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Clinical Medicine III > GI: Diagnostic Studies > Flashcards

GI: Diagnostic Studies Flashcards

1
Q

Which diagnostic should be ordered for these sxs?

abd. pain, N/V, distension

A

Abd. X-Ray

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2
Q

A patient presenting with the following can be evaluated with what study?

Obstruction
Ileus
Perf
Stool Burden
Ureteral Calculi
FB
A

abd. XR

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3
Q

What are the three views of abd XR?

A

Supine, Upright, PA CXR

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4
Q

Which abd XR view has the following characteristics…

  • assess dilated bowel
  • 1st test to eval abd. problems
A

Supine (aka KUB)

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5
Q

Which abd. XR view offers better visualization of air fluid levels?

A

Upright

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6
Q

Which abd. XR view visualizes free air under diaphragms to assess for perf?

A

PA CXR

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7
Q

The below two findings on abd XR indicate what?

dilated proximal bowel/collapsed distal bowel

air fluid levels

A

small bowel obstruction

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8
Q

What condition has the below features on abd XR?

no air-fluid levels

dilated bowel w. air in small intestine and colon

A

ileus

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9
Q

Free air outside of the bowel/pneumoperitoneum indicates…

A

perforation

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10
Q

XR is C/I in what two conditions?

A

radiation exposure

pregnancy

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11
Q

Abd. US can be ordered for a specific organ or…

A

region/quadrant

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12
Q

A patient presenting with the following can be assessed with what diagnostic imaging?

Abd. Pain (Epigastric, RUQ/LUQ)
elevated LFTs
Liver Disease
Stones
renal failure
AAA ( > 3cm)
A

Abd. US

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13
Q

The below liver conditions can be identified with what imaging modality?

cysts, abscess, tumor, steatosis, hepatitis, cirrhosis

A

US

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14
Q

The below gallbladder conditions can be assessed with what imaging modality?

tumors, polyps, stones, sludge, inflammation, dilated bile ducts

A

US

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15
Q

Possible US findings on pancreas (4)

A

cysts, abscess, tumor, inflammation

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16
Q

Possible US findings on kidney/bladder (5)

A

cysts, abscess, tumor, hydronephrosis, renal calculi

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17
Q

Initial test of choice for cholelithiasis…

A

RUQ/Gallbladder US

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18
Q

Assessment of what condition should not be done with contrast CT?

A

renal stone study

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19
Q

A patient presenting with the following is indicated for what imaging modality?

Abd. pain
Abd. distension
NV
Diarrhea
Constipation
Rectal Bleeding
Jaundice
A

CT Abdomen/Pelvis

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20
Q

Which imaging modality is the preferred study for pancreatitis?

A

CT

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21
Q

Diverticulitis can be assessed with what study?

A

CT

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22
Q

What can be seen on CT A/P in acute pancreatitis?

A

inflammation/swelling

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23
Q

What can be seen on CT A/P in chronic pancreatitis?

A

white calcifications

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24
Q

Patient presents with right flank pain and hematuria. What initial study should you order?

A

Non-contrast CT A/P

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25
Q

The below are C/Is for what diagnostic study?

pregnancy
unstable vitals
morbid obesity
allergy
elevated Cr
A

CT A/P

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26
Q

What type of AKI can occur due to contrast CT?

A

acute tubular necrosis/intrinsic renal

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27
Q

Metformin must be held for 48 hrs after contrast administration to prevent what condition?

A

lactic acidosis

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28
Q

This test…

-assess bile excreting function of liver and GB via IV radioactive tracer

A

HIDA scan

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29
Q

Interpret the following result of HIDA scan…

  • no radionuclide seen in GB w/in 15-60 min
  • ordered w/ CCK stimulation & EF < 35%
A

cholecystitis

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30
Q

HIDA scan showing no GB visualization can mean ______, which is present in what two conditions?

A

obstruction

Cholecystitis, Acalculous cholecystitis

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31
Q

C/I for HIDA scan

A

pregnancy (radiation)

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32
Q

This series of studies are helpful in assessing luminal GI tract disorders and offer visualization by coating the GI mucosa…

A

barium studies

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33
Q

What are the 4 types of barium studies?

A

esophagram/barium swallow

UGI

SBFT (small bowel follow through)

BE (barium enema)

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34
Q

which barium study visualizes the esophagus and the gastroesophageal junction?

A

esophagram/barium swallow

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35
Q

Which study has the following indications?

reflux sxs
odynophagia
dysphagia
stricture assessment
diverticula
tumor
hiatial hernia
achalasia
A

Esophagram/barium swallow

36
Q

which barium study visualizes the esophagus, stomach and 1st part of the duodenum?

A

UGI series

37
Q

The below are indications for what diagnostic study?

GERD
odynophagia
dysphagia
hiatial hernia
early satiety
peptic ulcer disease
CA
stricture/obstruction
perforation
A

UGI

38
Q

Barium can’t be used with suspected perforation. What should be used instead?

A

Gastrografin

39
Q

4 contraindications for UGI series…

A

pregnancy

complete bowel obstruction

suspected upper GI perf
(use gastrografin)

unstable vitals

40
Q

SBFT stands for…

A

small bowel follow through

41
Q

SBFT can visualize what 5 GI regions?

A

esophagus, stomach, duodenum, jejunum, ileum

42
Q

This diagnostic study…

assess peristalsis
ID mucosal abnormality
polups
diverticula
bowel wall thickening
nodularity
strictures
obstruction
A

SBFT

43
Q

SBFT uses what type of contrast on fluoro for visualization?

A

barium

44
Q

SBFT is useful for evaluating what two conditions?

A

Crohn’s Disease, small bowel tumors

45
Q

Is a barium enema useful in colorectal cancer screening?

A

no

46
Q

What study is indicated?

change in bowel habit
constipation
diarrhea
polyp/tumor assessment

A

barium enema

47
Q

which test is useful in assessing the below conditions?

Extrinsic compression
IBD 
perforation
mass
CA
diverticula
A

barium enema

48
Q

An apple core lesion and focal stricture are two findings on what study?

A

barium enema

49
Q

4 contraindications to barium enema…

A

pregnancy
megacolon
perf
unstable vitals

50
Q

barium enema can cause what two complications?

A

perf

fecal impaction

51
Q

This study has the following features…

  • direct visualization of UGI
  • conscious sedation
  • diagnostic and therapeutic
A

EGD (esophagogastroduodenoscopy)

52
Q

EGD should be used with caution in what patient population?

A

cardiopulmonary disease

53
Q

Alarm sxs (dysphagia, weight loss, early satiety, bleed) are an indication for what study?

A

EGD

54
Q

The below are indications for…

NV/pain
dyspepsia
chronic GERD
IDA
FB/food bolus
esophageal varices
abnormal UGI
enteropathies
A

EGD

55
Q

The below conditions can be identified with what study?

esophagitis
barrett's esophagus
strictures/webs/rings
esophageal varices
hiatial hernia
tumors
polyps
ulcer
celiac
A

EGD

56
Q

Schatzki’s ring can be found on EGD with what condition?

A

stricture

57
Q

the below are contraindications of…

uncooperative pt
bleeding
esophageal diverticula
perf
recent UGI surgery
A

EGD

58
Q

Esophageal diverticula during an EGD confers increased risk for…

A

perf

59
Q

4 complications from EGD…

A

perf
bleeding
aspiration
oversedation

60
Q

ERCP stands for…

A

endoscopic retrograde cholangiopancreatography

61
Q

This is an invasive diagnostic and therapeutic procedure that obtains radiographic visualization of bile and pancreatic ducts

A

ERCP

62
Q

this procedure uses fiberoptic endoscope passed into duodenum with radiographic dye injectd to ducts for pancreobiliary visualization…

It is performed with conscious sedation or anesthesia

A

ERCP

63
Q

This is a diagnostic, but non-therapeutic and non-invasive procedure to visualize liver, gallbladder, biliary tree, pancreas and pancreatic ducts

A

MRCP

64
Q

MRCP uses what for visualization?

A

magnetic resonance

65
Q

What should be ordered first? MRCP or ERCP?

A

MRCP: non-invasive

66
Q

The below are indications for…

abd. pain
weight loss
obstructive jaundice

investigation/tx of bile/pancreatic obstruction

mass/choledocholithiasis/cholangitis

A

ERCP

67
Q

What procedure can perform sphincterotomies, remove stones, place stents and obtain biopsy?

A

ERCP

68
Q

Important complication of ERCP…

A

pancreatitis

69
Q

2 C/I for ERCP…

A

uncooperative pt

previous GI surg w/ inaccessible ampulla of vater

70
Q

Colonoscopy provides direct optical visualization of what structures?

A

rectum, colon, terminal ileum

71
Q

Flex sig is limited to…

A

rectum and sigmoid colon

72
Q

gold standard for colorectal cancer screening…

A

colonoscopy

73
Q

The below are indications for…

Abd pain
change in bowel habits
IDA
hematochezia
weight loss
IBD sxs
embolization of diverticula
prior abnormal BE/CT
FB removal
volvulus decomp.
CRC Screen
A

colonoscopy

74
Q

What is a major contraindication of colonoscopy due to increased risk of perf?

A

active diverticulitis

75
Q

What study?

hepatobiliary disease
cholelithiasis
cholecystitis
hepatic steatosis

A

abd. US

76
Q

What study…

pancreatitis, diverticulitis, appendicitis

A

CT Abd/Pelvis

77
Q

CT consideration if evaluating nephrolithiasis?

A

non-contrast CT A/P

78
Q

HIDA is used for…

A

biliary dysfunction

79
Q

What study?

luminal GI disorders

A

barium studies (esophagram, UGI, SBFT, Enema)

80
Q

If suspected perf… what is used instead of barium?

A

gastrografin

81
Q

What study?

esophagitis
barrett's esophagus
PUD
Celiac
CA
A

EGD

82
Q

ERCP/MRCP are useful for…

A

pancreaticobiliary disorder

83
Q

Complication for ERCP…

A

acute pancreatitis

84
Q

What study?

IBD, diverticulosis, colon CA

A

colonoscopy/flex sig

85
Q

Colonoscopy C/I?

A

active diverticulitis

Clinical Medicine III (21 decks)

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