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43 Cards in this Set
- Front
- Back
where are valvulae connectivae found?
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most in jejunum, less in ileum, non in colon
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what causes thickened mucosal folds in the small bowel? (>3cm)
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1) FLUID/EDEMA (ischemia, hypoproteinemia); 2) BLOOD (trauma, anticoag); 3) PUS (infection); 4) LYMPH; 5) CELLS (lymphoma, leukemia); 6) STUFF (amyloid, glycogen)
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what causes barium dilution on SBFT?
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increased secretions (eg from cryptsporidium) --> see a point after which barium contrast becomes less prominent?
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how to differentiate diarrhea and obstruction on abdominal plain film?
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both have a/f levels, but diarrhea has normal caliber SB, obstruction has dilated loops
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MCC mechanical SBO (2)
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adhesions and hernias
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strictures and skip lesions
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crohn's disease
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displacement of loops in which IBD?
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Crohn's -- transmural inflammation --> inflammation of mesenteric "creeping" fat --> displacement
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radiologic findings with crohn's
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STRICTURES with increased surrounding MESENTERIC fat, ulcers, SKIP LESIONS; STRING SIGN, COMB SIGN (increased visualization of mesenteric vessels due to fat hypertrophy), PSEUDODIVERTICULAE
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common complications of crohn's seen by radiology
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abscesses, fistuale --> aberrent air, bowel obstruction, extraintestinal (sacroiliitis, stones, ascending cholangitis, pancreatitis)
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what is "comb sign"
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seen with crohn's disease: increased visualization of vessels in mesenteric fat due to fat hypertrophy from transmural inflammation
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what does ahaustral colon suggest?
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ulcerative colitis; aka leadpipe colon
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complications of UC
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toxic megacolon, colonic adenocarcinoma, extrainstestinal (sacroiliitis, stones, ascending cholangitis, pancreatitis)
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what imaging study contraindicated with toxic megacolon?
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BE -- mucosa very friable
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differential for ahaustral colon (5)
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1) LAXATIVE abuse; 2) UC; 3) ISCHEMIA; 4) chronic CONSTIPATION; 5) s/p RADIATION
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which two segments of GI should be featureless on double contrast study?
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esophagus and colon
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linear / filiform polyposis seen with what dz?
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"burnt-out" IBD -- regenerative foci
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what causes pneumocystis coli?
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may be due to bug, may be due to constipation; can be asymptomatic
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sequence of findings with untreated ischemia
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aperistaltic loop (sentinal loop) --> thumbprinting --> pneumatosis coli --> perf or portal venous gas
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what is thumbprinting?
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thickened mucosal wall (usu 2/2 ischemia --> scalloped mural indents --> bowel air with sharp angles
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smooth cecal polyp with fat density on CT scan
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lipoma
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"mexican hat sign"
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polyp on stalk seen on plain film; NOT MALIGNANT (cancers on stalks are BENIGN)
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what does sigmoid volvulus look like on radiology?
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"coffee bean sign:" central white line separating lumens
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hallmark feature of intussception on CT
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mesenteric fat within lumen of bowel
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whats the dx? CT with thickened bowel wall with trapped air
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diverticulitis
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what does appendicitis look like on CT?
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ARROW SIGN: pointed luminal contour of barium contrast
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how to dx inguinal hernia on plain film?
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look for air / bowel overlying obturator foramen
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which lobes of liver spared in cirrhosis?
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caudate and left lobe (relative enlargement)
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radiographic findings in cirrhosis
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shrunken nodular liver with relative enlargement of caudate and left lobes, splenomegaly, varices / collateralization
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what does spleen look like on mri?
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T1: darker than liver (approx = muscle); T2: brighter than liver
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what are gamna-gandy bodies?
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aka siderotic nodules -- nodules of fibrous tissue + ?calcium salts, usu seen on MRI -- areas of low signal intensity on T1
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what causes gamna-gandy bodies (siderotic nodules)?
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cirrhosis, AML, sickle cell anemia, hemoglobinopathies
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which organs affected in polycystic disease
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kidneys --> liver --> pancreas (NOT SPLEEN)
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what does spleen look like in sickle cell anemia?
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small, calcified (autosplenectomy)
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what does splenic hemangioma look like?
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centripetal enhancement on CT +/- central scar
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most common benign tumor of the spleen
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hemangioma; others benign focal lesions: lymphangioma, cyst, calcification, abscess, infarct
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mgmt of splenic artery aneurysm
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close monitoring with US (b/c of rupture risk); consider splenectomy based on size of aneurysm, other factors
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in a pt with known malignancy, what do multiple homogenous lesions in the spleen suggest?
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mets
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causes of malignant focal lesions in the spleen (3)
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1) METS; 2) LYMPHOMA; 3) LEUKEMIA
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hemosiderosis vs hemochromatosis
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HEMOSIDEROSIS: RES only (liver, spleen; no pancreas), no end organ dysfunction; HEMOCHROMATOSIS: iron in the parenchyma (liver, pancreas; no spleen); end organ dysfunction
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what does hemosiderosis look like on MRI?
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low signal in liver and spleen on T1
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what does splenic sarcoid look like?
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spleen with scalloped nodular border
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air pockets seen in the spleen with what pathology?
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abscess
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indications for splenectomy
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TRAUMA (grade III-V injury), HEMATOLOGIC with failed mgmt (thal, HS, ITP/TTP), CANCER
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