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99 Cards in this Set
- Front
- Back
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What is contained within a pancreatic pseudocyst?
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amylase
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What is contained within a pancreatic serous cystadenoma?
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glycogen
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Pancreatic grandma lesion?
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serous cystadenoma
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Findings of serous cystadenoma?
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micocystic (unless rare macrocystic form)
does NOT communicate with duct Benign greater in HOP calcs and/or central scar |
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Pancreatic mother lesion?
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Mucinous cystic neoplasm
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Findings of mucinous cystic neoplasm?
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Large cysts
BOP>TOP does NOT communicate with ducy malignant potential ovarian-type stroma on pathology |
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What is the pancreatic Grandpa lesion?
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IPMN
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Malignant potential of IPMN?
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branch<main duct and mixed
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fish-eye papilla?
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bulging papilla in IPMN
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DDx for cyst with solid nodule in pancreas?
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cystic neuroendocrine tumor
solid pseudopapillary tumor mucinous cystic adenocarcinoma mets cystic pancreatic adenocarcinoma |
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Differentiating mucinous cystic neoplasm from mucinous cystic adenocarcinoma?
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carcinoma may have non-dependent soft tissue nodules/anhancement
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Pancreatic daughter lesion?
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solid pseudopapillary tumor
benign |
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Emphysemetous cholecystitis? which organisms?
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Klebsiella and E. Coli
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Grading of pancreatic lacerations?
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Grade A - <50% thickness or focal pancreatitis
Grade B - > 50% laceration of body or tail (B1) or transection of body or tail (B2) Grade C - > 50 % laceration of head (C1) or transection of head (C2) |
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Grading of hepatic laceration?
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I - < 1 cm parenchymal depth
II - 1-3 cm depth III >3 cm depth IV - 25-75% of lobe or 1-3 segments in a lobe V - >75% of a lobe or > 3 segments within a lobe VI - hepatic avulsion |
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Management of hepatic adenoma?
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resection ,can turn malignant
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Tc-99m - SC appearance of hepatic adenoma?
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positive
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Enhancement pattern of hepatic adenoma?
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Arterial enhancement, iso on portal phase
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What is the most common presentation of GI lymphoma>
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gastric
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Linitis plastica - what cancers to consider?
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schirrhous gastric ca, lymphoma, breast mets
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Ram's horn stomach?
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Crohn's
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Ribbon-like small bowel? What infection has a similar appearance?
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GVHD
CMV |
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DDx of thickened jejunal folds with lymphadenopathy?
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Whipple, MAI, lymphoma
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Proximal small bowel infections to consider?
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MAI, Giardia, Cryptosporidium
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Characteristic appearance of nodes in Whipple disease?
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fatty and also hepatosplenomegaly
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Most common places for epiploic appendagitis?
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sigmoid>descending>ascending
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Colonic urticaria appearance ddx?
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obstruction
herpes, yersinia, crohn |
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Stages of retractile mesenteritis?
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Mesenteric panniculitis - inflammation
Mesenteric lipodystrophy - fat necrosis sclerosing mesenteritis - sclerosis |
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DDx of multiple fine nodules within the spleen?
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Lymphoma, leukemia, fungal infection, Tb, sarcoid
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DDx upper esophageal stricture?
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Barret, radiation, Epidermolysis Bullosa, bullous pemphigoid, tumors, ingestion
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What percent of barret esophagus undergo malignant degeneration?
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10%
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What may cause intramural pseudodiverticulosis?
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Barret, candida
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Most common mesenchymal neoplasm?
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GIST
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a polyp within the lumen without desmoplastic reaction is more likely a GIST or carcinoid?
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GIST
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Which lesions can contain fat?
HCC Adenoma FNH |
Yes
Yes rarely |
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Which side of the small bowel are pseudosacculations in scleroderma on?
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antimesenteric
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Differentiation of celiac disease from scleroderma on fluoro?
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celiac will have increased folds in the ileum and decreased in the jejunum
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Differntiation of simple cyst from epidermoid cyst in the spleen?
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epidermoid cyst will have a true epithelium
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Spleen mets?
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melanoma, breast, lung
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Where is a spigelian hernia?
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B/w rectus abdominis and internal oblique, just cephalad to anterior iliac creset through transverse abdominis, covered by external oblique
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Location of a Zenker?
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posterior, midline at cricopharyngeus muscle, usually at C5-6
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Three pulsion diverticula
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Zenker, K-J, epiphrenic
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Bull's eye lesion on barium?
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Ectopic pancreatic rest
spindle cell tumor EG ulcer Kaposi |
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Classification of choledochal cyst?
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Todani
I - most of CBD II - isolated diverticulum III - choledochocele (duodenal wall) IV - IHD/EHD V - IHD - Caroli |
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four associations with Caroli disease?
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MSK, congenital hepatic fibrosis, PCKD, renal tubular ectasia
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plaque-like crenulations?
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endometriosis
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Enhancement patterns?
islet serous cystadenoma adenocarcinoma |
marked
moderate none |
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Expansile esohageal mass without obstruction?
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spindle cell (carcinosarcoma)
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Why might lymphoma cause dilation of the GI?
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invasion of the autonomic plexus
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DDx of intramural polypoid lesion of the distal esophagus?
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inflammatory esophogogastric polyp, myofibroblastic pseudotumor, adenocarcinoma
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Three malignant retroperitoneal sarcomas?
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liposarcoma >leiomyosarcoma > MFH
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Schatzki ring is seen only with _______and is located_______.
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hiatal hernia, just below squamocolumnar junction or Z line.
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Hypertrophic gastritis associated with steroids?
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eosinophilic gastritis
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Tc99m-SC on hepatic adenoma?
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cold
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Why does scleroderma affect the lower 2/3 of espohagus?
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because the lower 2/3 is made of of smooth muscle
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What distinguishes the esophageal atony in scleroderma from achalasia?
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The GE jxn is usually widely patent.
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Most common type of mucinous appendiceal neoplasm?
Is carcinoid more or less common? |
mucinous cystadenoma
More |
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Metabolic changes in Menetrier disease?
Which area of the stomach is spared in Menetrier disease? |
loss of Chief cells and thus hypochlorhydria
antrum |
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Why do patients with renal failure get gastritits?
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hyperchloremic state
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What finding may distinguish fibrolamellar HCC from FNH
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calcification
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draped peripheral vessel liver tumor?
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hepatic adenoma
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DDx of multiloculated smooth hepatic lesion?
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bilary cystadenoma
hepatic cyst echinococcal cyst abscess |
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managment of bilairy cystadenoma?
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resection, can turn into cystadenocarcinmoa
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Ulcer from zollinger-ellison are almost exclusively in what location?
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postbulbar
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Differentiation of primary hemochromtasis from secondary on MR
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T2:
primary - low liver and pancreas signal compared to muscle secondary - low lover and spleen signal compared to muscle |
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DDx of carpet lesion in colon?
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villous adenoma
tubulovillous adenoma, crohn, endometrial crenulations |
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Implication of an internal hernia through the lesser sac?
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through foramen of winslow - surgical emergency due to impending strangulation, including GB
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Lesser sac
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posterior to stomach and caudate
anterior to pancreas and TV colon |
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colorectal Ca staging?
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T1 - mucosa
T2 - muscularis mucosa T3 - transmural T4 - adjacent organs, visceral peritoneum N - nodes M - mets |
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Mets to esophagus?
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breast and melanoma
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What type of diverticula may occur with achalasia?
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epiphrenic because of increased pressure at LES
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most common tumor of SB?
most common primary malignancy of SB? |
LM
Lymphoma |
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angle for SMA syndrome
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25 - 30 degrees
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Two types of gastric volvulus?
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organoaxial - more common - line from GE jxn to pylorus
Mesenteric - around gastrohepatic ligament |
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Which crosses the pylorus more lymphoma or gastric andenoCa?
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AdenoCa is seen crossing more because more common; however, lymphoma will cross a higher percentage of the time.
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organism for emphysemetous gastritis?
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hemolytic streptococci
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What is Carmen meniscus sign?
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flat malignant ulcer with heaped up margins on lesser curve on single contrast exam, with compression captures contrast and has convex border toward lumen.
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What is kirkland complex?
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apposing margins in malignant ulcer
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Gardner?
Turcot? |
FAP + osteomas
FAP + medulloblastoma and GBM |
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Proposed etiology for porcelain gallbladder?
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chronic cystic duct obstruction
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Littre's hernia?
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Meckel's in a hernia
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Significance of an ulcer in the fundus?
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most are malignant
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Which polyposis syndrome is associated with retractile mesenteritis?
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Gardner
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The more distal a lesion in the duodenum the more likely____________.
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it is to be malignant
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two most common primary tumors of pharynx?
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SCC and lymphoma
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Size for enlarged duodenal papilla? what is often associated?
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>1.5 cm
choledochocele |
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most common cause of gastric outlet obstruction?
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peptic ulcer disease
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Bourne test?
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see if barium shows up in urine = + for fistula
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most common parasitic infection of small bowel?
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ascariasis
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lye ingestion, increase risk of __________.
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SCC
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most common calcified hepatic met in adults? kids?
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adenoCa of colon. NB.
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Colitis cystica profunda?
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sequela of solitary rectal ulcer
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what is unique about the coned-shaped cecum in amebiasis?
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no involvement of TI
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Greater omentum - anterior margin, posterior margin
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encloses lesser sac anteriorly, posterior margin is transverse colon. includes gastrocolic ligament.
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Anything that affects the stomach can also affect the transverse colon via the _____________.
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gastrocolic ligament
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Wide mouth sacculations?
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scleroderma - true diverticula
the diverticula in diverticulosis are false |
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dorsal pancreatic bud
ventral pancreatic bud |
body/tail - L - minor papilla - Santorini
head/uncinate - R major papilla - Wirsung |
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What is a dragstead ulcer?
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distal antrum to base of duodenum - double pyloric channel sign.
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Why do jump metastases occur in espohageal carcinoma?
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longitudinal orientation of myenteric plexus
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