Gastrointestinal GW

Question 1

Liver-spleen indications

Answer 1

Determination of size, configuration, and position
Detection of tumors, hematomas, cysts, abscesses, and trauma
Evaluation of function liver disease (cirrhosis and hepatitis)

Question 2

RE cells are also called

Answer 2

Kupffer cells

Question 3

RE cells are responsible for

Answer 3

Phagocytosis

Question 4

Hepatocytes are responsible for

Answer 4

Bile formation

Question 5

Liver/spleen RP

Answer 5

99mTc Sulfur Colloid

5-10 mCi

Question 6

Liver/spleen acquisition

Answer 6

Flow
Statics taken after 10-15 mins
- all views
- ANT view w/marker on right costal margin for liver size and location, or left costal margin for spleen size
- breath holding views may be obtained for mobility of liver
SPECT optional

Question 7

Imaging too soon on liver spleen scan will show

Answer 7

Cardiac blood pool activity

Question 8

Imaging too soon on liver spleen scan will show

Answer 8

Cardiac blood pool activity

Question 9

Liver/spleen scan upright acquisition considerations

Answer 9

Skin folds in obese patients

Breathing attenuation

Question 10

Bile is a product of ______ and _____

Answer 10

Erythrocyte breakdown and Hepatocyte metabolism

Question 11

Bile does what

Answer 11

Break down fats, stimulate peristalsis, enhance absorption of fatty acids

Question 12

CCK is produced where

Answer 12

By the duodenum

Question 13

What cells uptake RP for liver/spleen scan

Answer 13

RE (Kuppfer) cells

Question 14

What cells uptake RP for HIDA

Answer 14

Hepatocytes

Question 15

Cystic duct obstruction is also called

Answer 15

Acute cholecystitis

Question 16

Patients with elevated bilirubin levels may need ________ dose of tracer

Answer 16

Higher

Question 17

Morphine _____ the SOO

Answer 17

Constricts. Promotes back flow

Question 18

Patient prep for HIDA

Answer 18

No pain killers or sedatives for 6-12 hours

fast 2-4 hours, but no more than 24 hours

Question 19

GB is not visualized 1 hour after tracer
- what should you do?

Answer 19

Image out for up to 24 hours
Or
Give morphine

Question 20

Protocol for CCK for patients who fasted more than 24 hours (or need hyperalimentation)

Answer 20

0.01-0.02 ug/kg over 3-5 minutes

Given 30-60 minutes before tracer

Question 21

Can CCK be given after morphine

Answer 21

No, it would result in a falsely low EF

Question 22

If gallbladder is visualized but small bowel is not

Answer 22

Image delays until it is

Question 23

How long is imaging continued after morphine is given

Answer 23

30 minutes

Question 24

What is biliary atresia

Answer 24

Blockage of ducts from the liver to the gallbladder

Question 25

What is phenobarbital used for

Answer 25

To differentiate biliary atresia from other causes of neonatal jaundice - tracer will not be excreted into the bowel in patients with biliary atresia

Question 26

In patients with extremely high bilirubin levels may see

Answer 26

Kidneys on scan because they will take over excretion of tracer

Question 27

Most common benign tumors of the liver

Answer 27

Cavernous hemangioma

Question 28

Liver hemangioma RP

Answer 28

Tech labeled RBCs 20-25 mCi

Question 29

Liver hemangioma acquisition

Answer 29

Flow (optional) Blood pool (optional) Delay 45-180 minutes - SPECT preferred

Question 30

Meckels is usually located

Answer 30

Distal ileum

Question 31

Meckels rule of 2s

Answer 31

Found in 2% of the population

Question 32

Meckels pt prep

Answer 32

Fast for 2 hours No diagnostic tests or laxatives 3-4 days prior

Question 33

Camera positioning for Meckels

Answer 33

Between xyphoid and symphysis pubis

Question 34

Imaging time for Meckels

Answer 34

Sequential statics every 30-60 seconds for 30-60 minutes

Question 35

Why are tech labeled RBCs better for intermittent GI bleeding?

Answer 35

Because tracer stays in blood pool for longer which allows for delayed imaging

Question 36

Gastro reflux RP

Answer 36

99mTc Sulfur colloid - adults: mixed with 150 mL of OJ and 150 mL of hydrochloric acid - babies: mixed with formula and given through nasogastric tube or baby bottle

Question 37

Patient position for gastro reflux study

Answer 37

Supine with abdominal binder - serial images obtained

Question 38

Pt prep for gastric emptying

Answer 38

NPO 4 hours minimum Prokinetic agents and agents that delay emptying stopped 2 days prior Premenopausal women should ideally be studied on days 1-10 or cycle

Question 39

Proximal part of stomach

Answer 39

Fundus

Question 40

Distal part of stomach

Answer 40

Antrum

Question 41

3 pairs of salivary glands

Answer 41

Parotids Submandibular Sublingual

Question 42

Salivary gland imaging RP

Answer 42

99mTc pertechnetate 10 mCi

Question 43

Salivary gland acquisition

Answer 43

Flow optional ANT images every 5 minutes LATs at 30 minutes If obstruction is suspected, pt will suck on a lemon - ANT and LATs taken 10 mins later

Question 44

Leveen shunt is placed where

Answer 44

Draining fluid in peritoneal cavity through tube in the internal jugular being into the superior vena cava

Question 45

Leveen shunt RP

Answer 45

99mTc Sulfur Colloid 99mTc MAA 1-2 uCi into the peritoneal space

Question 46

Leveen shunt image acquisition

Answer 46

Serial imaging begins when lower part of tube is visualized Liver/spleen or lung imaging is performed 1 hour after Delays may be necessary

Question 47

H pylori produces

Answer 47

Urease, which is not typically found in stomach

Question 48

Breath test prep

Answer 48

Overnight fast Swallows C14 urea pill and blows into balloon 10-15 mins later

Question 49

Breath test RP

Answer 49

C14 urea oral pill 1 uCi Given 10-15 minutes prior to breath sample