GI Imaging

Question 1

Right upper quadrant pain, often exacerbated by eating +/- deranged LFTs suggests what?

Answer 1

Cholecystitis/ Biliary colic

Question 2

What is the first line investigation for cholecystitis/biliary colic?

Answer 2

Ultrasound

Question 3

Following ultrasound, what test would give you further clarification about cholecystitis/gallstones?

Answer 3

MRCP +/or ERCP

Question 4

What is epigastric/diffuse abdominal pain with an elevated serum amylase likely to be?

Answer 4

Acute pancreatitis

Question 5

What test can be used first line in acute pancreatitis and why?

Answer 5

Ultrasound- to look for gallstones and or biliary obstruction

Question 6

What is the main purpose of imaging in pancreatitis?

Answer 6

Evaluate complications

Question 7

When are investigations for pancreatitis complications best done?

Answer 7

Around 1 week following onset of symptoms

Question 8

What is the first line investigation for a suspected perforation?

Answer 8

Erect CXR

Question 9

What would you be looking for in an erect CXR of suspected perforation?

Answer 9

Free subphrenic gas

Question 10

What is the send test you would do for perforation?

Answer 10

CT

Question 11

What is central abdominal pain, later associated with localised RIF pain, with slight fever and raised inflammatory markers suggestive of?

Answer 11

Appendicitis

Question 12

What should be a differential diagnosis of appendicitis in women?

Answer 12

Gynaecological pathology

Question 13

What is the first line investigation for suspected appendicitis?

Answer 13

Ultrasound

Question 14

What is lower abdominal pain, classically LIF with associated diarrhoea and maybe PR bleeding with elevated inflammatory markers suggestive of?

Answer 14

Diverticulitis

Question 15

What is the initial investigation of diverticulitis?

Answer 15

CT

Question 16

What is a sudden onset back pain and associated hypotension likely to be?

Answer 16

Ruptured AAA

Question 17

What is the first line investigation for a distended abdomen with a suspected bowel source?

Answer 17

AXR

Question 18

What will a small bowel obstruction show on AXR?

Answer 18

Dilated small bowel loops

Question 19

What will a large bowel obstruction show on AXR?

Answer 19

Dilated large bowel loops and no gas in rectum

Question 20

What is the second test to do for a distended abdomen after AXR?

Answer 20

CT

Question 21

What test should be done if it is fluid that is suggested to be causing distension i.e. ascites?

Answer 21

Ultrasound

Question 22

Where can haematemesis arise from?

Answer 22

Oesophagus, stomach or duodenum

Question 23

What are possible cause of haematemesis?

Answer 23

Tumour, inflammation, trauma, vascular cause i.e. varices

Question 24

What is the first line test for haematemesis?

Answer 24

Endoscopy

Question 25

What are the advantages of using an endoscopy for haematemesis?

Answer 25

Allows intervention or biopsy

Question 26

What test should be done after endoscopy for acute GI bleeding and when?

Answer 26

CT while still bleeding

Question 27

Should the CT for acute upper GI bleed be done with contrast? If so, what kind?

Answer 27

Yes, IV- not oral

Question 28

What is a third line test/management which can be used for acute upper GI bleed?

Answer 28

Angiography and intervention

Question 29

Is the protocol the same for an upper and lower acute GI bleed with regards to radiological tests?

Answer 29

Yes

Question 30

What is the first line investigation for dysphagia?

Answer 30

Endoscopy

Question 31

What less common tests can be used to assess the oesophagus?

Answer 31

Fluoroscopic studies- barium or water soluble contrast

Question 32

What are radiological investigations for change in bowel habit?

Answer 32

Barium enema or CT virtual colonography

Question 33

What further test is used to assess the right colon?

Answer 33

Flexible sigmoidoscopy

Question 34

What is the first line investigation for inflammatory bowel disease?

Answer 34

Endoscopy

Question 35

What test is used is a small bowel disease is suspected to have caused a change in bowel habit?

Answer 35

Fluoroscopic contrast studies

Question 36

What is a useful test for Crohn's with known or suspected small bowel involvement?

Answer 36

Small bowel MRI

Question 37

What can a radio-labelled white cell scan do?

Answer 37

Localise active inflammation

Question 38

What is the purpose of investigations for jaundice?

Answer 38

Too determine if intra or post hepatic

Question 39

What is the first line investigation for jaundice?

Answer 39

Ultrasound

Question 40

What is the second line test for jaundice?

Answer 40

MRCP or ERCP

Question 41

What can be done at the time of ERCP?

Answer 41

Removal or stents

Question 42

If there is suspected mets on ultrasound of liver, what should be the next test?

Answer 42

CT