Crack The Core > Differential GI > Flashcards

Differential GI Flashcards

(46 cards)

Study These Flashcards
1
Q

Hyperattenuating liver: The normal unenhanced attenuation of the liver is 30 to 60 HU. An
absolute attenuation greater than 75 HU is considered hyperattenuating.

A

Iron overload is by far the most common cause of a hyperattenuating liver.
Medications (e.g., amiodarone, gold, and methotrexate).
Wilson disease (Copper overload).
Glycogen excess.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hypovascular hepatic metastases include:

A

Breast.
Pancreas.
Lung.
Lymphoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hypoattenuating liver: The liver is generally considered hypoattenuating if it attenuates less
than the spleen on an unenhanced CT.

A

Fatty liver (hepatic steatosis) is by far the most common cause of a diffusely hypoattenuating liver.
Hepatic amyloid is rare and may cause either focal or diffuse hepatic hypoattenuation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hypervascular hepatic metastases include (mnemonic = MRCT):

A

Melanoma.
Renal cell carcinoma.
Carcinoid / Choriocarcinoma.
Thyroid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Calcified hepatic metastases include:

A

Mucinous cancers (including colon, gastric, ovarian).
Osteosarcoma.
Treated lymphoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cystic hepatic metastases include:

A

Ovarian cystadenocarcinoma.
Gastrointesti nal sarcoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hepatic capsular retraction

A

Epithelioid hemangioendothelioma is one cause of capsular retraction.

the diff erenti al of capsular retracti on includes:

Mass-forming cholangiocarcinoma.

Fibrolamellar HCC (seen in 10% of cases of fi brolamellar HCC)

Epithelioid hemangioendothelioma.

Pseudocirrhosis (macronodular liver contour with capsular retracti on due to treated metastases).

Confl uent hepatic fibrosis (wedge-shaped fi brosis that may be seen in cirrhosis).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

4 subtypes of hepatic adenomas

A

Inflammatory: Most common, has the highest bleeding risk.

HNF-alpha 1 mutated: Second most common, characterized by multiple adenomas, associated with FAP
and von Gierke’s.

Beta-catenin mutated: Least common, seen in men on anabolic steroids, has the highest risk of
malignant transformation.

Unclassified.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Multicystic liver lesions

A

Multiple simple cyst or biliary hamartomas.
Caroli disease (saccular dilation of the intrahepatic bile
ducts).

ADPLD (associated with ADPKD).

VHL.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hyperenhancing liver lesions

A

FNH.
Adenoma.
HCC.
Hemangioma (especially flash-filling subtype).
Hypervascular metastases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Haemorrhagic liver lesions

A

Adenoma.
HCC.
Metastases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Calcified liver lesions

A

Mucinous metastases.
Osteosarcoma metastases.
Biliary cystadenoma/cystadenocarcinoma.
Granulomata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cystic with internal echos liver lesions

A

Simple cyst with internal hemorrhage or superimposed
infection.
Abscess.
Hematoma.
Necrotic or cystic metastasis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fat containing liver lesion

A

Focal fat.
Adenoma.
HCC.
Angiomyolipoma, lipoma, pseudolipoma of the Glisson’s
capsule (rare).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Central Scar on a liver lesion

A

FNH.
Fibrolamellar HCC.
Giant hemangioma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hepatic capsular retraction

A

Mass-forming cholangiocarcinoma.

Fibrolamellar HCC.

Epithelioid hemangioendothelioma.

Pseudocirrhosis (treated metastases).

Confluent hepatic fibrosis (wedge-shaped fibrosis that
may be seen in cirrhosis).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Echogenic material within the gallbladder

A

Gallstone(s) (echogenic, mobile, shadowing).

Gallbladder sludge (echogenic, mobile, non-shadowing).

Gallbladder polyp (echogenic, non-mobile, non-shadowing, oft en att ached to the gallbladder wall via a
stalk, may be vascular).

Hyperplastic cholecystoses (echogenic, non-mobile, multi ple polyps).

Porcelain gallbladder (echogenic wall, shadowing).

Adjacent bowel (echogenic wall, dirty shadowing).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Diffuse gallbladder wall thickening

A
  • Fluid-overload/edematous states:
    -Cirrhosis: Hypoalbuminemia leads to diffuse gallbladder wall thickening.
    -Congestive heart failure.

Protein-wasting nephropathy.

  • Inflammatory/infectious:
    Cholecystitis, usually with associated cholelithiasis.

Hepatitis.

Pancreatitis.

  • Infiltrative neoplastic disease:

Gallbladder carcinoma.

Metastases to gallbladder (rare).

  • Post-prandial state.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Cholangioca types

Study These Flashcards
A

Mass forming cholangiocarcinoma.

Periductal cholangiocarcinoma: most oft en at the confl uence of the right and left hepati c biliary ducts
(known as Klatskin tumor).

Intraductal cholangiocarcinoma: has variable imaging appearance.

20
Q

Risk factors for cholangioca

Study These Flashcards
A

Risk factors for development of cholangiocarcinoma include:
-Choledochal cyst(s).
-Primary sclerosing cholangiti s.
-Familial adenomatous polyposis syndrome.
-Clonorchis sinensis infecti on.
-Thorium dioxide (alpha-emitt er contrast agent), not used since the 1950s. -Thorium dioxide is also
associated with angiosarcoma and HCC.

Gallstones and chronic cholecysti ti s.
Porcelain gallbladder (somewhat controversial).
Primary sclerosing cholangiti s.
Infl ammatory bowel disease (ulcerati ve coliti s more frequently than Crohn’s disease).
Adenomatous polyp >10 mm or with multi ple risk factors, as described above.

21
Q

Pancreatic Solid Epithelial Neoplasm

Study These Flashcards
A

Ductal Adenocarcinoma - 80-90% of pancreatic tumours
Acing cell carcinoma - rare, aggressive can cause fat necrosis
Metastasis

22
Q

Cystic Epithelial Neoplasms

Study These Flashcards
A

Serous cystic- benign, many small cysts, elderly woman

Mutinous cystic - malignant potential surgical lesion, single or few large cysts, middle age women

Solid psudopapillary tumour - young women, heterogenous, irone to haemorrhage

Intraductal papillary mutinous neoplasm - malignant potential, elderly males

23
Q

Pancreatic endocrine neoplasms

Study These Flashcards
A

Insulinoma - most are benign and small

Gastronome

Glucagonoma

Lipoma

Somatostatinoma

Cystic neuroendocrine tumour

24
Q

Pancreatic mass with no ductal dilatation

Study These Flashcards
A

Autoimmune pancreatitis.
Duodenal gastrointestinal stromal tumor (GIST).
Groove pancreatitis.
Peripancreatic lymph node.
Cystic pancreatic tumor.
Pancreatic metastasis (e.g., renal cell, thyroid, or melanoma).
Neuroendocrine tumor.
Lymphoma.

25
IPMN Guidelines The Fukuoka consensus guidelines (2017) for IPMNs and MCNs recommend imaging with CT or MRI for cysts greater than 5 mm.
The Fukuoka consensus guidelines (2017) for IPMNs and MCNs recommend imaging with CT or MRI for cysts greater than 5 mm. Further evaluation with either endoscopic ultrasound (EUS) or resection is recommended based on the following imaging features: Worrisome features (should be evaluated by EUS) * Cyst ≥3 cm * Enhancing mural nodule <5 mm * Thickened enhanced cyst walls * MPD 5–9 mm * Abrupt change in the MPD caliber with distal parenchymal atrophy * Lymphadenopathy * Elevated CA 19-9 * Rapid rate of cyst growth >5 mm over two years High-risk stigmata (should undergo resection without further testing) * Obstructive jaundice * Enhancing mural nodule ≥5 mm * MPD ≥10 mm
26
Pancrease hyper vascular lesion
Neuroendocrine tumor. Metastases (usually renal cell carcinoma). Intrapancreatic accessory spleen. Pseudoaneurysm (often seen after pancreatitis).
27
Diffuse pancreatic enlargement
Acute pancreatitis. IgG4-mediated autoimmune pancreatitis. Immunotherapy-related changes. Lymphoma.
28
Fatty infiltration of pancreas
Cystic fibrosis. Exogenous steroids. Obesity. Schwachman-Diamond syndrome.
29
Atrophy of pancreas
Age-related. Immunotherapy-related changes. Chronic pancreatitis. Metabolic syndrome.
30
Cystic lesions of pancreas
Cystic fibrosis. von Hippel-Lindau. Pseudocyst. IPMN. SPT, MCN, and serous cystadenoma.
31
Splenic lesions Simple cystic
Epithelial cyst Lymphangioma Pseudocyst Hydatid cyst
32
Splenic cystic and solid lesions
Benign Haemangioma Trauma Infarction Malignant Angiosarcoma PSCS/MFH - PSCS = pleomorphic spindle cell sarcoma (previously Metastasis
33
Solid splenic lesion Hypervascular vs non-hyper vascular
Hypervascular Malignant: -Angiosarcoma -Hemangioendothelioma Benign: -Hamartoma -Castleman’s disease Non-hypervascular Malignant: -Sarcoma -Lymphoma -MFH -Metastasis Benign: -SANT: SANT = sclerosing angiomatoid nodular transformation -IMT = inflammatory myofibroblastic tumor -EMH = extramedullary hematopoiesis -Infarction
34
Splenic lesions - infectious/inflammatory
Tuberculosis Fungal Sarcoid Abscess
35
Splenic calcification
Splenic calcification Granulomatous disease (calcifications may be scattered or diffuse). Infarct (remote). Hematoma. Calcified splenic artery aneurysm.
36
Cystic splenic lesion
Cystic splenic lesion (on ultrasound, color Doppler should always be used to exclude a vascular etiology) Epithelial cyst. Splenic artery aneurysm or pseudoaneurysm. Hematoma. Abscess. Pancreatic pseudocyst.
37
Hypervascular or hyperechoic splenic lesions
Hypervascular or hyperechoic splenic lesion Hemangioma (can also be hypoechoic). Hamartoma. Lymphangioma. Angiosarcoma.
38
Hypovascular or hypoechoic splenic lesions
Hypovascular or hypoechoic splenic lesion Laceration (in the setting of trauma). Abscess. Lymphoma. Sarcoidosis. Metastasis. Infarct (tends to be peripheral). Extramedullary hematopoiesis.
39
Splenomegaly (defined as >14 cm in sagittal plane)
Splenomegaly (defined as >14 cm in sagittal plane) Mild to moderate splenomegaly: * Portal hypertension (most common). * Infection. * AIDS. Moderate to marked splenomegaly: * Leukemia/lymphoma. * Infectious mononucleosis. Massive splenomegaly: * Myelofibrosis.
40
circumferential esophageal constriction
The differential of circumferential esophageal constriction includes: Focal stricture. Muscular esophageal ring above the GE junction (also known as an A ring). Esophageal cancer (associated with irregular mucosal contour and an apple-core appearance). Esophageal web (rarely circumferential, usually in cervical esophagus).
41
submucosal gastric mass includes:
The differential diagnosis of a submucosal gastric mass includes: Mesenchymal tumors (GIST, fibroma, lipoma, neurofibromas, etc). Carcinoid. Ectopic pancreatic rest.
42
Complications of coeliac disease
Other complications of celiac disease include: Intussusception, thought to be due to uncoordinated peristalsis, without a lead-point mass. Pneumatosis intestinalis, thought to be due to dissection of intraluminal gas through the inflamed bowel wall. Pneumatosis in the setting of celiac disease is not thought to reflect bowel ischemia. Splenic atrophy. Increased risk of venous thromboembolism. Lab abnormalities include anemia (secondary to malabsorption), leukopenia, and immunoglobulin deficiency. Skin abnormalities include the characteristic dermatitis herpetiformis rash. Cavitating mesenteric lymph node syndrome (CMLNS) is a very rare complication of celiac disease. The central portion of affected lymph nodes become low attenuation due to liquid necrosis. CMLNS is thought to be highly specific for celiac disease when seen in combination with villous atrophy and splenic atrophy. The differential diagnosis of low attenuation mesenteric lymph nodes includes TB, Whipple disease, treated lymphoma, and CMLNS.
43
low attenuation mesenteric lymph node
low attenuation mesenteric lymph nodes includes TB, Whipple disease, treated lymphoma, and CMLNS.
44
Gardner syndrome
Gardner syndrome is a variant of FAP. In additi on to colon polyps, pati ents also have: Desmoid tumors. Osteomas. Papillary thyroid cancer. Epidermoid cysts. Mnemonic: DOPE Gardner
45
mesenteric mass includes:
mesenteric mass includes: Carcinoid. Desmoid tumor. Sclerosing mesenteritis. Lymphoma. Metastasis.
46
Differential diagnosis for hepatic capsular retraction:
Differential diagnosis for hepatic capsular retraction: Cholangiocarcinoma Fibrolamella HCC Metastases (breast, lung, carcinoid, colorectal) IgG4 related disease Iatrogenic/ post-traumatic Cirrhosis
Crack The Core
flashcards
Decks in class (15)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions