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Clin Med III > Dx Tests for GI > Flashcards

Dx Tests for GI Flashcards

1
Q

radiolucent appears

A

dark

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2
Q

radiopaque appears

A

light (white,grey)

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3
Q

3 way views of abdomen x-ray series

A

Anterior/posterior while patient was supine

upright - air-fluid levels

PA chest x-ray - free air underneath hemidiapharagms and check chest pathology

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4
Q

what are three indications for abdominal x-ray

A

abdominal pain, nausea, vomiting, and distention

looking for: intestinal obstruction, perforation, intussusception

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5
Q

what will an obstruction look like on abdominal x-ray

A

dilated bowel proximal to obstruction with collapsed bowel distally

air fluid levels

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6
Q

what will a paralytic ileus (non-mechanical bowel obstruction) look like on abdominal x-ray

A

dilated bowel

gas in both small and large intestines

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7
Q

what will perforation look like on abdominal x-ray

A

free air outside the bowel

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8
Q

what will intussusception look like on abdominal x-ray

A

obstruction signs

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9
Q

2 risks associated with abdominal x-rays

A

contraindicated in pregnancy

radiation exposure

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10
Q

use of reflected sound waves to visualized the abdominal aorta, liver, gallbladder, pancreas, bile ducts, spleen, kidneys, ureters, bladder

A

abdominal ultrasound

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11
Q

doppler ultrasound provides info regarding what

A

blood flow

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12
Q

dark areas on abdominal ultrasound are ______

what are four examples

A

hypoechoic

aorta, bile ducts, abscesses, cysts

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13
Q

white areas are _____ on abdominal ultrasound.

what is one example

A

echogenic (solid)

tumors

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14
Q

when do you consider using an abdominal ultrasound

A

abdominal pain

elevated LFTs

known or suspected liver disease

kidney, pancreas, liver transplant

acute/chronic renal failure

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15
Q

what five things can you visualize on ultrasound of the liver

A

cysts

abscesses

tumors

cirrhosis

dilated bile ducts

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16
Q

what five things can you visualize on gallbladder ultrasound

A

tumors

polyps

stones

sludge

inflammation (wall thickening)

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17
Q

what four things can you visualized on pancreas ultrasound

A

cysts

abscesses

tumors

inflammation

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18
Q

what are the risks/complications of ultrasound

A

ummm… none

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19
Q

When do you not use CT scan with contrast?

A

low GFR

kidney disease

allergy to iodine

renal stone studies

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20
Q

What kind of CT scan do you use for GI bleeds (vomiting blood)

A

CT angiography

embolization procedure

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21
Q

Indications for CT scan A/P view

A

abdominal pain

abdominal distension

N/V

Diarrhea

Constipation

Rectal bleeding

Jaundice

Make sure you use other radiologic studies that have less radiation, fewer complications if possible

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22
Q

CT scan is best for what two things

A

appendicitis and pancreatitis

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23
Q

US is preferred over CT for what

A

cholecystitis, cholelithiasis

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24
Q

When looking at the liver on CT scan, what can you see?

A

cysts, abscesses, tumors, bile duct obstruction

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25
When looking at the pancreas on CT scan, what can you see?
cysts, abscess, tumor, calcification, pancreatitis
26
When looking at GI tract/bowel on CT scan, what can you see
tumor, obstruction, perforation, inflammation (appendicitis), bleeding
27
When looking at spleen on CT scan, what can you see
tumor, laceration, hematoma, splenic vein thrombosis
28
When looking at abdominal aorta on CT scan, what are you looking for
visualization for aneurysm
29
Contraindications for CT scan
pregnancy unstable vitals morbid obestiy contraindications to IV contrast (allergy to iodine or shellfish) elevated creatinine
30
Complications associated with CT scan
reaction to contrast (ranges from itch to anaphylaxis) acute renal failure from contrast
31
Metformin precautions with CT scan
hold for 48 hours post-contrast administration
32
Why do you want to avoid unnecessary CTs?
radiation risks - 1 CT abdomen = 250-500 CXR
33
Hepatoiminodiacetic acid scan OR GB nuclear scan OR cholescintigraphy =
HIDA scan
34
Explain process of HIDA scan
pt receives IV radioactive tracer technetium labeled hepatic iminodiacetic acid (HIDA) is taken up by liver and excreted into bile if cystic duct is OPEN (patent), tracer will go to gall bladder where it can be visualized nuclear scanner tracks flow of tracer
35
what is a positive HIDA scan
if gall bladder does not visualized due to cystic duct obstruction in the setting of obstructing stone or edema
36
What test should you combine with HIDA scan to get best information
CCK stimulation and ejection fraction
37
primary indication for HIDA scan
suspected acalculous cholescystitis
38
What HIDA scan findings will be consistent with cholecystitis?
no radionuclide seen in gall bladder within 15-60 minutes ejection fraction of less than 35% test reproduces pt's symptoms
39
When do you not use HIDA scan
pregnancy
40
Upper GI series AKA
esophagram, barium swallow
41
Upper GI series procedure
patient drinks barium sulfate contrast and fluoroscopy is used to visualize esophagus, stomach, and first part of duodenum
42
what is fluoroscopy
x-ray movie in real time
43
esophagram/barium swallow shows what
throat and esophagus only can add on small bowel follow-through
44
What are the indications for UGI series?
dysphagia GERD symptoms early satiety suspected peptic ulcer disease suspected obstruction/inflammation
45
What are some findings on the upper GI series?
hiatal hernia potential cancer - strictures, obstructions, filling defects, tumors, ulcerations ulcers diverticula extrinsic compression perforation - leakage of barium outside the upper GI tract (IF THIS IS THE CASE - USE GASTROGRAFIN)
46
How will a filling defect look on UGI series?
displacement of contrast medium by a space-occupying lesion in a radiographic study of a contrast-filled hollow viscus
47
If you suspect an upper GI perforation, what do you do on UGI series?
use water-soluble gastrografin not barium!
48
complications of UGI series
aspiration if they are throwing up and accidentally aspirate constipation from barium
49
contraindications of UGI series?
pregnancy complete bowel obstruction suspected upper GI perforation unstable vital signs
50
barium enema is used to see what
colon and distal small bowel
51
what can you use as an alternative to colonoscopy
barium enema
52
When can a barium enema be therapeutic
reduce a non-strangulated ileocolic intussusception
53
what will you see with inflammatory bowel disease on a barium enema
narrowing of the barium column due to inflammation of surrounding colon
54
what will you see that would indicate cancer with a barium enema
strictures obstructions filling defects tumors ulcerations
55
what other things can you visualize with barium enema
ulcers, diverticula, benign tumors, extrinsic compression, perforation (leakage of barium outside of colon)
56
if perforation, what should you do with barium enema
not use barium - use water-soluble gastrografin
57
four contraindications of barium enema
pregnancy megacolon suspected perforation - use gastrografin unstable vitals
58
2 complications of barium enema
perforation fecal impaction due to barium
59
Esophagogastrodudoenoscopy AKA
EGD
60
Direct visualization of the upper GI tract via a long flexible fiberoptic lighted scope
EGD
61
EGD is performed with what type of anesthesia
conscious sedation
62
___ can be dx and tx
EGD
63
When do you consider doing an EGD
alarm symptoms - dysphagia, weight loss, early satiety, epigastric pain N/V, abdominal pain Dyspepsia Chronic GERD Dysphagia Suspected esophageal varices Hematemsis or melena Iron def anemia abnormal UGI suspected enteropathies (like celiac) foreign body/food bolus
64
EGD findings
hiatal hernia tumors (cancer) polyps varices mucosal inflammation ulcers barret's esophagus obstructions webs, rings (schatzski's ring) infection anteriovenous malformations
65
complications from EGD
perforation bleeding from biopsy aspiration of gastric contents oversedation
66
Endoscopic retrograde cholangiopancreatography AKA
ERCP
67
what is difference between ERCP and EGD
goes into bile and pancreatic ducts - endoscope is passed into duodenum and small catheter inserted into biliary duct where x-rays are taken once dye is injected
68
MRCP used when
when you don't want to do a procedure - do this and then see if ERCP is needed
69
MR visualization of biliary tree and pancreatic ducts dx not therapeutic
ERCP
70
indications for ERCP
obstructive jaundice obstruction of bile and pancreatic ducts - mass, choledocholithiasis, cholangitis
71
therapeutic uses of ERCP
sphinterotomies, remove stones, place stents, and obtain brushings/biopsies incision in ampulla of vater to widen common bile duct and gallstones can be removed
72
contraindications for ERCP
uncooperative pt previous GI surgery with inaccessible ampulla of Vater
73
complications of ERCP
pancreatitis, perforation, gram-negative bacteremia or sepsis, aspiration of gastric contents, oversedation
74
involves direct visualization of rectum, colon, and terminal ileum via long, flexible fiberoptic-lighted scope dx and therapeutic req bowel prep
colonoscopy
75
flexible sigmoidoscopy
limited to rectum and sigmoid colon
76
indications for colonoscopy
colon cancer screening - remove polyps and biopsy them signs/symptoms of IBD - Crohn's and ulcerative colitis Hematochezia Diarrhea Prior abnormal test Foreign body removal Decompression of volvulus
77
what are potential colon cancer symptoms
change in bowel habits, hematochezia, iron def anemia
78
contraindications of colonoscopy
uncooperative pt severe rectal bleeding suspected perforation recent colon surgery toxic megacolon active diverticulitis or colitis
79
complications of colonoscopy
perforation bleeding due to biopsy or polypectomy oversedation
80
cologuard
colon-cancer screening test non-invasive stool test with DNA markers and immunochemical test for hemoglobin in stool do every 3 years

Clin Med III (6 decks)

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