Pulmonary vasculature,Peutz-Jeghers syndrome,BUDD-CHIARI SYNDROME

BUDD-CHIARI SYNDROME
01) regarding the pulmonary vasculature

a) the pulmonary trunk bifurcates posterior to the left main bronchus
b) the interlobar artery passes anterior to the right upper lobe bronchus
c) the left lower lobe bronchi are supplied by segmental arteries that travel with the bronchi
d) the pulmonary veins follow the bronchial pattern of distribution
e) there are usually two left bronchial arteries

02) recognised features of Peutz-Jeghers syndrome

a) alopecia
b) intussusception
c) association with gastric carcinoma
d) brown buccal pigmentation
e) dystrophic nail changes

03) BUDD-CHIARI SYNDROME

a) is usually idiopathic
b) is defined as occlusion of the inferior vena cava
c) the caudate lobe is atrophic
d) the peripheral zones of the liver are of high attenuation on CT
e) Tc-99m sulfur colloid preferentially collects in the spleen


01) The correct answer is F F F F T  

Explanation : no explanation

02) The correct answer is F T T T F

Explanation

A. this is a feature of Cronkhite-Canada syndrome
B. cramping abdominal pain (small bowel intussusception in 47%)
C. Carcinoma of breast, pancreas (13%), reproductive organs [endometrium, malignant adenoma of cervix, ovary (in 5%), testis], GI tract (2 - 3%)
D. mucocutaneous pigmentation (similar to freckles)= 1 - 5 mm small elongated melanin spots on mucous membranes (lower lips, gums, palate) + facial skin (nose, cheeks, around eyes) + volar aspects of toes and fingers (100%)
E. a feature of Cronkhite-Canada syndrome

03) The correct answer is T F F F T

Explanation

A. IDIOPATHIC (66%) B. There are three types, two of which do not necessitate occlusion of the IVC ; Type I = occlusion of IVC ± hepatic veins Type II = occlusion of major hepatic veins ± IVC Type III = occlusion of small centrilobar veins
C. hypertrophy of caudate lobe (88%)
D. HYPODENSE nonenhancing peripheral zones of liver (= reversed portal venous blood flow due to increased postsinusoidal pressure produced by hepatic venous obstruction)
E. there is a colloid shift to spleen + bone marrow


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