1
Q
What organ is imaged during a Barium Swallow study?
A
Esophagus
2
Q
What is the contrast agent used in a Barium Swallow study?
A
Barium sulfate
3
Q
What conditions is a Barium Swallow study best for diagnosing?
A
Dysphagia, strictures, motility disorders
4
Q
What organs are imaged during a Barium Meal study?
A
Stomach and Duodenum
5
Q
What is a Barium Meal study best for diagnosing?
A
Ulcers, gastritis, tumors
6
Q
What part of the digestive system does a Barium Follow-Through study image?
A
Small bowel (entire)
7
Q
What conditions is a Barium Follow-Through study best for diagnosing?
A
Small bowel obstruction (SBO), Crohn’s disease, Tuberculosis (TB)
8
Q
What is the route of administration for Enteroclysis?
A
Tube to DJ flexure
9
Q
What contrast agents are used in Enteroclysis?
A
Barium sulfate and air
10
Q
What conditions is Enteroclysis best for diagnosing?
A
Intussusception, strictures
11
Q
What organs are imaged during a Barium Enema study?
A
Colon and rectum
12
Q
What is a Barium Enema study best for diagnosing?
A
Diverticulosis, colon cancer (CA), Inflammatory Bowel Disease (IBD)
13
Q
What is the mnemonic for remembering which barium study images which organ?
A
Swallow = Esophagus; Meal = Stomach; Follow = SB; Enema = Colon
14
Q
What is Achalasia Cardia?
A
A condition where the Lower Esophageal Sphincter (LES) fails to relax.
15
Q
What is the ‘Bird Beak Sign’ observed in imaging?
A
A narrowed LES with a dilated esophagus above it.
16
Q
What is the IOC (In-vitro confirmation) for the ‘Bird Beak Sign’?
A
Barium swallow
17
Q
What is the etiology of the ‘Bird Beak Sign’?
A
Deficiency of inhibitory neurotransmitters (VIP, NO)
18
Q
What is the ‘Rat Tail Sign’ appearance?
A
A smooth tapering at the gastroesophageal junction (GEJ).
19
Q
What condition is the ‘Rat Tail Sign’ classic for?
A
Achalasia
20
Q
What does a ‘Dilated proximal esophagus’ appearance indicate?
A
Megaesophagus, often seen in chronic achalasia.
21
Q
What is the likely cause of a dilated proximal esophagus in chronic achalasia?
A
Smooth muscle atrophy
22
Q
What is a differential diagnosis for achalasia, particularly in Central/South America?
A
Chagas disease
23
Q
What is pseudoachalasia?
A
A condition that mimics achalasia, often caused by malignancy.
24
Q
What diagnostic tests confirm Achalasia?
A
Upper GI endoscopy and Manometry.
25
What does Manometry confirm in Achalasia diagnosis?
Lower Esophageal Sphincter (LES) pressure and aperistalsis.
26
What is the mnemonic for Achalasia?
Bird Beak = Achalasia (LES fails to open).
27
What does the 'Bird Beak' sign indicate?
Achalasia, where the LES fails to open.
28
What is Diffuse Esophageal Spasm (DES)?
A condition characterized by uncoordinated peristalsis in the esophagus.
29
What appearance is associated with 'Cork-Screw Esophagus'?
Serpentine, irregular contractions.
30
What does 'Cork-Screw Esophagus' signify?
Uncoordinated peristalsis.
31
What appearance is associated with 'Feline/Shaggy Esophagus'?
A ragged, saw-tooth mucosal pattern.
32
What does the 'Feline/Shaggy Esophagus' appearance indicate?
Severe spasm with air or secretion entry.
33
What is the IOC for Diffuse Esophageal Spasm (DES)?
Manometry.
34
What does Manometry show in Diffuse Esophageal Spasm (DES)?
Uncoordinated contractions.
35
What is Eosinophilic Esophagitis (EoE)?
A condition affecting the esophagus characterized by eosinophil infiltration.
36
What imaging finding may be seen in Eosinophilic Esophagitis?
Concentric, smooth narrowing.
37
What is the IOC for Eosinophilic Esophagitis?
Endoscopy with biopsy.
38
What does a biopsy reveal in Eosinophilic Esophagitis?
Eosinophil infiltration.
39
What condition may Eosinophilic Esophagitis mimic?
Pseudo-achalasia.
40
How is Eosinophilic Esophagitis differentiated from pseudo-achalasia?
Through biopsy.
41
What is the characteristic appearance of Candida esophagitis in an HIV-AIDS patient?
Shaggy Esophagus
42
What is the typical presentation of the mucosa in Candida esophagitis?
Granular, friable mucosa
43
Candida esophagitis is considered an AIDS-defining illness. True or False?
t
44
What is the common name for Congenital Hypertrophic Pyloric Stenosis (CHPS)?
CHPS
45
What is the typical presentation of CHPS in infants?
Projectile non-bilious vomiting (age 3-5 weeks)
46
What imaging modality is used as the 'Intraoperative Cholangiogram' (IOC) for CHPS diagnosis?
USG (Ultrasound)
47
What is the 'Single Bubble Sign' in the context of CHPS?
Only the gastric air bubble is visible; the rest of the abdomen is gasless.
48
What does the 'Single Bubble Sign' indicate?
Pyloric obstruction
49
What is the normal thickness of the pylorus muscle?
Less than 3-4 mm
50
What is the diagnostic finding for pylorus thickness in CHPS?
Greater than 3-4 mm (muscle hypertrophy)
51
What is the normal length of the pylorus?
Less than 14 mm
52
What pylorus length is considered diagnostic for CHPS?
Greater than 14 mm
53
What is the diagnostic finding for channel length in CHPS?
Greater than 12-16 mm
54
What is the surgical management for CHPS?
Ramstedt pyloromyotomy (surgical division of hypertrophied muscle)
55
What is Duodenal Atresia?
Complete absence of the duodenal lumen
56
What is the characteristic imaging finding for Duodenal Atresia?
Double Bubble Sign
57
What does the 'Double Bubble Sign' consist of?
A gastric bubble and a duodenal bubble, with the rest of the small intestine being gasless.
58
What syndrome is commonly associated with Duodenal Atresia?
Down's Syndrome (33%)
59
What is the cause of Duodenal Atresia?
Embryologic failure leading to the complete absence of the duodenal lumen.
60
What is the typical presentation of Duodenal Atresia in a newborn?
Bilious vomiting (day 1-3 of life)
61
Is Duodenal Atresia considered a medical emergency?
Yes, it is a neonatal emergency.
62
What is the 'Triple Bubble Sign' in the context of jejunal atresia?
It appears as the stomach, duodenum, and jejunum all being dilated, indicating multiple atretic segments.
63
What is a common symptom of jejunal atresia?
Bilious vomiting is a common symptom, typically occurring within the first 1-3 days of life, suggesting a proximal bowel obstruction.
64
What age group is typically affected by malrotation and midgut volvulus?
Neonates to infants are typically affected.
65
What are the key symptoms of malrotation and midgut volvulus?
Symptoms include bilious vomiting, abdominal pain, and shock.
66
Why is malrotation and midgut volvulus considered an emergency?
It can lead to bowel necrosis if left untreated.
67
What is the 'Cork-Screw Sign' and how is it visualized?
The 'Cork-Screw Sign' shows a twisted small bowel appearance and is visualized using a barium study or CT scan.
68
What is the 'Whirlpool Sign' and how is it best visualized?
The 'Whirlpool Sign' depicts the spiral wrapping of the mesentery around the superior mesenteric artery (SMA). CT provides the best visualization.
69
What contrast agent is recommended for Upper GI studies in suspected malrotation?
Gastrografin, a water-soluble contrast, is recommended as it is safer.
70
What is the surgical procedure used to manage malrotation and midgut volvulus?
The Ladd Procedure is used, which involves dividing Ladd's bands and widening the mesenteric base.
71
What mnemonic can help remember the signs of volvulus?
'Cork-Screw + Whirlpool = Volvulus (emergency)'.
72
What is the best sign of a neonatal perforation on an upright or sitting X-ray?
Air under the diaphragm, indicating free air in the peritoneum.
73
What is the most sensitive sign of neonatal perforation on a left lateral decubitus X-ray?
Air visible between the liver and the left abdominal wall.
74
What is the 'Football Sign' on a supine X-ray in the context of neonatal perforation?
Air outlining the bladder in an oval shape.
75
What imaging is recommended if a patient is too sick to stand for an X-ray to assess for perforation?
Contrast-enhanced computed tomography (CECT) of the abdomen.
76
What is a critical precaution when suspecting a perforation in a neonate?
Never use barium, as it can cause fatal barium peritonitis.
77
What should be used instead of barium if contrast is needed and perforation is suspected?
Gastrografin (water-soluble iodine).
78
What is the initial management for a neonatal perforation?
IV fluids, NG tube, and exploratory laparotomy.
79
What is a mnemonic for neonatal perforation?
"Perforation = Upright for air under diaphragm; Barium CI"
80
What is the primary finding of Necrotizing Enterocolitis (NEC) on imaging?
Pneumatosis intestinalis, which is air in the bowel wall.
81
What does pneumoperitoneum indicate in the context of NEC?
Perforation, which is an emergency.
82
What is portal venous gas a sign of in NEC?
An advanced stage with a poor prognosis.
83
What is the initial management for NEC if there is no perforation?
Conservative management.
84
When is surgery indicated for NEC?
If there is perforation or signs of toxicity.
85
What is the management for a gallbladder polyp less than 10 mm?
Ultrasound surveillance every 6 months.
86
What is the management for a gallbladder polyp greater than 10 mm?
Consider cholecystectomy.
87
What does a 'Comet Tail' finding on ultrasound of the gallbladder represent?
It is an artifact, not a true polyp, and requires reassurance.
88
What is a Phrygian Cap?
A normal anatomical variant of the gallbladder, requiring no follow-up.
89
What are common causes for non-visualization of the gallbladder?
Stones (WCPD), cystic duct obstruction, or it may simply not be visible in some normal variants.
90
What does cystic duct obstruction indicate?
Inflammation or a stricture.
91
What is the initial imaging modality for suspected obstructive jaundice?
Ultrasound of the abdomen (USG abdomen).
92
What does the 'Double Barrel Sign' on imaging indicate?
Dilated portal vein and dilated common bile duct, suggesting obstruction.
93
What is considered an abnormal size for the common bile duct (CBD)?
Greater than 6 mm.
94
What does a dilated CBD suggest?
Obstruction.
95
What is the significance of stones in the context of gallbladder non-visualization?
They can cause cystic duct obstruction.
96
What is the primary role of USG abdomen in obstructive jaundice?
To confirm obstruction and identify its level.
97
What is the characteristic appearance of Primary Sclerosing Cholangitis (PSC) in the biliary tree?
A 'beaded appearance' due to alternating dilation and strictures throughout the entire biliary tree.
98
What gastrointestinal condition is strongly associated with PSC?
Inflammatory Bowel Disease (IBD), with Ulcerative Colitis (UC) being more common than Crohn's Disease (CD).
99
How do the intrahepatic ducts typically appear in PSC?
Irregular and narrowed, reflecting fibroinflammation.
100
When do the extrahepatic ducts typically become involved in PSC?
Late in the disease process, indicating progressive disease.
101
What is the malignancy risk associated with PSC?
High, as it is considered a pre-malignant condition, particularly for cholangiocarcinoma.
102
What are the recommended imaging modalities for diagnosing PSC?
MRCP (Magnetic Resonance Cholangiopancreatography) or ERCP (Endoscopic Retrograde Cholangiopancreatography), with the beaded pattern being diagnostic.
103
What is a helpful mnemonic for remembering key features of PSC?
PSC = Beaded CBD + IBD + Cancer risk.
104
What is the characteristic appearance of Chronic Calcific Pancreatitis?
A 'Chain of Lakes' appearance, which refers to dilated pancreatic ducts with strictures and calcifications.
105
What is the best imaging modality for visualizing the 'Chain of Lakes' pattern in Chronic Calcific Pancreatitis?
ERCP (Endoscopic Retrograde Cholangiopancreatography).
106
What is considered a significant pancreatic duct dilatation in the context of chronic obstruction?
A diameter greater than 3-5 mm.
107
How do intraductal stones typically appear on imaging in pancreatic pathology?
As echogenic foci with shadowing, representing inspissated secretions.
108
What is the typical size of the pancreatic body in an atrophic pancreas?
Less than 2 cm, indicative of chronic fibrosis.
109
What is the best imaging modality for the diagnosis of Pheochromocytoma?
MRI (Magnetic Resonance Imaging), especially when adrenal origin involvement is suspected.
110
What are the three components of Rigler's Triad in Gallstone Ileus?
1. Small Bowel Obstruction (SBO), 2. Gallstones visible, 3. Pneumobilia.
111
What is the mechanism for Small Bowel Obstruction (SBO) in Gallstone Ileus?
A gallstone obstructs the ileocecal valve.
112
How are gallstones visualized in Gallstone Ileus?
As an echogenic focus with a shadow on imaging.
113
What is the mechanism for Pneumobilia in Gallstone Ileus?
A cholecystoenteric fistula.
114
Describe the pathophysiology of Gallstone Ileus.
A large gallstone erodes through the gallbladder wall into the duodenum, enters the small bowel, and obstructs at the ileocecal valve.
115
What is the mnemonic for Rigler's Triad?
Rigler's Triad = SBO + Stones + Pneumobilia.
116
What condition is associated with the 'Bird Beak' sign?
Achalasia.
117
What imaging modality is used to visualize the 'Bird Beak' sign?
Barium swallow.
118
What conditions can the 'Cork-Screw' sign indicate?
Esophageal spasm or Volvulus.
119
What imaging modalities are used for the 'Cork-Screw' sign?
Barium or CT.
120
What is the 'Shaggy Esophagus' a specific sign for, particularly in the context of AIDS?
Candida esophagitis.
121
What imaging is used to identify the 'Shaggy Esophagus' sign?
Barium.
122
What condition is the 'Single Bubble' sign pathognomonic for?
Pyloric stenosis.
123
What imaging modality is used to detect the 'Single Bubble' sign?
Ultrasound (USG).
124
What does the 'Double Bubble' sign on a plain X-ray indicate?
Duodenal atresia.
125
What does the 'Triple Bubble' sign on a plain X-ray indicate?
Jejunal atresia.
126
What is the 'Whirlpool Sign' highly specific for?
Midgut volvulus.
127
What imaging modality is used to identify the 'Whirlpool Sign'?
CT.
128
What does air under the diaphragm on an upright X-ray indicate?
Perforation.
129
What is the 'Double Barrel Sign' on USG specific for?
Obstructive jaundice.
130
What condition is indicated by a 'Beaded CBD' on MRCP/ERCP?
Primary sclerosing cholangitis.
131
What does the 'Chain of Lakes' sign on ERCP indicate?
Chronic calcific pancreatitis.
Radio diagnosis
flashcards
Decks in class (21)
# Cards
-
basics and usg abdo184
-
usg abdo 2123
-
usg abdo 3156
-
machines161
-
MRI150
-
mri and c270
-
usg145
-
contrast media78
-
GI131
-
Intestine156
-
gallbladder117
-
gallbladder 232
-
Kidneysss158
-
Uretheral trauma ovaries and pregnancy130
-
thoracic radio210
-
thoracic park 2108
-
neuroradio139
-
neuroradio 296
-
MSK145
-
nuclear radio155
-
nuclear radio 2119
