abdominal imaging

Question 1

where are the most common places for renal stones to form

Answer 1

• uretopelvic junction
• uretovesical junction
• crossing of iliac vessels

(know what renal stones look like on CT scan)

Question 2

what is the best modality for seeing gall stones, although can be done on CT

Answer 2

Ultrasound

Question 3

inflammation of the biliary system is likely due to what pathology

Answer 3

gallstones

Question 4

what are gallstones made of

Answer 4

hardened deposits of bile made mostly of cholesterol (can have calcium, bilrubinate and calcium carbonate)

Question 5

gall stones are most common cause of blocked bile ducts, if a gallstone stops between the gallbladder and common bile duct what named infection can occur

Answer 5

cholecystitis

Question 6

if bacteria accumulates and backs up into the liver due to bile stone blockage, what pathology can this ause

Answer 6

cholangitis

Question 7

what is the difference between cholecystitis and cholangitis

Answer 7

cholecystitis = inflammation in gall bladder

cholangitis = inflammation in bile ducts

Question 8

what is the most common cause of acute pancreatisits and how

Answer 8

gallstones

• pancreatic duct joins to the common bile duct near the small intestine
• gallstones can enter the common bile duct and and impinge on the main pancreatic duct causing obstruction of normal flow of pancreatic fluid
• leading to pancreatic injury

OR

• stone causes back flow of bile into pancreatic duct

Question 9

what dose chronic pancreatitis look like on scan

Answer 9

• coarse calcification /calcified stones throughout pancreas

Question 10

what are the 2 main function of the pancreas (endocrine and exocrine)

Answer 10

endocrine = producing insulin and glucagon

exocrine = producing digestive enzymes ( proteins mainly)

Question 11

what artery runs close to the pancreas

Answer 11

splenic artery

Question 12

what could happen if the pancreas walls were damaged considering the fact that the splenic artery is near by

Answer 12

digestiv e enzymes lead out and erode the splenic artery causing internal bleeding

Question 13

what is a lobulated kidney and what does it look like on scan

Answer 13

the result of fetal lobulation that persists into adulthood and is caused by incomplete fusion of the developing renal lobules.

(should be smooth but isnt)

• very bumpy, almost like grapes

Question 14

a fetal pelvic kidney is a normal variant, why is it in this position

Answer 14

• fails to ascend to normal position due to being blocked by blood vessels in aorta

Question 15

what are 2 common complications of horseshoe kidney

Answer 15

• recurrent infections
• recurrent calculus formation

Question 16

what is necrotic small intestine and what does this look like on scan

Answer 16

• cellular death due to recuced blood flow to GI tract
• on axial CT, many hollow/dark areas all over (where intestines surround) due to infarction

Question 17

what is pneumoperitoneum and what does it look like on scan

Answer 17

• air in the peritoneal cavity
• in supine axial scan, you will see dark circles on the anterior border of cavity which is air

Question 18

what area of the intestine is diverticulum most common in

Answer 18

sigmoid colon

Question 19

what are 3 functions of the liver

Answer 19

• absorbing and breaking down nutrients
• making bile
• filtering and removing toxins from blood

Question 20

what is the role of bile

Answer 20

breaks down fatty acids

Question 21

most liver metastases are secondary to cancer in other abdominal viscera e.g colon why?

Answer 21

blood supply from intestine is directly connected to the liver through the portal vein

Question 22

what does cirrhosis of liver look like on CT

Answer 22

• brighter, rough edged patter found in the liver due to fibrosis/scarred tissue

Question 23

what do you call and enlarged spleen and what is the cause of this

Answer 23

• splenomegaly
• caused by hypertension and back flow from portal vein down to splenic vein towards spleen

Question 24

where is the base of the appendix located

Answer 24

• 2cm below the ileocecal valve

Question 25

where would pain/ irritation be caused if you had a retrocecal or pelvic appendix

Answer 25

retrocecal = pain in right flank pelvis = irritate bladder or rectum, suprapubic pain, pain with urination