Eradiology -- Abdominal Plain Film

Front 1

What are the cardinal features of Paget's Disease?

Back 1

1) increased density, 2) Increased size, 3) Coarsened trabeculae

Front 2

What is required for radiologic hepatomegaly?

Back 2

Vertical height in mid-clav line > 15.5 cm OR projection of liver edge beyond the inferior margin of the right kidney

Front 3

What types of infiltrates can lead to hepatomegaly?

Back 3

1) Cells, 2) blood, 3) fluid, 4) Fat, 5) Carbohydrate, 6) Iron, 7) Amyloid

Front 4

DDx for splenomegaly (3 major categories)

Back 4

1) Portal htn, 2) myeloproliferative dz, 3) infectious dz

Front 5

Radiologic splenomegaly

Back 5

projection of splenic tip below liver or left kidney OR > 14cm in any dimension

Front 6

Film findings with mild ascities

Back 6

loss of liver edge

Front 7

film findings with moderate ascites

Back 7

pelvic density, bladder ears

Front 8

film findings with marked ascites

Back 8

ground glass abd, buldging flanks, widened paracolic gutters, centralized bowel loops

Front 9

Gas pattern in stomach

Back 9

rugal folds

Front 10

gas pattern in small bowel

Back 10

plicae

Front 11

gas pattern in large bowel

Back 11

haustra

Front 12

If your pt cannot stand upright, what is the best film to detect free air?

Back 12

LLD film

Front 13

Ddx for pneumoperitoneum

Back 13

1) outside -- s/p surgery, penetrating trauma, 2) Inside -- perforated DU, perforated colon CA, 3) Infection -- emphysematous peritonitis

Front 14

Composition of radio-opaque calculi

Back 14

1) CaPO4, 2) Ca oxalate, 3) struvite, 4) uric acid

Front 15

Ddx of pelvic mass in male

Back 15

1) large bladder d/t obstructing BPH, 2) prostate CA

Front 16

Ddx of pelvic mass in female

Back 16

1) mucinous tumor of ovary, 2) non-calcified fibroid, 3) recent delivery

Front 17

Approach to reading abd plain films

Back 17

1) QC, 2) Lung bases and bones, 3) organ/soft tissue outlines, 4) Gas, Checkpoints 5) aberrant air, 6) calcifications, 7) paucity of gas

Front 18

Detailed gas examination

Back 18

1) lumen size, 2) air-fluid levels, 3) Contour, 4) bowel wall

Front 19

What are the 2 major categories of obstruction?

Back 19

1) Mechanical, 2) Functional (adynamic ileus)

Front 20

Transition point favors which type of obstruction?

Back 20

Functional

Front 21

marked dilation favors which type of obstruction?

Back 21

Mechanical

Front 22

What are the three types of causes for mechanical bowel dilation?

Back 22

1) Inside the lumen, 2) In the wall (benign or malignant), 3) Extrinsic

Front 23

What are the two types of causes of functional bowel dilatation?

Back 23

1) Generalized, 2) Focal (sentinel loop) -- pancreatitis, appendicitis, cholecystitis, pyelonephritis, abscess

Front 24

DDx for short strictures

Back 24

1) Tumor, 2) Inflammation, 3) Infection, 4) Trauma, 5) radiation, 6) Drugs, 7) Congenital

Front 25

DDx of Ahaustral Colon

Back 25

1) UC, 2) chronic laxative abuse, 3) chronic obstruction, 4) s/p ischemia, 5) s/p radiation

Front 26

What causes thumbprinting?

Back 26

focal infilatrations of bowel wall with edema, hemorrhage, and/or inflammatory cells.

Front 27

Riglers sign

Back 27

denotes free air in abd cavity (pneumoperitoneum)

Front 28

Approach to detailed evaluation of gas patterns

Back 28

1) identify, 2) check lumen diameter, 3) Check number of a/f levels, 4) check luman contour (ahaustral or thumbprinting), 5) check bowel wall (pneumatosis coli or Riglers)

Front 29

Types of aberrant air collections can be of what types?

Back 29

1) linear, 2) tubular, 3) branching, 4) pointed, 5) mottled

Front 30

DDx of portal venous gas

Back 30

1) Outside -- umbilical vein cath, 2) Inside -- bowel infarction, 3) infection -- emphysematous cholecystitis

Front 31

DDx of biliary tract air

Back 31

1) Outside -- external biliary stent, 2) Inside -- Tubular GI tract and biliary fistula, 3) Infection -- emphysematous cholecystitis

Front 32

What are the 2 major categories of calcium outside the skeleton?

Back 32

1) metastatic (hypercalcemic), 2) dystrophic (normocalcemic)

Front 33

What appearance does a uterine fibroid have on abd plain film?

Back 33

it is a hammartoma which demonstrates "popcorn calcification"

Front 34

Paucity of gas indicates what?

Back 34

1) a mass, 2) proximal obstruction

Front 35

What is the classic triad of gallstone illeus?

Back 35

1) Biliary tract air, 2) Low SBO, 3) Calcified RLQ stone

Front 36

DDx Long stricture

Back 36

1) IBD, 2) Ischemia, 3) Radiation