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45 Cards in this Set
- Front
- Back
what are risk factors for pancreatic adenoca
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smoking
longstanding DM hereditary pancreatitis *pearl* ETOH and caffeine are not risk factors |
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what makes pancreatic ca unresectable
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adjacent organ involvement (not duodenum)
vascular invasion (including SMA encircled more than 270 degrees, SMV encased over 1cm or portal vein confluence involved) lymphadenopathy distant metastasis malignant ascites |
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ddx: intussusception
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polyp
carcinoma lymphoma lipoma meckel's diverticulum scleroderma sprue cystic fibrosis |
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ddx: chronic pancreatitis
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ETOH
hereditary pancreatitis cystic fibrosis hyperlipidemia hyperparathyroidism pancreas divisum |
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ddx: irregular thickened sb folds
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WAGCLEM
whipple's waldenstrom's amyloid abetalipoproteinemia giardia crohn's lymphoma lymphangiectasia eosinophilic gastroenteritis mastocytosis, mets |
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describe partial gastrectomy complications
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anastomotic ulcer (efferent loop)
gastric ca (afferent) bezoar intussusception (jejuno-gastric) afferent loop syndrome |
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ddx: splenomegaly
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infection
- mono - malaria - TB malignancy - lymphoma - leukemia - mets congestion - portal hypertension - splenic vein thrombosis autoimmune - collagen vascular disease infiltration - gauchers - sarcoid - mastocytosis hematologic - thalasemia - sickle cell (small or big) trauma - cyst - hemorrhage |
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ddx: LUQ calcs
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splenice hematoma
splenic cyst adrenal cyst adrenal hemorrhage adrenal TB neuroblastoma pancreatic pseudocyst pancreatic neoplasm splenic artery aneurysm |
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ddx: adynamic ileus
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gastroenteritis
appendicitis pancreatitis pyelonephritis cholecystitis drugs - morphine, atropine, cocaine DM uremia post-op metabolic - hypokalemia |
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ddx: colonic obstruction
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carcinoma
volvulus hernia impaction diverticulitis pelvic tumor |
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ddx: delayed gastric emptying
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pyloric ulcer
gastric neoplasm vagotomy pancreatitis hypocalcemia/hypokalemia drugs myxedema scleroderma DM |
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ddx: fatty infiltration of liver
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ETOH
DM obesity hyperalimentation steroids chemotherapy malnutrition reye's syndrome |
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what diseases mimic crohn's
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TCBY
TB Campylobacter Yersinia enterocolitica |
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what diseases mimic UC
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amebiasis
salmonella/shigella ischemia pseudomembranous colitis behcet's |
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what 2 features seen in crohn's are not present in UC
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skip lesions
fistulae |
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what is the approach to diffuse small bowel nodularity
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>4mm nodules - lymphoid metaplasia (neoplasm)
<4mm nodules - lymphoid hyperplasia |
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ddx: lymphoid hyperplasia
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infection
immune deficiency *pearl* with malabsorption think giardia; over 40y look for carcinoma |
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ddx: target lesions of bowel
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mets - melanoma, breast, colon
lymphoma kaposi's leiomyoma/sarcoma pancreatic rest apthous ulcers |
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ddx: multiple small bowel strictures
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CIA RIM
crohn's ischemia adhesions radiation infection mets |
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ddx: regular, thick small bowel folds
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hemorrhage
- ischemia (vasculitis) - atherosclerosis - hemophilia - ITP/TTP - trauma - HUS/HSP Edema - hypoalbunemia - radiation - lymphatic obstruction tumor - lymphoma |
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ddx: small bowel nodules
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WAGCLEM
whipples amyloid giardiasis crohn's/crypto lymphoma eosinophilic gastroenteritis mets/mastocytosis |
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ddx: hypervascular liver lesion
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FNH
HCC Mets - islet cell - melanoma - choriocarcinoma - carcinoid |
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what is the does of glucagon used in GI studies
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0.1 - 0.25 mg IV for UGI
0.5 - 1.0 mg IV for BE |
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what are absolute contraindications to glucagon
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pheochromocytoma
*pearl* mets are 20x more common than primary malignancy |
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ddx: segmental colitis
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infection
- amebic - yersinia - salmonella/shigella - viral inflammatory - crohn's - behcet's radiation ischemia pseudomembranous colitis |
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ddx: rectal colitis
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chlamydia
gonococcus lymphogranuloma venerum |
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ddx: coned cecum
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TB
carcinoma mets |
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ddx: gastric fold thickening
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neoplasm
- gastric ca - lymphoma - mets gastritis - erosive - corrosive hemorrhagic hypertrophic - menetier's - ZE |
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ddx: toxic megacolon
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UC
amebiasis *pearl* 20% mortality with BE |
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which tumor spreads to the superior surface of transverse colon, inferior surface
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superior: stomach
inferior: pancreas |
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barium buzz words:
- mucosal - submucosal - serosal |
mucosal: granular, shaggy, erosion
submucosal: thumb-printing, pinky-printing serosal: spiculated,tethered, mass-effect |
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risk of ca with polyps
<1cm 1-2cm >2cm |
<1cm: 1%
1-2cm: 10% >2cm: 50% |
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what are the 3 most common causes of small bowel obstruction
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adhesions
hernia tumor |
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ddx: mesenteric mass
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CRADLE
carcinoid retractile mesenteritis adenoca desmoid lymphadenopathy (lymphoma, TB, yersinia, whipple's, MAI) everyone forgets mets |
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ddx: spiculated bowel folds
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RID ME
radiation ischemia diverticulitis metastasis endometritis |
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ddx: focal esophageal ulcer
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CMV
herpes HIV drugs |
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ddx: dilated small bowel
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scleroderma
obstruction meds (narcotics) |
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ddx: small bowel filling defect
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lipoma
nerver sheath tumor lymphoma carcinoma carcinoid mets |
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ddx: small bowel nodule
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Major League PC
mastocytosis/mets leukemia/lymphoma/lymphoid hyperplasia polyps (hamartomas in sb, familial polyposis in lb) crohn's |
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appearance of hemangioma on MRI
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on T2 it is > CSF and spleen
nodular, interrupted enhancement |
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appearance of HCC on MRI
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on T2 and T1 it is > liver
early enhancement *pearl* look for venous invasion |
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ddx: shaggy esophagus
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candidiasis
reflux esophagitis |
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FNH vs fibrolamellar HCC
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FL has increased size
FL scar is low on T2WI, FNH is high FL scar does NOT enhance, FNH does |
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appearance of adenoma on MRI
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on T1 it is > liver
on T2 heterogenous |
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appearance of liver mets on MRI
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on T2 they are > CSF but < spleen
*pearl* note that hemangiomas are > spleen |