Imaging Pathology Chap 5

What is a common complication of cirrhosis?

Ascites ... The accumulation of fluid in the peritoneal cavity, known as ascites, is a common complication of liver cirrhosis.

Preexisting polyps

Colon cancer

Cholelithiasis

Ultrasound

What is the current imaging modality of choice for the gallbladder?

Ultrasound ... Ultrasound is now the imaging modality of choice for the gallbladder. Oral cholecystogram was the gold imaging standard in the past.

A twisting of the bowel on itself that may lead to obstruction is termed:

A volvulus

A common disorder of intestinal motor activity in which fluid and gas do not progress normally through an unobstructed bowel is called:

Adynamic ileus ... Adynamic ileus is a common disorder in which the lack of peristalsis, or motor activity in the intestine, causes fluid and gas to not progress through the intestines.

GERD

Barrett's esophagus

Which of the following is an emulsifier that aids in the breakdown of fats during digestion?

Bile

In which age group is appendicitis more common?

Children and adolescents ... Appendicitis occurs in all age groups, but it is more common in children and adolescents.

Progressive shortening and rigidity of the colon and absent haustral patterns are radiographic evidence of:

Chronic ulcerative colitis ... Chronic ulcerative colitis demonstrates radiographically with progressive shortening and rigidity of the colon and absent haustral patterns caused by ulcer healing and subsequent reepithelization.

Liver metastasis

CT

Pancreatic cancer

CT

Which imaging modality is used to stage gastric carcinoma?

CT ... CT is used to stage gastric carcinoma and also used for treatment planning and in evaluating response to therapy.

Which imaging modality is the most effective for detection of carcinoma of the pancreas?

CT ... Whereas ultrasound is often the screening modality for suspected pancreatic carcinoma, CT is the most effective imaging modality for diagnosis of pancreatic cancer.

Which imaging modality is the gold standard for appendicitis?

CT is the gold standard for detection of appendicitis and provides a more precise evaluation of the nature, extent, and location of the pathologic process.

What is the modality of choice to image hepatocellular carcinoma?

CT is the imaging modality of choice for diagnosis of hepatocellular carcinoma.

What is mastication?

Chewing ... Mastication is the medical term for chewing.

A chronic inflammatory disorder of unknown cause that often affects the terminal ileum is called:

Crohn's disease ... Crohn's disease, or regional enteritis, is a chronic inflammatory disorder of unknown cause and has a wide range of symptoms. The terminal ileum is usually the area most often affected.

Which imaging procedure is used to demonstrate dilated veins in the walls of the esophagus?

Double-contrast barium swallow ... A double-contrast barium swallow best demonstrates the wormlike filling defect that is evidence of esophageal varices.

Esophageal cancer

Double-contrast fluoroscopy exam

What is the most common manifestation of peptic ulcer disease?

Duodenal ulcer

Where does the greatest amount of digestion occur?

Duodenum ... The greatest amount of digestion occurs in the duodenum, the first part of the small intestine.

Hepatocellular carcinoma most commonly occurs in patients with:

Diffuse hepatocellular disease... Primary liver cancer is more common in persons with diffuse hepatocellular disease, such as alcoholic and postnecrotic cirrhosis.

Where in the stomach do most gastric cancers occur?

Distal stomach

A condition of acquired herniations of mucosa and submucosa through muscular layers at points of weaknesses of the bowel wall is known as:

Diverticulosis ... Diverticulosis is a condition of acquired herniations of the mucosa and submucosa through muscular layers at points of weaknesses in the bowel wall. Almost 50% of patients over age 60 have diverticulosis.

Excessive smoking and alcohol intake

Esophageal cancer

Acute pancreatitis

Excessive alcohol consumption

What is the most common cause of acute pancreatitis?

Excessive alcohol consumption ... Excessive alcohol consumption is the most common cause of acute pancreatitis. Occasionally, acute pancreatitis is the result of gallstones.

The most common cause of a mechanical small bowel obstruction is:

Fibrous adhesions ... About 75% of small bowel obstructions are caused by fibrous adhesions from previous surgery or peritonitis. The second most common cause of mechanical small bowel obstruction is external hernia.

Varicose veins of the lower end of the rectum that cause symptoms of pain, itching, and bleeding are:

Hemorrhoids ... Hemorrhoids are varicose veins of the lower end of the rectum with symptoms of pain, itching, and bleeding.

Cirrhosis

Hepatocellular carcinoma

What is the most common abnormality found on upper GI exams?

Hiatal hernia

Perforation of the esophagus may be a complication of all of the following EXCEPT:

Hiatal hernia ... Perforation of the esophagus may be a complication of esophagitis, peptic ulcer, neoplasm, external trauma, or instrumentation.

What is the primary cause of acute cholecystitis?

Impacted gallstone in the cystic duct ... Acute cholecystitis usually occurs after obstruction of the cystic duct by impaction of a gallstone.

Where in the colon do most primary cancers arise?

In preexisting polyps ... There is evidence that most primary cancers of the colon arise from preexisting polyps.

Which of the following is appropriate when imaging a patient with known liver cirrhosis complicated by ascites?

Increase in kVp ... Fluid attenuates radiation, so an increase in kVp is necessary to penetrate the accumulated fluid in ascites.

Pancreatic pseudocyst

Inflammation or necrosis

Which of the following is a major cause of bowel obstruction in children?

Intussusception ... Intussusception is a major cause of bowel obstruction in children but is rare in adults.

Which of the following is associated with prior cardiovascular disease?

Ischemic colitis

Where is the most common location of gastric ulcers?

Lesser curvature ... Gastric ulcers are usually located along the lesser curvature of the stomach.

The _____ is the largest gland in the body.

Liver ... The liver is the largest gland in the body; it provides many vital functions for the body, many of which are related to digestion.

Acquired tracheoesophageal (TE) fistulas are commonly caused by:

Malignancy in the mediastinum ... Acquired TE fistulas are commonly caused by a malignancy in the mediastinum and are a serious, late complication of esophageal carcinoma. Another common cause of acquired TE fistulas is infections.

Where does the process of digestion begin?

Mouth ... Digestion begins in the mouth with chewing breaking down food and mixing it with saliva.

Acute cholecystitis

Obstruction of cystic duct by an impacted gallstone

Pyloric stenosis usually results in:

Obstruction that prevents food from entering the duodenum ... Pyloric stenosis causes a complete or near-complete obstruction preventing food from entering into the duodenum.

An increase in glucose in the blood stimulates the beta cells in the _____ to secrete _____.

Pancreas; insulin ... Blood glucose levels in the blood are maintained by the secretion of insulin and glucagon by the pancreas. When there is an increase in glucose, the pancreas secretes insulin. When glucose is low, the pancreas secretes glucagon to accelerate glycogen breakdown by the liver.

What is the most common cause of acute gastrointestinal bleeding?

Peptic ulcer disease

Pneumoperitoneum

Perforation of GI tract

Smooth muscle contractions that move the contents of the digestive system along the GI tract are called:

Peristalsis ... Peristalsis is the term that refers to the smooth muscle contractions that move the contents of the digestive system through the GI tract.

Which of the following is a sign of perforation of the GI tract?

Pneumoperitoneum ... pneumoperitoneum, or free air in the peritoneal cavity, is a sign of a perforation of the GI tract.

What condition results from chronic cholecystitis in which the gallbladder becomes fibrotic and calcified?

Porcelain gallbladder ... Porcelain gallbladder results from chronic cholecystitis and causes extensive calcification and fibrosis of the walls. The name is derived from the bluish discoloration and brittle consistency of the gallbladder.

What is the most common cause of dilated veins in the walls of the esophagus?

Portal hypertension ... Dilated veins of the esophagus, termed varices, are usually caused by portal hypertension.

What is one of the most common causes of obstruction in the large bowel?

Primary colon cancer ... About 70% of large bowel obstructions are due to primary colonic cancers. Diverticulitis and volvulus account for most of the remaining cases of obstruction.

Which imaging modality is the preferred method for the detection of pyloric stenosis?

Radiography ... In today's imaging arena, ultrasound is the modality of choice due to the high sensitivity and specificity, an accuracy approaching 100%. Pyloric stenosis will appear as a thickened pyloric muscle width greater than 3 mm and an elongated pyloric canal (greater than 1.2 cm) on the longitudinal sonogram.

What is the function of the gallbladder?

Store and concentrate bile ... The gallbladder functions to store and concentrate bile. It releases bile into the duodenum when stimulated by the presence of dietary fat in the small bowel.

Deglutition is defined as:

Swallowing

Which of the following are digestive enzymes secreted by the pancreas? (1) Trypsin, (2) Chyme, (3) Chymotrypsin

The correct answer is: 1 and 3 only ... Trypsin and chymotrypsin are digestive enzymes secreted by the pancreas. Chyme is the term applied to the milky white substance that is formed in the stomach when chewed food is mixed with hydrochloric acid and pepsin.

Which of the following are complications of peptic ulcer disease? (1) Hemorrhage, (2) Obstruction, (3) Perforation

The correct answer is: 1, 2, and 3 ... Hemorrhage, obstruction, and perforation are all complications of peptic ulcer disease.

A pear-shaped organ that lies on the under surface of the liver is the:

The gallbladder

What is intussusception?

The telescoping of one part of the intestinal tract into another ... Intussusception is the telescoping of one part of the intestinal tract into another and is a major cause of bowel obstruction in children.

Which of the following is an ominous complication of ulcerative colitis?

Toxic megacolon ... Toxic megacolon, characterized by extreme dilatation of a segment of colon with systemic toxicity, is a severe and ominous complication of ulcerative colitis.

Dilated veins in the walls of the esophagus are termed:

Varices ... Dilated veins in the walls of the esophagus are termed varices. Outpouchings of the esophagus are called diverticula. Dysphagia is difficulty swallowing. Achalasia is a condition in which the esophagus is dilated from abnormal functioning of the sphincter.