The above CT scan reveals a cirrhotic contour of the liver.
59 yo male with a history of hepatitis C and alcoholism was referred to the Liver Clinic for transplant evaluation. His symptoms included intermittent abdominal bloating from ascites, a persistent epigastric discomfort and one episode of upper GI bleeding. He underwent a CT scan shown below.
The following four questions are T/F.
Question 1 - Single Best Answer
The above CT scan reveals a cirrhotic contour of the liver.
A) True
B) False
Question 2 - Single Best Answer
The above CT scan reveals splenomegaly.
A) True
B) False
Question 3 - Single Best Answer
The above CT scan reveals splenorenal blood vessel collaterals.
A) True
B) False
Question 4 - Single Best Answer
The above CT scan reveals a mass in the liver.
A) True
B) False
Question 5 - Single Best Answer
Which of the following are complications that arise from cirrhosis?
A) Abdominal ascites
B) Esophageal varices
C) Encephalopathy
D) Hepatocellular carcinoma (HCC)
E) all of the above
Question 6 - Single Best Answer
Which of the following is the most likely diagnosis of the liver mass in the patient above?
A) Metastatic colon cancer
B) Severe liver disease with development of hepatocellular carcinoma
C) Ulcerative colitis
D) Liver abcess
65 yo otherwise healthy male presented to his primary care physician complaining of constipation and pencil size stools for 2 months. He underwent a barium enema (BE) shown below.
Question 7 - Single Best Answer
Blood work revealed a microcytic anemia. Which of the following signs/symptoms would be the most likely in this patient?
A) Guiac positive stools
B) Bloody diarrhea
C) Coughing up blood
D) Vomiting up blood
Question 8 - Single Best Answer
The patient (from question 7) was further evaluated with a CT scan shown above. What is the most likely dx of the liver lesions?
A) Hemangiomas
B) Cirrhosis
C) Metastatic colon cancer
D) Hepatocellular carcinoma
Question 9 - Single Best Answer
45 yo alcoholic presents with 2 days of severe mid-epigastric pain radiating to the back which is made worse with eating. What is the most significant finding on the above CT scan images?
A) Dilatation of the sigmoid colon with an abrupt change to normal size caliber of the more distal rectum suggesting an obstructive lesion.
B) An enlarged and edematous pancreas with peri-pancreatic stranding (inflammation).
C) A dilated appendix, greater than 6mm in diameter, with surrounding stranding in the adjacent fat.
Question 10 - Single Best Answer
Based on the clinical history and the CT images in question 9, which of the following is the most likely diagnosis?
A) Acute appendicitis
B) Colorectal Cancer
C) Acute pancreatitis
Question 11 - Single Best Answer
In the patient above (question 9), which of the following is not a complication of acute pancreatitis?
A) Hypocalcemia
B) Fat malabsorption
C) Pancreatic hemorrhage
D) Duodenal obstruction
Question 12 - Single Best Answer
When does the formation of a pancreatic pseudocyst occur?
A) Prior to the acute episode of pancreatitis
B) Within the first 48 hours of acute pancreatitis
C) Several weeks after the acute episode of pancreatitis
Question 13 - Single Best Answer
47 yo female presents with a 4 day history of epigastric pain associated with vomiting and poor PO intake. An upper GI series was performed (shown above). What is the significant finding?
A) Obstructing mass in the antrum of the stomach.
B) Abnormal collection of barium in the antrum of the stomach
C) Herniation of the cardiac fundus above the diaphragm.
D) Dilatation of the duodenum
Question 14 - Single Best Answer
What is the differential diagnosis of gastric ulcers?
A) Benign gastric ulcer
B) Malignant gastric ulcer
C) Lymphoma
D) All of the above
Question 15 - Single Best Answer
Which of the following is a complication of a gastric ulcer?
A) Gastric outlet obstruction
B) Perforation
C) Bleeding
D) All of the above
Question 16 - Single Best Answer
True/False. An UGI using barium can be used if a perforation is suspected.
A) True
B) False