WlwG GIT Flashcards by WlwG W

Oesophageal Narrowing: Multiple ring-like indentations, previous atopy

Eosinophilic oesophagitis

How well did you know this?

Not at all

Perfectly

Oesophageal Narrowing: Web with iron deficiency anaemia, thyroid issues

Plummer-Vinson

How well did you know this?

Not at all

Perfectly

Oesophageal Narrowing: Strictures with numerous outpouchings

Pseudo-diverticulosis

How well did you know this?

Not at all

Perfectly

Oesophageal Narrowing: Increased peristalsis/emptying

Spasm (opposite of achalasia)

How well did you know this?

Not at all

Perfectly

Oesophageal Narrowing: Thickening from radiotherapy/infn/NGT

Oesophagitis

How well did you know this?

Not at all

Perfectly

Oesophageal Narrowing: Upper oesophagitis in immunocompromised

Candidiasis

How well did you know this?

Not at all

Perfectly

Oesophageal Narrowing: Multiple small ulcerations in immunocompromised

Herpes simplex (“H small”)

How well did you know this?

Not at all

Perfectly

Oesophageal Narrowing: Single large ulcer in immunocompromised

HIV/CMV (“H 1”)

How well did you know this?

Not at all

Perfectly

Oesophageal Narrowing: Mid level ulcers

Drug-induced (tablet stuck at extrinsic compressive sites)

How well did you know this?

Not at all

Perfectly

Oesophageal Narrowing: Low ulcers

Caustic oesophagitis

How well did you know this?

Not at all

Perfectly

Oesophageal Narrowing: Low short stricture

Schatzki ring

How well did you know this?

Not at all

Perfectly

Oesophageal Narrowing: Low long stricture

Barretts (reflux oesophagitis)

How well did you know this?

Not at all

Perfectly

Oesophageal Dilations: Upper focal dilation

Oesophageal divert (“Front kill, Phar side, Back to zen” = Front Killian, Pharyngocele side, Back Zenkers)

How well did you know this?

Not at all

Perfectly

Oesophageal Dilations: Whole oesophagus dilated

Scleroderma (“Clear all dilated”)

How well did you know this?

Not at all

Perfectly

Oesophageal Dilations: Beak sign/tapered

Achalasia (Compare pseudoachalasia in GEJ malignancy where the ‘beak’ doesn’t relax)

How well did you know this?

Not at all

Perfectly

Oesophageal Dilations: Beak sign/tapered with mass

GEJ malignancy (pseudoachalasia where the ‘beak’ doesn’t relax)

How well did you know this?

Not at all

Perfectly

Oesophageal Dilations: Achalasia with colon and heart issues

Chagas (“CHA = Colon, Heart, Achalasia”)

How well did you know this?

Not at all

Perfectly

Oesophageal Dilations: DM/Etoh/bulbar palsy

Neuropathic

How well did you know this?

Not at all

Perfectly

Oesophageal Dilations: Lower focal

Hiatus hernia

How well did you know this?

Not at all

Perfectly

Oesophageal Perforations: Pneumomediastinum present, from increased pressure

Boerhaave Syndrome (“Have pneumo”)

How well did you know this?

Not at all

Perfectly

Oesophageal Perforations: No pneumomediastinum, prolonged vomiting

Mallory-Weiss Tear (“Wheres the pneumo”)

How well did you know this?

Not at all

Perfectly

Oesophageal Mass: Low oesophagus with calcs

Leiomyoma

How well did you know this?

Not at all

Perfectly

Oesophageal Mass: Upper-mid oesophagus in smoker/etoh

Squamous cell ca associated with H&N cancer/smoking/alcohol (“Ingested stuff, thus upper. No cell transformation, so squamous”)

How well did you know this?

Not at all

Perfectly

Oesophageal Mass: Low oesophagus mass with Barretts/Reflux

AdenoCa (“Reflux, thus lower due to cell transformation, so adenoCa”).

How well did you know this?

Not at all

Perfectly

Stomach Ulcers: Top/Fundus with large gastric folds

Menetriers ("Men have big folds & on top")

Stomach Ulcers: Side/Greater curvature

Nsaid/Aspirin peptic ulcer disease ("Tablet rests on greater curvature")

Stomach Ulcers: Diffuse including base/antrum

H. Pylori ("Infection, thus diffuse")

Stomach Ulcers: Also involves proximal small bowel with gastrinoma

Zollinger-Ellison

Stomach Ulcers: Also involves small +/- large bowel

Crohns

Stomach Masses: Grows inwards and obstructs/ulcerates

AdenoCa

Stomach Masses: Grows along pylorus but doesn't obstruct

Lymphoma/MALT

Stomach Masses: Grows outwards of stomach with no LN

GIST, do PET scan as mets to liver/mesentery

Stomach Polyps: Whole GIT involved

FAP

Stomach Polyps: Breast/Thyroid involved

Cowden ("Cow breasts")

Stomach Polyps: Brain involved

Turcot ("Turcot fish brain")

Stomach Polyps: Skin/reproductive organs involved

Peutz-Jeghers

Stomach Polyps: Bone/Connective tissue involved

Gardner ("Garden grass and mushrooms")

Gas in stomach wall from trauma/infection/vomiting

Gastric emphysema

Causes of duodenal fold thickening

H. Pylori, Crohns, Whipple disease, Lymphoma, Pancreatitis

What is Superior Mesenteric Artery Syndrome?

Duodenum compression between aorta and SMA causing obstruction

Small Bowel: Flushing/diarrhoea, local starburst mass

Carcinoid

Small Bowel: Flushing/diarrhoea, diffuse symptoms involving skin/bone

Mastocytosis

Small Bowel: Circumferential focal thickening with obstruction

AdenoCa

Small Bowel: Exophytic tumour

GIST

Small Bowel: Polypoid nodular ileal thickening with LN without obstruction

MALT Lymphoma

Small Bowel: Thickening with diffuse dilated peri-intestinal lymphatics

Lymphangiectasia

Small Bowel: Thickening post marrow transplant

Graft vs Host

Small Bowel: Thickening with many organs involved

Amyloidosis ("All got")

Small Bowel: Obstruction from encasement of small bowel by fibrosis/collagen

Peritoneal sclerosis

Small Bowel: Micro-nodules in jejunum

Whipples

Small Bowel: Distal ileum out-pouchings with obstruction/GI bleed

Meckels

Small Bowel: Dilated jejunum with loss of jejunal folds

Coeliac disease

Small Bowel: Dilation after surgery/IBD

Ileus

Colorectal AdenoCa: Duke stages A - D?

A = limited to bowel wall B = Serosa or mesentery involved C = LN D = distant mets

What scan for Colorectal Ca staging?

MRI T2 NON-contrast. >5cm from anorectal angle = high rectal Ca = Low anterior resection surgery (LAR) <5cm = low recta Ca = AP resection

Signs of Crohns vs UC?

CrohnSSS: Skip lesion, String sign Small bowel, Stricture, Stones, Spondylitis, Sacroilitis, Sizeable LN --> Several mucosa layers involved (Transmural) thus fistulas/abscesses. -->Presents with abdo pain, no bloody diarrhoea. --> Starts at terminal ileum Ulcerative Colitis = Continuous Ulcers in the Colon and “all the -itis”. -->Presents with bloody diarrhoea --> Starts at rectum

Colon Ulcers/Colitis: Involvement of genitals/mouth/eyes/skin

Behcets ("Bae playing GAMES" = Genetals, Aneurysms, Mouth, Eyes, Skin)

Colon Ulcers/Colitis: Bloody diarrhoea

Entamoeba & UC

Colon Ulcers/Colitis: Thumb-printing, antibiotic use

Pseudomembranous colitis

Colon Ulcers/Colitis: Right/Ascending

"Food" = Salmonella/Shigella

Colon Ulcers/Colitis: Left/Descending

"Worms" = Schistosomiasis

Colon Ulcers/Colitis: Rectosigmoid

"Anal" = Gonorrhoea/Herpes/Chlamydia

Colon Ulcers/Colitis: Diffuse

"HIV" = CMV

Colon Ulcers/Colitis: Steroid use, concentric Sigmoid bowel wall thickening

Diverticular disease

Colon Dilations: Sigmoid volvulus vs Caecum volvulus?

Sigmoid (coffee-bean sign, points to RUQ) > caecum (points to LUQ) > transverse colon.

Colon Dilations: Dilation of transverse colon with absence of haustra

Toxic megacolon, due to UC/Crohns

Colon Dilations: Persistently dilated colon without transition point

Pseudo-obstruction/Ogilvie syndrome

Colon Bleeding: Left sided vs right sided causes?

Left = Divert Right = Angiodysplasia

Paeds Upper GIT: Single bubble without distal gas, no vomiting

Gastric atresia

Paeds Upper GIT: Double bubble without distal gas, bilious vomiting

Duodenal atresia

Paeds Upper GIT: Triple bubble without distal gas

Jejunal atresia

Paeds Upper GIT: Liver obstruction (jaundice/hepatomegaly/brown urine)

Biliary atresia

Paeds Upper GIT: Triangular cord at porta hepatis, HIDA normal liver activity but absent bowel activity

Biliary atresia

Paeds Upper GIT: Bubble with distal gas, no vomiting

Gastric volvulus

Paeds Upper GIT: Bubble with distal gas, bilious vomiting

Midgut volvulus

Paeds Upper GIT: Non-bilious vomiting, narrow duodenum

Annular pancreas

Paeds Upper GIT: Non-bilious vomiting, thickening pylorus

Hypertrophic pyloric stenosis

Paeds Upper GIT: NGT stuck in upper oesophagus, gas in GIT

Tracheo-oesophageal fistula type C (Commonest = type C, proximal oesophagus atresia, distal oesophagus fistula. 2nd commonest = type A, both prox and distal oesophagus atresia) Thus usually NGT stuck in midline upper thorax with gas in GIT.

Paeds Upper GIT: NGT stuck in upper oesophagus, no gas in GIT

Oesophageal atresia/TOF type A (compare Tracheo-oesophageal fistula type C with gas in GIT)

Paeds Upper GIT: NGT stuck in lower oesophagus

Gastric volvulus

Paeds Upper GIT: NGT stuck in left lower lung

Diaphragmatic hernia (Anterior morgagni, Back bochdalek)

Paeds Upper GIT: NGT stuck in right lower lung

Misplaced in lung

Paeds Upper GIT: Abdo hernia in middle

OMphalocoele ("Open in the middle")

Paeds Upper GIT: Abdo hernia at para-umbilical

GastRoschisis ("Gas to the Right")

Paeds Lower GIT: Dilated loops in distal ileum

Meconium ileus

Paeds Lower GIT: Dilated loops in ileocolic/right

Intussusception

Paeds Lower GIT: Dilated large bowel in Down's

Hirschsprung

Paeds Lower GIT: Dilated descending colon in DM

Meconium plug

Paeds Lower GIT: Perforation with ascites/fibrosis/peritoneal calcs

Meconium peritonitis

Paeds Lower GIT: Perforations with pneumos in premature (pneumatosis/pneumoperitoneum)

NEC ("Necrotizing, thus NEonate, pNEumatosis, pNEumoperitonium")

Paeds Upper GIT: Swallowing and breathing issues with polyhydramnios

Tracheo-oesophageal fistula (Commonest = type C, proximal oesophagus atresia, distal oesophagus fistula. 2nd commonest = type A, both prox and distal oesophagus atresia) Thus usually NGT stuck in midline upper thorax with gas in GIT.

Paeds GIT: What does VACTERL stand for?

Vertebra/Anal/Cardiac/Trachea/Esophageal fistula/Radius/Renal/Limbs

Difference between right duplication and left duplication, situs and isomerism

Right dupe: 2 fissures per lung, absent spleen Left dupe: 1 fissure per lung, multiple spleens Situs: Left organs are now right, right are now left Isomerism: Only 1 organ is mirror-imaged

Stomach vascular supply: Lesser curvature

Left/right gastric arteries

Stomach vascular supply: Greater curvature

Left gastro-omental (aka gastro-epiploic)

Stomach vascular supply: Antrum

Right gastro-omental (aka gastro-epiploic)

Stomach vascular supply: Superior/fundus

Short gastric branches of splenic artery

Stomach vascular supply: Inferior/pylorus

Gastroduodenal artery (branch of common hepatic artery)

GIT: White plaques in upper-mid oesophagus

Glycogen acanthosis (looks similar to candida but no narrowing)

GIT: Causes of GI fistula

Divert & Crohns