RCA Final Guide

What are the standard abdominal radiographic views? ________________, __________________, and __________________.

AP supine; PA erect; KUB

What is the usual kVp for abdominal radiography? _______________

70-80 kvp

What kind of contrast is used for radiographic swallows and enemas?

________________.

Barium

What type of intravenous contrast is used for computed tomography?

_____________________.

iodinated contrast

In general, what are the indications for an abdominal or pelvic diagnostic ultrasound? _____________/____________________, __________________, ____________, and abnormal lab _____________ serum levels

Infections; inflammatory conditions; neoplasms; stones; bilirubin

What contrast agent is used for abdominal MRI? _____________

Gadolinium

What is the most common renal fusion anomaly? __________

Horseshoe kidney

Bilateral renal agenesis has a normal life expectancy.

False

What is crossed fused renal ectopia?

An anomaly where the kidneys are fused and located on the same side of the midline.

A pelvic kidney is a normal variant, but WHAT ELSE would cause a kidney to be seen in the pelvis? ________________ _____________________.

Renal transplant

Which kidney does a dromedary hump occur?

Left

Which lobe does a Riedel Lobe occur? ________________

Right

Which lobe does a Beaver Tail lobe occur? __________________

Left

What are malformations or agenesis of the female reproductive system called?

Mullein Duct Anomalies

What is the most common gastric malignancy?

adenocarcinoma

What are the 3 types of lymphadenopathies (nodal metastases) that may present

with abdominal malignancies and where are they located?

a. _______________- Where? ______________________________________________.

b. ___________ _______ _______________- Where? ________________________. c. ___________- Where? _________________________________________________

A. Virchows node: left supraclavicular lymphadenopathy

B. Sister Mary Joseph's node: umbilical node lymphadenopathy

C. Irish node: axillary lymphadenopathy

What is the most common location for small intestine adenocarcinoma? _________________.

duodenum

What is the most common location for large intestine adenocarcinoma? _________________.

Rectosigmoid

What is the most common benign tumor of the gastrointestinal tract? _______________________________

Leiomyomas

What is the most common cause of appendicitis and where is it located?

_____________________________________________________________________________

appendiocolith - calcification in the right iliac fossa

What is the most common location of epiploic appendagitis? What other pathologies can have a similar presentation clinically?

rectosigmoid; acute appendicitis and diverticulitis

What is the most common cause of abdominal aortic atherosclerosis?

______________________________.

Chronic hypertension

What are the 4 risk factors for abdominal aortic aneurysms?

a. _____________________________________ b. _____________________________________

c. _____________________________________ d. _____________________________________

A. >65 yoa

B. male

C. Hx of smoking

D. Chronic HTN leading to atherosclerosis

What measurement of an abdominal aorta is considered aneurysmal? _______ cm.

>3

When is an abdominal aorta considered emergent? ___________ cm or _________ at any measurement above 3 cm.

>5-6; symptomatic

What is the most common location of an abdominal aortic aneurysm? ______________________________________.

above bifurcation into common iliac arteries

What imaging modality is most appropriate for screening and monitoring an AAA?

Diagnostic US

Are phleboliths clinically significant?

No

Which granulomatous disease prefers the spleen? H_____________

Histoplasmosis

What is the most common location for echinococcus? __________

Liver

What organism causes schistosoma infection? _____________________

blood fluke (trematode worm)

What is the most common liver tumor?

Metastatic disease

What is the most common primary carcinoma to metastasize to the liver?

_____________________.

colon

What is the most common benign tumor of the liver and spleen? _____________________.

Hemangioma

What is the most common cause of acute pancreatitis? ____________________.

Gallstones lodged in the ducts

What percentage of gallstones calcify? ________%

15

What tissue type is the most common gallbladder malignancy? A______________

Adenocarcinoma

What is gallstone ileus?

Large gallstone that erodes through to the duodenum, passes through the GI tract and gets stick at the ileocecal valve

What are the 3 main causes of pseudocysts of the spleen?

a. ____________________________ b. _______ _______ c. _______ _________

A. Trauma

B. Splenic infarction

C. Locoregional inflammation

What is the most common cause of autosplenectomy? ________________________.

sickle cell anemia (homozygous)

How does someone acquire chronic pancreatitis? ___________________________

excessive alcohol consumption

What is the most common benign tumor of the pancreas? _______________ _______________

Microcystic adenoma

What is the most common malignant tumor of the pancreas? A____________

Adenocarcinoma

What is the most common cystic lesion of the pancreas? ________________

Psuedocyst

What is the most common etiology for unilateral adrenal hemorrhage? __________________

Trauma

What is the most common adrenal lesion? __________________

adenoma

Which adrenal tumor causes uncontrolled secondary hypertension? _______________________________.

Pheochromocytomas

What is the most common composition of kidney stones?

Calcium oxalate

What % of kidney stones are radiopaque?

85%

What advanced imaging is the most appropriate follow-up for kidney stones?

Abdominopelvic CT without contrast

Locations stone commonly "get stuck":

a. __________________________

b. __________________________

c. __________________________

d. __________________________

e. __________________________

A. Uretopelvic junction

B. In ureter overlying lumbar TPs

C. In ureter at pelvic brim

D. Ureterovesical junction

E. Bladder outlet (rare)

Which 2 types of stones are radiolucent?

a. __________________________

b. __________________________

A. Uric acid

B. Protease-related (Indinavir)

What is the composition of a staghorn calculus?

struvite (triple phosphate)

Which type of nephrocalcinosis is most common?

medullary nephrocalcinosis

What is the classiication used to describe renal cysts?

Bosniak classification

Which level of renal cyst needs follow-up at 6 months after initial CT exam?

2 F

Which benign tumor looks similar to renal cell carcinoma clinically and on imaging?

Oncocytomas

What is the clinical triad of renal cell carcinoma?

a. _____________________ b. _____________________ c. _____________________

A. Hematuria

B. Flank pain

C. Palpable flank mass

What is the most common cause of bladder stones?

Urinary stasis

What tumor does schistosomiasis predispose a patient to?

squamous cell carcinoma

What is the most common solid benign tumor of the uterus?

leiomyomas (fibroids)

What kind of calciication is seen in a uterine leiomyoma?

Popcorn

What is the most common ovarian neoplasm?

Cystic teratoma

What is the most common ovarian malignancy?

Cystadenocarcinoma

What calciication in the male pelvis is most seen in diabetics?

Ductus deferens

If prostatic calculi are symptomatic, what underlying etiologies are possible?

a. ___________________

b. __________________

c. ______________

A. Prostatitis

B. Prostate cancer

C. Benign prostatic hypertrophy

What are scrotal pearls?

benign incidental extratesticular marcocalcification w/in the scrotum

What is the most common cause of small bowel obstruction? _________ ________

Adhesive disease

What are the measurements for dilated small bowel loops that are at risk for rupture? __________ cm proximally and __________ cm distally

3; 2.5

What is the step ladder sign?

Stacked prominent valvulae conniventes due to obstruction

What is the string of beads sign?

small pocket of gas w/in a fluid filled small bowel

What is the most common of large bowel obstruction? _________________

Colorectal carcinoma

What are the measurements for dilated large bowel loops that are at risk for rupture? ____________ cm. Cecum dilation? ____________ cm

6; 9

What sign is associated with sigmoid volvulus? __________ _______ _______

Coffee bean sign

What distinguishes a sigmoid volvulus from a cecal volvulus? No _________________ ________

Haustral markings

What sign is associated with a cecal volvulus? ______ _______

Comma sign (reversed C sign)

What is a dynamic ileus?

Stasis of bowel contents without mechanical obstruction

What portion of the bowel is typically affected by Crohn disease? ______ ______

terminal ileum

What are prominent radiological features of Crohn disease? ____________________ and ________________

Thumbprinting and Skip Lesions

What portion of the bowel is typically afected by ulcerative colitis?

Distal colon and rectum

What are the most common causes of toxic megacolon?

a. ____________________________________ b. ____________________________________

A. Acute ulcerative colitis

B. Crohn's disease

What is the diference between diverticulosis and diverticulitis?

Both have multiple outpouchings along the colon wall but diverticulitis involves inflammation/ infection of the diverticula

What portion of the colon is most commonly affected by diverticulosis/diverticulitis? ___________

Sigmoid colon

What is pneumobilia?

Air within the biliary tree causing central linear radiolucent branching over the liver

Most common cause of pneumobilia?

Sphincterotomy during a ERCP

Emphysematous cholecystitis is a surgical emergency?

Yes

What special population is prone to developing emphysematous infections?

Diabetes mellitus

What bacterium is most implicated in emphysematous infections?

E. coli

What radiographic view is pneumoperitoneum the most readily identified?

PA chest

What is the most common cause of pneumoperitoneum?

perforated gas-filled viscus

What radiographic signs are associated with pneumoperitoneum?

a. _________________________

b. _________________________

c. _________________________

d. _________________________

A. Rigler's sign

B. Football sign

C. Falciform Ligament Sign

D. Continuous Diaphragm Sign

What is ascites?

Free fluid within the peritoneal space

What is the most common cause of ascites?

Liver disease or malignancy