Appendix
Pancreas
SBP
Abdominal pain mimics
Biliary Ultrasound
Aortic Ultrasound
100
List at least 2 pediatric scoring tools for appendicitis.
Alvarado score, pediatric appendicitis score (PAS), pediatric appendicitis risk calculator (pARC)
100
What are the 2 most common causes of pancreatitis?
Gallstones, ethanol.
100
What PMN count is indicative of SBP?
≥ 250 cells/mm3
100
23F with RLQ pain. Most at risk for?
Ovarian torsion.
100
What is this sign? What vessels are involved?
Seagull sign.
Celiac artery, splenic artery, hepatic artery.
100
Should you use A or B used to measure the aorta?
A.
200
For acute uncomplicated appendicitis initially treated with antibiotics, what is the recurrence rate and appendectomy rate 10 years later?
40%
200
What scorpion genus can cause pancreatitis?
Tityus.
200
What is the recurrence rate of SBP at 1 year?
70%
200
39F. Protein C deficiency. Epigastric pain after eating.
SMA thrombosis
200
What is the name of this sign? What structures are involved?
Exclamation point sign.
Gallbladder, portal vein, liver, IVC.
200
What pathology is seen here?
Aortic dissection.
300
What is an abnormal appendix diameter?
> 6 mm
300
Ranson's criteria predicts mortality based on labs obtained at which 2 points in a patient's visit?
Upon presentation and at 48 hours.
300
List the top 3 causative organisims of SBP.
Enterobacter (63%) Pneumococcus (15%) Enterococcus (10%)
300
23 yo F. Smokes 3g cannabis daily. Name that rash.
Erythema ab igne
300
Where is the gallbadder wall thickness measured? Why?
Anterior wall. Posterior wall has posterior acoustic enhancement.
300
What is the normal diameter of the common iliac arteries in men/women?
1.5 cm men.
1.2 cm women.
400
Bloody diarrhea. RLQ pain. CT: terminal ileitis, cecitis, mesenteric lymphadenitis. Causative organism?
Yersinia enterocolitica
400
Diagnosis of acute pancreatitis requires at least 2 of which 3 criteria?
1. Abdominal pain
2. Lipase > 3x ULN
3. Imaging findings
400
How is treatment different for patients on peritoneal dialysis?
Vancomycin and cefepime
400
59 yo male with epigastric abdominal pain after eating meals x 2 weeks.
SMV thrombosis
400
Identify these structures.
CBD, hepatic artery, portal vein.
400
Name the 3 main vessels shown here.
Celiac artery, SMA, Aorta.
500
19 yo. RLQ pain, fever. Diagnosis?
Mesenteric adenitis
500
A 50-year-old man was admitted with pancreatitis 3 weeks ago. He now returns with early satiety and persistent abdominal discomfort. Ultrasound shows a well-circumscribed anechoic fluid collection adjacent to the pancreas with posterior acoustic enhancement.
Which of the following is the most likely diagnosis?
A. Pancreatic abscess
B. Pancreatic pseudocyst
C. Pancreatic necrosis
D. Pancreatic hematoma
E. Pancreatic carcinoma
A pancreatic pseudocyst typically forms ≥2–4 weeks after pancreatitis.
Ultrasound features:
Well-defined cystic structure
Anechoic or hypoechoic
Posterior acoustic enhancement
Located near the pancreas
Abscess → internal debris, septations, or gas
Necrosis → poorly defined heterogeneous tissue
Tumor → solid mass rather than simple fluid
500
Albumin is recommended in many patients to reduce the risk of hepatorenal syndrome and mortality, particularly with what 3 lab abnormalities?
Cr > 1 mg/dL
BUN > 30 mg/dL
T. bilirubin > 4 mg/dL
500
Abdominal pain 2 days after cardiac surgery. No mechanical obstruction on imaging.
Colonic pseudo-obstruction (Ogilvie syndrome)
500
What is the normal common bile duct diameter by age?
4 mm.
+ 1 mm/decade after 40.
500
Where on the abdomen does the aorta bifurcate?
Umbilicus.