Ct - Chest And Abdomen, Part 2

Front 1

what is the max diamter of chd or cbd

Back 1

6mm up till age 60, then a mm per decade

Front 2

mirizzi syndrome

Back 2

gb stone impacted in cystic duct --> colangitis or erosion into cbd --> obx jaundice

Front 3

findings of biliary obx

Back 3

gb >5 cm (obx distal to cystic duct)
dilated common duct at portal hepatis
dilated hepatic biliary ducts

Front 4

typical findings if biliary obx is seconary to malignancy

which malignancies can be to blame

Back 4

abrupt termination of a dilated cbd

pancreatic ca
ampullary ca
cholangioca

Front 5

findings that indicate benign biliary obx

benign etiologies

Back 5

gradual tapering of ducts

stricture
pancreatitis

Front 6

what can gallstones contain

Back 6

fat
fat + calcium
calcium

Front 7

pathophys of cholangioca

Back 7

adenoca arising from epithelial cells of bile ducts
can be complication of choledochal cysts, psc, intrahepatic stones

Front 8

types of cholangioca

Back 8

intrahepatic
periductal
intraductal
extrahepatic

Front 9

findings of intrahepatic cholangioca

Back 9

homogeneous irregular borders
low attenuation
very fibrotic
weak peripheral enhancement on early post-contrast
make take hrs after contrast for central/diffuse enhancement
dilated bile ducts

Front 10

ct findings of periductal infiltrating cholangioca

Back 10

grows along bile ducts in elongated branching pattern
duct narrows and wals thicken
peripheral ductal dilatation

Front 11

intraductal choleangioca

Back 11

extends superficiallly along bile duct mucosa
secretes a lot of mucin --> dilated ducts

Front 12

extrahepatic cholangio ca

Back 12

ductal obx with a nodule or abrupt structure with wall thickening
or, may present as mustiple intraductal frondlike masses

Front 13

ct findings of psc

Back 13

multiple segmental strictures within bile ducts, with thickening of bile duct walls, alternating with nml caliber ducts

Front 14

what is ascending cholangitis

Back 14

bacterial infx of obx biliary system

Front 15

what may be associated with ascending cholangitis

Back 15

liver abscess/sepsis

Front 16

what other entity mimics psc

Back 16

aids related cholangitis

Front 17

what organisms are involved in aids related cholangitis

Back 17

cryptosporidium
cmv

Front 18

pathophys of acalculous cholecystitis

Back 18

biliary stasis
ischemia
bacteremi a

Front 19

who gets emphysematous cholecystitis

Back 19

elderly
diabetics

Front 20

risk factor for porcelain gb

Back 20

chronic chole

Front 21

ct findings of porcelain gb

Back 21

calcified gb wall

Front 22

complication of porcelain gb

Back 22

cancer of gallbladder

Front 23

what is considered a thickened stomach wall?

Back 23

>5mm

Front 24

ddx for thickened stomach wall

Back 24

carcinoma
lymphoma
inflammation (crohn's, pud)
pancreatitis
radiation

Front 25

ct findings of gastritis

Back 25

thickened gastric folds, most often in antrum
mucosa may enhance stilghtly and will see a 3layered appearance (this = benign)

Front 26

what causes emphysematous gastritis

Back 26

e coli

Front 27

what type of ca is most common in stomach

otherh stomach malignancies

Back 27

adeno

gastric lymphoma, gist, malt

Front 28

findings in gastric carcinoma

Back 28

nodular or thickened gastric wall

Front 29

indication that gastric carcinoma has seeded into perigastric fat

Back 29

if stomach wall >2 cm thick

Front 30

likelihood of hematogenous mets from gastric ca

Back 30

liver
lungs
adrenals
kidneys
bones
brain

Front 31

most common site of ln involvement in gastric ca

Back 31

along hepatic artery
para-aortic region

Front 32

site of most common gi lymphoma

what type of lymphoma is most common
other type of lymphoma

Back 32

stomach, the sm intestines

non-hodgkin's, b cell
malt

Front 33

how to differentiate btwn lymphoma and carcinoma on ct

Back 33

finings of lymphoma

stomach wall >3 cm, or involves at 2 or more areas within git

more widespread LAD (above and below renal hilum)

luminal narrowing is more typical of carcinoma

Front 34

where does gist arise

Back 34

in muscularis propria
60-70% are in stomach, 20-30% in sm bowel

Front 35

malignancy potential for gist

Back 35

10-30% malignancy rate

Front 36

ct findings of gist

Back 36

tumors arise in bowel wall and grow away from gut lumen to project into abdominal cavity and lumen of bowel

Front 37

how do pts with gist present

Back 37

gib

Front 38

what increases likelihood of malignancy in gist

Back 38

if mass >5 cm or if it arises outside stomach

Front 39

ct findings of gastric varices

Back 39

tubular densities in/around wall of stomach

Front 40

when would you see gastric varices without esophageal varices

Back 40

splenic vein thrombosis

Front 41

findings of sclerosing mesenteritis

Back 41

inflammation of sm bowel mesentary or mesocolon
see hazy fat within mesentary (aka "misty mesentary")
can envelope bv with preserved surrounding fat

Front 42

etiology of sclerosing mesenteritis

Back 42

unclear, but may be associated with lymphoma or hemorrhag/edema

Front 43

wandering spleen

Back 43

spleen not in luq, usually asx but are more susceptable to torsion/trauma

Front 44

top nml size of spleen

Back 44

14 cm

Front 45

etiology of cysts

Back 45

post-traumatic (from previous hemorrhage, infarct, infx)
congenital epidermoid cyst
echinococcal cysts

Front 46

appearance of echinococcal cysts

Back 46

mother cysts wiht smaller daughter cysts within them
calcifications common

Front 47

etiology of splenic infarct

Back 47

ath dz
arteritis
tumor
pancreatitis
emboli
scd
splenomegaly

Front 48

who gets microabscesses of spleen

Back 48

immunocompromised

Front 49

what organisms tend to be in microabscesses

Back 49

fungi
cmv
tb
pcp

Front 50

#1 mets that go to spleen

Back 50

melanoma

Front 51

presentation of angiosarcoma of spleen

Back 51

widespread mets
spontaneous rupture/hemorrhage of spleen

Front 52

ct finings of angiosarcoma of spleen

Back 52

well defined enhancing nodules
or
cystic + solid mass