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34 Cards in this Set
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- Back
- 3rd side (hint)
Non Visualization of the Gall Bladder
During oral cholecystography |
Technical failure (no fatty meal prior, vomiting, Bilirubin > 34 mmol)
Previous Cholecystectomy Ectopic gallbladder Cholcystitis Cystic duct obstruction |
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Non Visualization of the Gall Bladder
During IV Cholangiography |
Technical failure (contarst medium given too rapidly, Bilirubin > 50 mmol)
Previous Cholecystectomy Ectopic gallbladder Cholcystitis Cystic duct obstruction |
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Filling Defect in the GB
Multiple |
Calculi
Cholesterosis (strawberry GB, multiple fixed mural filling defects) |
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Filling Defect in the GB
Single and small |
calculus
adenomyomatosis |
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Filling Defect in the GB
Single and large |
calculus
carcinoma |
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Gas in Biliarry tract
Within the Bile Ducts |
Incompetence of Spincter of Oddi (following sphincterotomy, passage of gallstone, patulous in elderly)
Postoperative cholecystoenterostomy choledochoendorostomy Sponataneous Biliarry Fistula Passage of gallstone directly from an inflammed GB Duodenal ulcer perforation the bile ducr malignancy or trauma |
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Gas in Biliarry tract
Within the Gall Bladder |
All of the above
Emphysematous cholecystitis ( gas forming organism DM) |
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Gas in the Portal Veins
Children |
Necrotizing Enterocolitis
umbilical vein catheterization erythroblastosis fetalis |
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Gas in the Portal Veins
Adults |
Mesenteric Infarction
Air embolus during double contrast barium enema acute gastric dilation (may recover following placememt of NG tube) |
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Hepatomegaly
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Neoplastic
Mets Hepatoma Lymphoma Raised Venous Pressure congestive heart failure constrictive pericarditis tricuspid stenosis Bud Chiari synd. Degenerative Cirrhosis Fatty Infiltrate Myeloproliferative Disorder Polycthaemia Rubra Vera Myelofibrosis Infective Viral Bacterial Protozoal (amebic abscess, malaria, trypanosomiasis and kalar azar Parasitic hytatid Storage Disorders Amyloid hemochromotosis Gauchers Nieman Pick Disease Congenital Reidels Lobe Polycystic disease |
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Hepatic Tumors in Children
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Hepatoblastoma
Hepatocellular Ca (see comparison pg 281 Chapman) Hemangioendothelioma Stage IV-S neuroblastoma (increased urine VMas MIBG positive) Adenoma (solitary or multipe associate glycogen storage disease, teenager ocp) DDx focal nodular hyperplasia simple cyst choledochal cyst abscess |
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Hepatic Calcifications
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Multiple and Small
healed granuloma Curvilinear Hydatid Abscess Calcified porcelain GB Localized in Mass Mets GIT (colloid CA)met, folowing Rx) Adenoma (rare calcification punctate) Sunray Spiculation Hemangioma Mets (colloid ca) Adenoma |
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Fetal or Neonatal luiever calcification
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Peritoneal
Meconium peritonitis Plastic peritonitis due to rupture hydrometrocolpos Parenchymal Congenital Infections TORCH Tumors (hemangioma, hamartoma, hepatoblastoma, teratoma and metaststic neuroblastoma) Vascular Portal Vein Thromboemboli Ischemic Infarcts |
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Jaundice in Infancy
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Anatomical Abnormalities
Biliary Atresia (3 types) Choledocal Cyst (5 types) Alagille Syndrome Metabolic Defects alpha antitrypsin deficiency, galactosemia, tyrisonemia Infection Neonatal Hepatitis (probable secondary to Reovirus) |
Biliary Atresia 3 types
i) focal (extemely rare) ii) intrahepatic (uncommon) iii) subtype 1 66% with abile duct remnant at the porta hepatis subtype 2 34% associated multipe congenital abnormalities (polysplenia) Chledochal cysts 5 types i)Fusiform or focal dilation of the CBD+/- common hepatic duct80% ii) 2% diverticulum of the CBD iii) 2-5% Outpouching of the CBD in the wall of the 2nd part of the duodenum (choledococele) iva)Dilation of CBD and focal dialtion of the intrahepatic ducts ivb) Focal dialtions of the CBD v) focal dilation of the intrahepatic ducts Caroli's Disease |
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Ultarsound of the Liver
Generalized Hypoechoic |
Acute Hepatitis
Diffuse Malignant Infiltration |
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Ultrasound of the Liver
Generalized Hyperchoic (bright liver) |
fatty infiltation
cirrhosis hepatitis infiltration / deposition (maligannt, granulomata, glycogen storage disease |
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Ultrasound of the Liver
Focal Hyperechoic |
Mets (GIT,ovary,pancreas urogenital
Capillary hemangioma Focal Nodular Hyperplasia Debris within lesion Hepatoma (can be hypo or hyperechoic) |
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Ultrasound of the Liver
Focal Hypoechoic |
Mets (cystic mets ovary, pancreas stomach)
Lymphoma Hepatoma Cysts Abscess hematoma Cavernous hemangioma |
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Ultrasound of the Liver
Periportal Hyperechoic |
Air in biliary tree schistosomiasis
cholecystitis recurrent pyogenic cholangitis (oriental) |
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Ultrasound of the Liver
Periportal Hypeoechogenicity (collar sign) periportal low attenuation on CT |
Orthotopic liver transpalnt rejection
Congestive hepatomegaly malignant lymphatic obstruction blunt abdominal trauma cholangitis viral hepatitis |
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Thickened BB Wall >3mm
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cholecystitis hepatitis
hypoalbunemia cirrhosis congestive heart failure renal failure |
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CT Liver Focal Hyperenhancincing Lesion
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During Arterial Phase
heoatocellular ca hemangioma FNH Adenoma Mets (particlar carcinoid panceatic islet cells) During Portal Phase Hemangioma HCC Venous Collaterals (from obstructed IVC/SVC) During Equilibrium Phase Hemangioma Cholangiocarcinoma Solitary fibrous tumor treated Mets |
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CT Liver Focal Hyperdense Lesion
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Pre IV contarst
calcification in: (mets, primary tumor, infective lesion) Acute hemorrhage Post IV contrast Hypervascualr Masses Mets (carcinoid, RCC, melanoma) Adenoma ? FNH enhancement seen only in arterial phase after this thery may appear hyperdense Vascular Abnormalities (arterioportal shunts may occur in hepatoma) |
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CT Liver Generalized Low Density Pre-IV contrast Medium
Assess by comparing liver with spleen |
Fatty Infiltrate
Malignant Infitration Budd Chiari Amyloid |
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CT Liver Generalized Increase in Density Pre-IV contrast Medium
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hemochromatosis
hemosiderosis iron overload glycogen storage disease amiodorone |
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CT Liver Patchy Areas of Low Density Post-IV contrast Medium
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cirrhosis
hepatitis portal vein thrombosis Budd Chiari lymphoma Sarcoid |
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MR Liver Focal Hyperintense Lesion on T1W
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Fat
blood (acute stage methemoglobin) proteinacious material melanoma mets chemical Gadolinium relative artefact 'ghost artefact' |
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MR Liver Ringed Hepatic Lesions
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Capsules of Primary Liver Tumors
Mets suacute hematoma Hydatid cyst Amebic abscess |
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Splenomegaly
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Huge Spleen
CML Myelofibrosis Malaria Kal-azar Gaucher's Lymphoma Moderately Large Spleen All of the above Storage Diseases hemolytic anemia portal hypertension leukemias Slightly Large Spleen All of above Infections (hepatitis, mononucleosis, ricketstial typhus, histoplasmosis) Sarcoid Amyloid RA (Felty's Syndrome) SLE |
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Splenic Calcification
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Curvilinear
Splenic Artery calcification cyst (HYDATID) Multiple Small Nodular phleboliths hemangioma TB histoplasmosis Brucellosis Sickle cell Disease Diffues Homogenous or Finely Granular Sickle cell anemia PCP Solitary > than 1 cm Healed infarct healed abscess TB |
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CT Spleen Foacal Low Density Lesion
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Lymphoma
Mets Hemangioma Abscess |
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Pancreatic Calcification
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Alcoholic Pancraetitis
Pseudocyst Ca Panreas Hyperparthyroidism CF Tumors (calcificationin 10% of cystadenomas.carcinomas) |
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CT Pancreas Focal Mass
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Adenocarcinoma (60% head, 10% body, 5% tail 20% diffuse)
Focal Pancreatitis Mets Islet Cell Tumor (equal incidence head/body/tail 80% non fuctioning large size) Mucinous cystadenoma and cystadenocarcinoma |
Beta Cell
Insulinoma 90% benign, 10% multiple, *0%, 2cm Non beta cell Gastrinoma 60% amlignant 30 benign adenoma 10% hyperplasia 90% loacted in pancreas 5% duodenum Glucagonoma usually < 4cm since endocrine disturbance is often less marked |
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Non Visualization of GB with TBIDA
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No Bowel Activity
CBD obstruction severe hepatitis opiates With Bowel Activity Acute cholecystitis chronic cholecystitis cholecystectomy inadequate fasting Bialry pancreatitis severe diffuse hepatocellular disease |
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