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141 Cards in this Set
- Front
- Back
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Ringed esophagus
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Eosinophilic esophagitis
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MC location GI duplication cyst
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#1 ileum, #2 esophagus (posterior mediastinum mass with fluid density)
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Barrett esophagus patterns
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reticulated mucosal pattern, hiatal hernia + high stricture
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Location of menetrier’s
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Fundus
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Locatin of Crohns in stomach
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Antrum
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Polyposis: skin, hair, nails involved
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Cronkite Canada
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Polyposis: gliomas/medulloblastoma
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Turcot
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Polyposis: Desmoids, osteoma
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Gardner
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Polyposis: mucocutaneous pigmentation, pancreatic/Gyn cancer
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Peutz Jeghers
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Polyposis: breast and thyroid cancer
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Cowden (milking the thyroid cow)
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Carney triad
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Extra-adrenal pheo, GIST, pulmonary chondroma/hamartoma
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Most common GI location for sarcoid
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Stomach
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Direct inguinal hernia
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less common, medial to inf epigastric, Hesselbeck triangle, not covered by fascia
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Indirect inguinal hernia
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more common, lateral to inf epigastric, covered by fascia
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Femoral hernia
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Medial to femoral vein, posterior to ing ligament
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Obturator hernia
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More superficial than femoral
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Spigelian hernia
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Lateral abdominal wall, risk of SBO
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Littre hernia
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Hernia wtih Meckel in it
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Amyand hernia
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A = appendix
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Richter hernia
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Only one wall of the bowel is invovled
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GIST - nodes?
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No nodes
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Crohns - nodes?
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Yes, enlarged
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UC - nodes?
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No LAD
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Crohns - which fat increased?
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Mesenteric
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UC - which fat increased?
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Perirectal
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Volvulus - Anterior folding of cecum
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Bascule, no twisting
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Volvulus - 20-40yo, long mesentery, LUQ
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Cecal, much less common than sigmoid
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Volvulus - Elderly, chronic constipation, RUQ
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Sigmoid
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Behcets in GI tract
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Ileocecal ulcers, ulcer of penis and mouth, pulmonary artery aneurysms
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Coned cecum with sparing of terminal ileum
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Entamoeba histolytica, risk of toxic megacolon
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Coned cecum with large IC valve and narrow TI
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TB
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Accordion sign
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C.diff. Also has thumb printing
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McKittrick Wheelock syndrome
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Villous adenoma secretes mucin = diarrhea
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Critical stage for rectal adenoCa
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T3 = tumor breaks out of rectum into perirectal fat = chemo/radiation prior to surgery
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Most common biliary variant
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R posterior branch goes into L hepatic duct
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Mickey mouse sign
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L ear = bile duct, R ear = hepatic artery, Head = PV
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Buzzword: Starry sky
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Viral hep
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Buzzword: double target
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pyogenic abscess
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Buzzword: bulls eye
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candida
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Buzzword: extrahepatic extension
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amoebic abscess
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Buzzword: water lily
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hydatid disease
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Buzzword: tortoise shell
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schistosomiasis = risk of SCC
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FNH vs Fibrolamellar (both have scar)
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FNH: T2 bright, sulfur colloid avid. FLHCC: T2 dark, gallium avid.
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Gallium hot in liver
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HCC, Fibrolamellar HCC, abscess
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Xenon hot in liver
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Abscess
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RBC scan hot in liver
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Hemangioma
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Sulfur colloid hot in liver
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The actual liver, FNH
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Primary vs secondary hemochromatosis
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Primary = Pancreas also involved. Secondary = spleen
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Giant caudate lobe ddx
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Budd Chiari, PSC, PBC
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Transplanted liver with destroyed bile ducts
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Hepatic artery failure (supplies biliary tree)
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PSC cancer risk
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Cholangiocarcinoma
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PSC associations
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S = s*hit = UC (80%) or Crohns. Cholangiocarcinoma. Cirrhosis. Strictures + dilations
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AID cholangiopathy association
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Papillary stenosis + looks like PSC (beaded)
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PBC assocations
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B = bitches = women (autoimmune, AMA), risk of HCC
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PBC cancer risk
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HCC
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Caroli associations
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PCKD, medullary sponge kidney
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Caroli types
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1 dilation, 2 diverticulum, 3 choledochocele of ampulla, 4 intra+extra, 5 caroli
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Portal vein pulsatility ddx
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right CHF, tricuspid regurg, cirrhosis
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Portal vein reversed flow ddx
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portal HTN
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Ideal doppler angle
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Less than 60
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Schwachman-Diamond
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Fatty hypertrophy of pancreas, diarrhea, chondroplasia, eczema
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Dorsal pancreatic agenesis
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risk of diabetes, with polysplenia
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Pancreatitis: Fluid collections without necrosis
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<4 wks acute peripanc, >4 wks pseudocyst
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Pancreatitis: Fluid collections with necrosis
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<4 wks acute necrotic collctn, >4 wks WON
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Major pancreatic duct
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Wirsung
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Minor pancreatic duct
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Santorini (mini santorini)
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IgG4 associations
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Autoimmune panc, retroperitoneal fibrosis, PSC, inflammatory pseudotumor, Riedel’s thyroiditis
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Serous cystadenoma
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Serious grandma, microcystic, pancreatic head, VHL
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Mucinous cystadenoma
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Mucinous mom, premalignant, unilocular large cyst
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Solid pseudopapillary tumor of pancreas
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Daughter is a SPENner
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Shrinking pancreatic transplant
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Chronic rejection
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Pancreas transplant arterial inflow
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Donor SMA, donor splenic A
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Pancreas transplant venous outflow
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Donor PV, recipient SMV
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T2/GRE dark numerous foci in spleen
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Gamna Gandy bodies (siderotic nodules) in portal HTN
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Splenic artery aneurysm - who gets, when fix
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Women with 2+ pregnancies, fix at 2-3 cm (or any woman)
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Floating membrane and calcs in cyst
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Hydatid cyst
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Isolated gastric varices
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Splenic vein thrombosis = pancreatitis, diverticulitis, Crohns
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Malignant masses of spleen ddx
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Angiosarcoma, Lymphoma, Mets (melanoma)
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Crossed fused ectopia - which kidney is inferior
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Ectopic is inferior, usually left kidney is crossed
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VHL RCC type
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Clear cell
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Hereditary papillary renal carcinoma RCC type
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Papillary
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Birt Hogg Dube RCC type
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Chromophobe + bilateral renal oncocytoma
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Sickle cell RCC type
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Medullary, worse prognosis
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RCC vs oncocytoma?
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PET: RCC is colder than renal, Oncocytoma is hotter than renal. Oncocytoma has central scar on CT or spoke wheel vascularity on US
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Bilateral renal oncocytoma
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Birt Hogg Dube
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Multilocular cystic nephroma
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Noncommunicating, goes into renal pelvis, biomdal occurance (4yo boy and 40yo woman) = Michael Jackson lesion
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RCC stage 3
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Inside gerota fascia, A = Renal vein, B = IVC below diaphragm, C = IVC above
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RCC stage 4
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outside gerota fascia
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Bosniak 2 vs 2F
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2: <3cm and 0% chance of cancer; 2F: >3cm and <5% chance oc ancer
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Bosniak 3
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Mural nodule, thick calcs
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Bosniak 2F followup
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6 months, then yearly x5 years
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Bosniak 3 or 4
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Surgery
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HU cutoff for adrenal nodules
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On NECT: <10 = adenoma, 10-30 = MRI, >30 = CT
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ARPKD liver finding
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Congenital hepatic fibrosis
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ADPKD liver finding
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cysts
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VHL renal finding
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renal cysts, RCC (clear cell)
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VHL pancreas findings
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cysts, serous (grandomother) cystadenoma, islet cell tumors
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VHL adrenal findings
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multiple pheos
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VHL CNS findings
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hamgioblastomas of brain stem, cerebellum, spinal cord
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Tuberous scl renal findings
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bilateral multiple AMLs, RCC
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Tuberous scl lung findings
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LAM (thin wall cysts + chylothorax)
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Tuberous scl cardiac findings
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rhabdomyosarcoma
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Tuberous scl brain findings
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Giant cell astrocytoma (SEGA), subependymal nodules, subcortical tubers
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Peri vs Para pelvic cyst
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Peri = from renal sinus (peripheral of pelvis), Para = from parenchyma (around the pelvis)
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“T2 dark” renal cyst ddx
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Lipid poor AML, hemorrhagic cyst, papillary RCC
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Renal - Bear paw appearance
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XGP
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Renal stone - most common
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Calcium oxalate
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Renal stone - women, UTI
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Struvite
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Renal stone - not on XR
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Uric acid
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Renal stone - metabolic disorder
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Cystine
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Renal stone - HIV
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Indinavir stone = not seen on CT
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Causes of medullary nephrocalcinosis
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Hyperparathyroidism, medullary spogne kidney, Lasix in a kid, RTA type 1 (distal)
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Renal - best way to diff ATN and acute rejection
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MAG-3: ATN has normal perfusion, Rejection is decreased perfusion
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Renal - Transplant hydronephrosis
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Lymphocele
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Renal - Transplant pt w lower ext edema
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Lymphocele (femoral vein compression)
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Renal - Transplant with reversed diastolic flow
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Renal vein thrombosis
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Weigert Meyer rule
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Upper pole inserts inferior/medial and has ureterocele/obstruction. Lower pole inserts normal (superior) and has reflux.
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Ureteral wall calcification ddx
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TB, Schistosomiasis
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Leukoplakia vs Malakoplakia
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Leuko = premalignant (SCC), chronic irritation. Malako = UTI, not premalignant
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Retroperitoneal fibrosis associations
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Ormond, IgG4, can be PET and gallium avid
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TCC locations
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Bladder #1, then renal pelvis, then ureter
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TCC location in ureter
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Lower ⅓
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SCC in lower GU tract
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Schistosomiasis
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Benign mass in ureter
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Fibroepithelial polyp
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Medial deviation of ureter ddx
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Retroperitoneal fibrosis, retroccaval R ureter, pelvic lipomatosis, psas hypertrophy
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Lateral deviation of ureter ddx
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Retroperitoneal LAD, aortic aneurysm, Psoas hypertrophy
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Patent urachus - malignancy?
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Adenocarcinoma
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Bladder cancer in kids <10yo
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Rhabdomyosarcoma = paratesticular mass
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Syndrome that causes bladder diverticula
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Ehlers Danlos
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Hutch diverticulum
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at UVJ, assoc w ipsilateral reflux, not assoc w PUV/neurogenic bladder
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MC cause of colovesical fistula
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Diverticulitis
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MC cause of ileovesical fistula
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Crohns
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MC cause of rectovesical fistula
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Neoplasm/trauma
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Molar tooth sign
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Contrast surrounds bladder = extraperitoneal = medical management
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Male urethra segments
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Penile, penile scrotal ligament, bulbar, membranous, verumontanum, prostatic
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Site of straddle injury
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Bulbar urethra
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Malignant tumor of urethra
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80% SCC, prostatic urethra gets TCC, urethral diverticulum gets adenocarcinoma
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Uretheral diverticulum malignancy
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Adenocarcinoma
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Female urethral cancer
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Adenocarcinoma
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Prostatic urethra cancer
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TCC
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Bladder/ureter calcs
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Schistosomiasis, TB
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