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45 Cards in this Set

  • Front
  • Back
what are risk factors for pancreatic adenoca
smoking
longstanding DM
hereditary pancreatitis

*pearl* ETOH and caffeine are not risk factors
what makes pancreatic ca unresectable
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
ddx: intussusception
polyp
carcinoma
lymphoma
lipoma
meckel's diverticulum
scleroderma
sprue
cystic fibrosis
ddx: chronic pancreatitis
ETOH
hereditary pancreatitis
cystic fibrosis
hyperlipidemia
hyperparathyroidism
pancreas divisum
ddx: irregular thickened sb folds
WAGCLEM

whipple's
waldenstrom's
amyloid
abetalipoproteinemia
giardia
crohn's
lymphoma
lymphangiectasia
eosinophilic gastroenteritis
mastocytosis, mets
describe partial gastrectomy complications
anastomotic ulcer (efferent loop)
gastric ca (afferent)
bezoar
intussusception (jejuno-gastric)
afferent loop syndrome
ddx: splenomegaly
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
ddx: LUQ calcs
splenice hematoma
splenic cyst
adrenal cyst
adrenal hemorrhage
adrenal TB
neuroblastoma
pancreatic pseudocyst
pancreatic neoplasm
splenic artery aneurysm
ddx: adynamic ileus
gastroenteritis
appendicitis
pancreatitis
pyelonephritis
cholecystitis
drugs - morphine, atropine, cocaine
DM
uremia
post-op
metabolic - hypokalemia
ddx: colonic obstruction
carcinoma
volvulus
hernia
impaction
diverticulitis
pelvic tumor
ddx: delayed gastric emptying
pyloric ulcer
gastric neoplasm
vagotomy
pancreatitis
hypocalcemia/hypokalemia
drugs
myxedema
scleroderma
DM
ddx: fatty infiltration of liver
ETOH
DM
obesity
hyperalimentation
steroids
chemotherapy
malnutrition
reye's syndrome
what diseases mimic crohn's
TCBY

TB
Campylobacter
Yersinia enterocolitica
what diseases mimic UC
amebiasis
salmonella/shigella
ischemia
pseudomembranous colitis
behcet's
what 2 features seen in crohn's are not present in UC
skip lesions
fistulae
what is the approach to diffuse small bowel nodularity
>4mm nodules - lymphoid metaplasia (neoplasm)
<4mm nodules - lymphoid hyperplasia
ddx: lymphoid hyperplasia
infection
immune deficiency

*pearl* with malabsorption think giardia; over 40y look for carcinoma
ddx: target lesions of bowel
mets - melanoma, breast, colon
lymphoma
kaposi's
leiomyoma/sarcoma
pancreatic rest
apthous ulcers
ddx: multiple small bowel strictures
CIA RIM

crohn's
ischemia
adhesions
radiation
infection
mets
ddx: regular, thick small bowel folds
hemorrhage
- ischemia (vasculitis)
- atherosclerosis
- hemophilia
- ITP/TTP
- trauma
- HUS/HSP
Edema
- hypoalbunemia
- radiation
- lymphatic obstruction
tumor
- lymphoma
ddx: small bowel nodules
WAGCLEM

whipples
amyloid
giardiasis
crohn's/crypto
lymphoma
eosinophilic gastroenteritis
mets/mastocytosis
ddx: hypervascular liver lesion
FNH
HCC
Mets
- islet cell
- melanoma
- choriocarcinoma
- carcinoid
what is the does of glucagon used in GI studies
0.1 - 0.25 mg IV for UGI
0.5 - 1.0 mg IV for BE
what are absolute contraindications to glucagon
pheochromocytoma

*pearl* mets are 20x more common than primary malignancy
ddx: segmental colitis
infection
- amebic
- yersinia
- salmonella/shigella
- viral
inflammatory
- crohn's
- behcet's
radiation
ischemia
pseudomembranous colitis
ddx: rectal colitis
chlamydia
gonococcus
lymphogranuloma venerum
ddx: coned cecum
TB
carcinoma
mets
ddx: gastric fold thickening
neoplasm
- gastric ca
- lymphoma
- mets
gastritis
- erosive
- corrosive
hemorrhagic
hypertrophic
- menetier's
- ZE
ddx: toxic megacolon
UC
amebiasis

*pearl* 20% mortality with BE
which tumor spreads to the superior surface of transverse colon, inferior surface
superior: stomach
inferior: pancreas
barium buzz words:
- mucosal
- submucosal
- serosal
mucosal: granular, shaggy, erosion
submucosal: thumb-printing, pinky-printing
serosal: spiculated,tethered, mass-effect
risk of ca with polyps
<1cm
1-2cm
>2cm
<1cm: 1%
1-2cm: 10%
>2cm: 50%
what are the 3 most common causes of small bowel obstruction
adhesions
hernia
tumor
ddx: mesenteric mass
CRADLE

carcinoid
retractile mesenteritis
adenoca
desmoid
lymphadenopathy (lymphoma, TB, yersinia, whipple's, MAI)
everyone forgets mets
ddx: spiculated bowel folds
RID ME

radiation
ischemia
diverticulitis
metastasis
endometritis
ddx: focal esophageal ulcer
CMV
herpes
HIV
drugs
ddx: dilated small bowel
scleroderma
obstruction
meds (narcotics)
ddx: small bowel filling defect
lipoma
nerver sheath tumor
lymphoma
carcinoma
carcinoid
mets
ddx: small bowel nodule
Major League PC

mastocytosis/mets
leukemia/lymphoma/lymphoid hyperplasia
polyps (hamartomas in sb, familial polyposis in lb)
crohn's
appearance of hemangioma on MRI
on T2 it is > CSF and spleen
nodular, interrupted enhancement
appearance of HCC on MRI
on T2 and T1 it is > liver
early enhancement

*pearl* look for venous invasion
ddx: shaggy esophagus
candidiasis
reflux esophagitis
FNH vs fibrolamellar HCC
FL has increased size
FL scar is low on T2WI, FNH is high
FL scar does NOT enhance, FNH does
appearance of adenoma on MRI
on T1 it is > liver
on T2 heterogenous
appearance of liver mets on MRI
on T2 they are > CSF but < spleen

*pearl* note that hemangiomas are > spleen