripheral gadolinium enhancement is seen in about 20%

Question 2

@# 3. The following are true of positron emission tomography (PET): (T/F)

a) Noise is higher than in single-photon emission computed tomography

b) Detectors are made of bismuth germinate

c) Resolution is better than in SPECT

d) The effective dose is much higher than in routine gamma imaging

e) It is reliant on the release of gamma rays

Answer 2

3.

a) False - lower

b) True

c) True

d) False

e) False-positive beta particle emission

Question 3

@# 5. The following statements regarding pancreatic carcinoma are true: (T/F)

a) 60-70% of pancreatic carcinomas arise in the tail

b) They are usually hypovascular

c) Calcification is common

d) Contiguous organ invasion is rare

e) On ultrasound appears as a hyperechoic pancreatic mass

Answer 3

5.
a) False - 60-70% in the head, 30% body and 10% in the tail

b) True

c) False - about 2%

d) False - 40% invade oesophagus, stomach, duodenum

e) False - hypoechoic

Question 4

@# 10. The following are features of extrahepatic cholangiocarcinoma: (T/F)

a) It accounts for 10-15% of all cholangiocarcinomas

b) Is most commonly identified in children under 6 years old

c) Inflammatory bowel disease increases the risk by 2 times

d) Most commonly found in the cystic duct

e) Hypovascular on angiography

Answer 4

10.

a) False - extrahepatic is commoner accounting for 90%

b) False - 50-60-year-olds

c) False - 10 times increased risk. Other predisposing factors include sclerosing cholangitis, Caroli’s disease, thorotrast exposure, alpha-1 antitrypsin deficiency and autosomal
dominant polycystic kidney disease

d) False - most commonly involves the common bile duct

e) False - hypervascular tumour

Question 5

@# 11. Features of the MEN II syndrome (Sipple’s syndrome) include: (T/F)

a) Insulinoma

b) Phaeochromocytoma

c) Hyperparathyroidism

d) Medullary carcinoma of the thyroid

e) Pituitary adenoma

Answer 5

11.

a) False

b) True

c) True

d) True

e) False

Question 6

@# 30. Causes of small bowel strictures include: (T/F)

a) Amyloidosis

b) Potassium chloride tablets

c) Mastocytosis

d) Radiation enteritis

e) Endometriosis

Answer 6

30.

a) False

b) True

c) False

d) True

e) True

Question 7

@# 40. Imaging features of intussusception on plain radiograph can include: (T/F)

a) No abnormality

b) Increased gas in the stomach

c) Loss of the inferior hepatic margin

d) Small bowel obstruction in 50-60%

e) ‘Pseudokidney’ appearance

Answer 7

40.

a) True

b) False - gas-free abdomen due to excess vomiting

c) True

d) False-seen in 25%

e) False - ultrasound sign

Question 8

@# 47. The following statements regarding large bowel obstruction are true: (T/F)

a) Nodal non-Hodgkin’s lymphoma is a cause

b) Peritoneal carcinomatosis is a recognized cause and is most commonly secondary to uterine cancer

c) Lipoma is a recognized cause

d) Volvulus is commoner in the large bowel than the small bowel

e) Gallstones may cause large bowel obstruction

Answer 8

47.

a) True - nodes in the mesentery cause extrinsic compression

b) False- ovarian cancer

c) True - rare

d) True

e) True - usually small bowel but can cause complete block of a pathologically narrowed segment in the colon