Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PCM III Final > abdominal and renal imaging lab > Flashcards

abdominal and renal imaging lab Flashcards

1
Q

why order a KUB xray?

A

– Can be used to evaluate for bowel distention, urinary tract stone/stent, foreign body, and tube placement – cannot be used to rule out free intra- peritoneal gas or detect air-fluid levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is a Acute Abdominal Series (AAS)

A

• Consists of 3 views: – Upright PA Chest, Upright Abdominal X-ray and Flat plate (supine) Abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

why order a AAS?

A

– Shows lung pathology, bowel distention, air fluid levels and free air • helpful if you suspect bowel obstruction, ileus, perforated viscus, or a radiopaque foreign body is suspected, but cannot be relied upon to exclude these disorders – Fast to do, relatively low cost and low radiation exposure – Low yield, the majority of AAS are negative or nonspecific • A negative AAS does not exclude pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how do you interpret an AAS?

A

• Chest (erect, PA or AP) – Look for free air, pneumonia at the bases, pleural effusions • ABD Flat Plate (prone) – Look for gas in rectum, sigmoid, ascending and descending colon, calcifications • Upright Abd (erect) – Look for free air, bowel distention, air-fluid levels, gas pattern, soft tissue masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is an ultrasound the test of choice for and also used for?

A

– Test of choice for: • Biliary pathology - Cholelithiasis, cholecystitis • Trauma Screen - Screen for intraperitoneal fluid/blood (FAST Scan) • Pregnant pelvic pain – ectopic pregnancy, ovarian cyst • Testiclular pain – Also used for • Assessment of hydronephrosis, soft tissue, procedural guidance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the strengths of an ultrasound?

A

• Fast to do, relatively low cost and no radiation exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the weaknesses of an ultrasound?

A

• Limited by: operator skill, adipose tissue (fat), air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what imaging is used for suspected biliary colic?

A

• US is first line • ERCP and MRCP - if suspect Choledocholithiasis • Ct Abd/pelvis with IV and oral contrast can be helpful • HIDA scan of Liver and GB – Functional test of GB – Done if US is negative and still suspect biliary colic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are indirect signs of acute cholecystitis whenever gallstones are identified on a sonogram:

A

• Gallstone impacted in the GB Neck (stone in the neck that does not move when the patient’s position is changed). • GB distension (transverse diameter > 4 cm) • “Sonographic Murphy’s sign” - pain when the transducer presses directly over the GB. This is THE most specific sign of acute cholecystitis if associated with gallstones, even without GB wall thickening ( > 3 mm) or pericholecystic fluid • Sludge • GB wall thickening > 3mm (suggesting edema of the wall) • Pericholecystic fluid (most commonly due to GB wall edema or rarely indicating GB perforation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

if you suspect Choledocholithiasis what other tests do you need?

A

MRCP +/or ERCP – MRCP – diagnostic – ERCP – diagnostic and therapeutic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when should you suspect Choledocholithiasis

A

– Patients present with Biliary colic and.. • LFT’s elevated in a “cholestatic” pattern (total bili and alkaline phosphatase are elevated to a greater extent than AST and ALT) • Dilated common duct on ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what does a renal US look for?

A

Quick and easy • Specifically to look for hydronephrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

when is US is the imaging modality of choice?

A

for abdominal and pelvic pain in the pregnant patient/male patients with testicular pain or mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

when is a US used in women/ pregnant women?

A

• No ionizing radiation = safe for baby • Used to evaluate fetal well being, and threatened miscarriage • rule out ectopic pregnancy, and ovarian torsion • Also good for diagnosing ovarian cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the purpose of a FAST scan?

A

– a standard set of ultrasound examinations for the evaluation of injured patients – Purpose: Detect free intraperitoneal fluid, pericardial fluid, pleural fluid, Hemothorax and pneumothorax in trauma patients – Limited sensitivity precludes the use of ultrasound as a definitive test to rule out intraabdominal injury • Used as a quick screening test for trauma patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Fast Scan – Morrison’s Pouch

A

• Right flank • Hepatorenal view

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

FAST scan Left flank

A

Perisplenic View

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

FAST scan subxiphoid view

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

FAST scan pericardial tamponade

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

FAST scan Pelvic (retrovesicular views)

A
21
Q

Ct Scan of the Abdomen and
Pelvis

A

• Multiple cross sectional images
• Multiple planes
– Sagittal
– Axial
– Coronal
• Allows for reconstructed images
• Usually gives the most information
• Significant radiation exposure

22
Q

CT planes

A
23
Q

Ct Scan of the Abd and Pelvis
• Without contrast (stone protocol)

A

– test of choice for ureterolithiasis

24
Q

Ct Scan of the Abd and Pelvis with IV contrast only

A

– Radiographic test of choice if suspected abdominal trauma

25
Q

CT scan of abd and pelvic With IV and oral contrast

A

– Test of choice for suspected
• Bowel pathology
• Solid organ (parenchymal) pathology
• Vascular pathology
• Best test for undifferentiated abd pain - Gives you the most information

26
Q

what most you confirm before giving IV dye?

A

good kidney function

• Check BUN, Creatinine, and GFR

27
Q

when is CT Scan Abdomen/Pelvis with IV and Oral Contrast the test of choice?

A

• Imaging modality of choice for bowel inflammation/ infection, solid
organ injury/infection, vascular problems and cancer
• Both abdomen and pelvis are scanned (because the bowel is variable in location
with portions in the Abd and pelvis

28
Q

what does the IV contrast do in CT Scan Abdomen/Pelvis with IV and Oral Contrast

A

– enhances the bowel wall
– optimizes detection of bowel inflammation and extra-luminal complications
such as perforation, abscesses and fistulae
– Shows vasculature

29
Q

what does the oral contrast do in CT Scan Abdomen/Pelvis with IV and Oral Contrast

A

provides better imaging of the bowel
– distends the bowel and highlights the bowel wall.

30
Q

CT Abd/Pelvis without Constrast (stone protocol)

A

• the imaging modality of choice for suspected
ureterolithiasis
• Both abdomen and pelvis are scanned (because the stone,
hydronephrosis and structure could be anywhere from the kidnety
to the bladder)
• No IV or oral contrast – might obscure identification of the stone

31
Q

what are CT Findings of Ureterolithiasis

A

• Hydronephrosis
• Hydroureter
• Perinephric stranding
• Note
– Location of stone
– Size of the stone

32
Q

what is the Imaging for Suspected Acute Appendicitis

A

• CT Abd/Pelvis with IV and oral contrast is first line.
• US or MR can be performed if concerned about radiation exposure.
• In children and pregnant patients, US of the RLQ should be first line
imaging.

33
Q

what are CT Scan Findings of Acute Appendicitis

A
  • Appendiceal wall thickening and enhancement - diameter > 6 mm
  • Pericolonic fat inflammatory changes (also called “fat stranding”)
  • Pericolonic fluid - free or loculated
  • Free intraperitoneal gas if perforated
  • +/- appendicolith
34
Q

when is EGD the test of choice?

A

– Imaging test of choice for gastritis, PUD, GERD

35
Q

what is EGD diagnostic and therapeutic for?

A
  • Upper GI Bleed
  • Choledocholithiasis
  • Esophageal narrowing or foreign body
36
Q

when is Flexible sigmoidoscopy used?

A

screening test for colon cancer

37
Q

what is Flexible sigmoidoscopy diagnostic and therapeutic for?

A

• lower GI bleed

38
Q

what imaging would you use for

• Bowel (infection, inflammation, obstruction, cancer)

A

– Ct Abd/Pelvis with IV and oral contrast

39
Q

what imaging would you use for

Solid organs (injury, infection, cancer)

A

– Ct Abd/Pelvis with IV contrast

40
Q

what imaging would you use for

Gallbladder

A

Ultrasound; If suspect Choledocholithiasis then MRCP or ERCP

41
Q

what imaging would you use for

GYN

A

– US if pregnant or suspect torsion or cyst
– Ct with contrast if suspect cancer or abscess

42
Q

what imaging would you use for

Male GU

A

– US for torsion, Ct with contrast if suspect cancer or infection (Fournier’s, abcess)

43
Q

what imaging would you use for

• Kidney/Ureter/Bladder

A

– Ct without contrast if suspect stone, with if suspect cancer, infection then IV contrast

44
Q

what imaging would you use for

• Abdominal Vasculature (aorta, mesenteric arteries)

A

– Ct Abd/Pelvis with IV contrast

45
Q

what imaging would you use for

• Appendicitis

A

CT abd/pelvis with IV and Oral contrast
– US first if child or pregnant

46
Q

what imaging would you use for

• Biliary Colic/Gallbladder pathology

A

– US RUQ

47
Q

what imaging would you use for

• Renal Colic (Kidney stone/ureterolithiasis)

A

– CT abd/pelvis without contrast (stone protocol)
– US if chronic kidney stones, pregnant or child

48
Q

what imaging would you use for

• Abd Trauma

A

– FAST scan initial screen for interperitoneal blood
– Ct Abd Pelvis with IV contrast only is gold standard

49
Q

what imaging would you use for

• Vasculature (AAA, Aortic Disection, Mesenteric Ischemia)

A

– Ct Abd/Pelvis with IV contrast
• If uncertain etiology then CT Abd/Pelvis with IV and Oral Contrast
– Gives you the most overall information

PCM III Final (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions