PATH 179 LO 4 Flashcards
(127 cards)
1
Q
What is renal calculi?
A
- underlying metalbolic abnormality such as hypercalcemia or any increased calcium excretion
- Urinary stasis and infection
- Most commonly form in the kidney
2
Q
What are signs and symptoms for renal calculi?
A
- asymptomatic until they lodge in the ureter and cause partial obstruction
- Pain radiates from kidney to groin - FLANK PAIN
3
Q
What are the radiographic exams for renal calculi?
A
- x-ray
- CT is the best to demonstrate stones
4
Q
what is the rad appearance for renal calculi? *
A
- is a stone contains enough Ca it will be visible
- If radiolucent then no Ca and are made up of magnesium or uric acid
- Films miss 34% of stones because of their size, location or they are obscured by bowel or bone
5
Q
What is the treatment of renal calculi?
A
- lithotripsy surgery (works well for stones in the kidney or upper ureter)
- Stones in lower ureter require basket removal or laser destruction
6
Q
What causes uterteral calculi?*
A
from the downward movement of kideny stones.
-Lodge in the lower portion of the ureter*
7
Q
What is bladder calculi associated with?
A
bladder-outlet obstruction, urethral strictures, neurogenic bladder, and bladder diverticula
8
Q
What are the two types of biliary calculi (cholelithiasis)?
A
cholesterol and pigmented
9
Q
What does the higher incidence include in biliary calculi? *
A
family history
10
Q
What are the sign and symptoms of biliary calculi?
A
pain can be involved in the RUQ but usually asymptomatic
11
Q
What are the radiographic exams for biliary calculi?
A
- x-ray
- CT
- Ultrasound
12
Q
What is the radiographic appearance of biliary calculi?
A
- only pigmented stones are visible b/c of the minerals they contain
- most are not visible on plain fil because cholesterol
- Appear as freely moving filling defects
- Solitary stones or multiple
- US for diagnosis
13
Q
What is the treatment for biliary calculi?
A
- lithotripsy
- Stone retrieval
- Cholecystectomy
14
Q
What is Acute cholecystitis?
A
inflammation of the gallbladder
15
Q
What causes acute cholecystitis? *
A
after obstruction of the cystic duct by impacted gallstone
16
Q
What does urinary tract obstruction include?
A
urinary calculi, pelvic tumors, urethral structures, and enlargement of the prostate
17
Q
What causes urinary tract obstruction in children?
A
due to congential ,malformations
18
Q
What are the normal points of narrowing for urinary tract obstruction?
A
ureteropelvic and urterovesical junctions, bladder neck and urethral meatus.
19
Q
What are the signs and symptoms of urinary tract obstruction?
A
- abdominal pain
- Frequent urination
- Dysuria
- Painful unrination
- Urinary tract infection
20
Q
Rad exams for urinary tract obstruction?
A
- x-ray
- IVU
- CT
21
Q
What is the rad appearance for urinary tract obstruction?
A
- CT is the best way to diagnosis**
- Acute obstruction: kidney is enlarged, calyces are moderaltry dilated
- Chronic: very dilated pelvicalyceal system with clubbing
- Any blockage above the level of the bladder will cause dilation of an unilateral ureter and renal pelvicalyceal system
- If blockage is below the level of the bladder bilateral involvement will occur
- Hydronephrosis can occur during pregnancy
22
Q
What is the treatment for urinary tract obstruction?
A
decompression of the urinary system to prevent damage
23
Q
What is gastritis?
A
inflammation of the stomach
24
Q
what is the cause of gastritis?
A
- various irritants: alcohol, corrosive agents and infection
- Heliobacter pylori can cause chronic gastrisis that can lead to peptic ulcer disease
25
What is the rad exams of gastritis?
- abdominal series
| - Upper GI
26
What is the rad appearance of gastritis?
- alcohol gastrits: thickening of gastric folds, multiple superfical erosion
- Corrosive gastritis: heals with fibrosis and scarring, narrowing of the antrum, possible gastric outlet obstruction
- Vhronic gastrsis: severe mucosal athrophy, absence of mucosal fold
- Due to age, malnutrition, medication and alcoholism
- Pernicoius anemia=can not absorb B12
27
What is the treatment for gastritis?
- medication
| - Avoid trigger foods
28
what is peptic ulcer disease?
inflammatory process involving the stomach and duodenum
29
What causes peptic ulcer disease?
- the action of acid and pepsin
| - Occurs most frequently on the lesser curvature
30
What are the complications of peptic ulcer disease?
hemorrhage, gastric outlet obstruction and perforation
31
What is the rad appearance for duodenal ulcer?
ulcer crater
32
Where does 95% of duodenal ulcer occur?
-duodenum (duodenal bulb)
33
Where does gastric ulcer occur?
the lesser curvature of the stomach
34
What is the radiographic appearance of gastric ulcer?
- penetration, projection of the ulcer outside the normal gastric lumen
- radiating gastric folds to the edge of the crater (smoothness indicates benign ulcer)
35
What is acute pancreatitis?
protein and lipid digesting enzymes become activates within pancreas and it digests itself
36
What causes acute pancreatitis?
alcohol is most common. Also obstruction of gallstones in ampulla of vater
37
What is chronic pancreatitis?
frequent intermittent injury that produces scar tissue. Loses its ability to produce digestive enzymes
38
What causes chronic pancreatitis?
usually from chronic alcohol abuse
39
What are the signs and symptoms of acute pancreatitis?
-sudden onset of severe, steady abdominal pain that radiates into the back, jaundice, nausea and vomiting
40
What are the signs and symptoms of chronic pancreatitis?
- Pain
- Malabsorption causing weight loss
- Diabetes
41
What are the rad exams for acute and chronic pancreatitis?
- x-ray
| - CT
42
What is the rad appearance for acute pancreatitis?
- usually no appearance, or at least not conclusive
- US and CT to definethe degree pancreatic inflammation and if its spread
- ERCP's and MRCP's are performed
43
What is the rad appearance for chronic pancreatitis?
-small, irregular calcifications at the head of the pancreas, can extend into body and tail or organ
44
What is the treatment for acute, chronic pancreatitis?
-depends on the case of pancreatitis
45
What is regional enteris (chrons)
chronic inflammation condition of small bowel (usually the terminal ileum) of unknown origin
46
What causes regional enteritis?
diet and psychological factors may play a role . Most common in young adults
47
What are the signs and symptoms for regional enteritis?
- attack and remission of severe abdominal pain, and diarrhea, blood in stools, and mucous
- Possible perianal/rectal abscesses from fistulas
48
What are the radiographic exams for regional enteritis?
- plain abdominal films
- UGI
- SBFT
49
What is the rad appearance for regional enteritis?
- irregular thickening, inflammation, edema
- 'cobblestone': transverse and longitudinal ulcerations and thickened mucosa and submucosa
- 'skip lesions': diseased sections followed by normal segments
- Fistula formation: burrow through bowel wall into adjacent loops of bowel
50
What is another name for regional enteritis?
chrons
51
What is the treatment for regional enteritis?
-medications, diet, surgical resection of diseased bowel
52
What is irrtable bowel syndrome?
any alteration in the intestinal motility
53
What are the signs and symptoms of IBS?
-chronic abdominal pain, constipation, intermittent water diarrhea or bouts of constipation and diarrhea,
54
What is ulcerative colitis?
affects mucosal layer of bowel
| -starts in the rectum/sigmoid and works way back, but only the large bowel affected
55
What causes ulcerative colitis?
unknown, but autoimmune and aggravated by stress
56
What are the signs and symptoms of ulcerative colitis?
- bloody diarrhea
- Abdominal pain
- Fever
- Weight loss
57
What is the rad exams of ulcerative colitis?
- x-ray
| - barium enema
58
What is the rad appearance of ulceratice colitis?
-large nodular protrusion of hyperplastic
-Deep ulcers outlined by intraluminal gas
-Loss of haustral marking
-Toxic megacolon: ddistent distal colon. If it affects the entire colon.
Patient may have abd tenderness and pain, tachycardia, fever and increased WBC count
59
What is the treatment for ulcerative colitis?
- anti-flammatory
| - Diet modification
60
What is chrons colitis?
same as chrons disease but happens in the large bowel instead of the small
- Proximal portion in most frequently affected
- Affects all layers of the GI tract
61
What causes diverticulosis?
- usually in older people as years of stress on bowel weaken the wall
- Though to be caused by strain on passing stool, so those with low fiber diet are at a higher
62
What is diverticulitis?
complication of 'osis' in which retained fecal material in the nodule causes inflammation, infection and perforation
-These can cause perforation or abscess
63
What is the signs and symptoms of diverticulosis?
- usually asymptomatic
- Chronic or intermittent lower abdominal pain, related to stress or meals
- Diarrhea/constipation/bleeding
- Positive occult blood test
64
What is the signs and symptoms of diverticulitis?
same as osis but may involve symptoms of excessive bleeding, pain
65
What are the radiographic exams for diverticulosis/lithus?
- 3 veiws abdominal
- BaEn
- CT
66
What is the rad appearance for diverticulosis?*
- round or oval outpouchings of barium projecting beyond the lumen
- Usually multiple and if so it produces 'saw tooth' configuration
67
What is the rad appearance for diverticulithis?
-requires evidence of diverticular perforation to indicate abscess and infection OR a soft tissue mass that indicates a healed, walled of abscess of an older perforation
68
What is the treatment for diverticulosis?
- Dietary changes (high fiber diet)
| - Exercise
69
What is the treatment for diverticulitis?
- antibiotics
| - Dietary adjustments
70
Who does cancer of the large bowel mostly affect?
-most occur in 50-70 year old range, men 2x as often as women
71
Where does cancer of the large bowel occur?
half occur in rectum and sigmoid where they can be felt in rectal exam
72
What causes cancer of the large bowel?
most come polyps, so detection of polyps is vital
73
What are the signs and symptoms of cancer of the bowel?
- Diarrhea
- Constipation
- Weight loss
- Fatigue
- Symptoms of obstruction
74
What is the rad exams for cancer of the large bowel?
- 3 views, BaEn, CT,US
| - radiography in conjunction with digital exam, scope, and biopsy
75
What is the rad appearance for cancer of the large bowel?*
- since polyps can produce cancers identifying them is important:
1. benign are smooth and have a stalk (pedunculated)*
2. Malignant: irregular surface, usually without stalks (sessile)*
- 'Apple core' or 'napkin ring' sign indicates annular carcinoma
76
What is the treatment for cancer of the large bowel?
- resection
- Chemo
- Radiation therapy
77
What is cirrhosis of the liver
chronic destruction of the liver cells
78
What causes cirrhosis of the liver ?
alcoholism and malnutrition that occurs during these years
- initally the liver enlarges, over time it shrinks
- Bumpy and nodular surface
79
What are the signs and symptoms of cirrhosis of the liver?
- Pt appears jaundice
- Fatigue
- Weakness
80
What are the rad exams of cirrhosis of the liver?
- x-ray
- CT
- MRI
81
What is the rad appearance for cirrhosis of the liver?
- enlargement of the spleen (splenomegaly)
- Edema, swelling of lower extremities
- Ascities: accumulation of fluid in peritoneal cavity
- Increase of exposure factors, overall haziness
82
What is the treatment of cirrhosis of the liver?*
cirrhosis is irreversible
83
What is hepatic metastases?
most common malignant tumor involving the liver
- After diagnosis most patients do not survive
- CT and MRI most sensitive
84
What is pneumoperiotoneum?
free air in the peritoneal cavity
85
What causes pneumoperitoneum?
perforation of a gas-containing viscus (internal organ) or abdominal, hyneocologic, intrathoracic surgey or iatrogenic cause. Perforation of peptic ulcer wither gastric or duodenal
86
What are the signs and symptoms of pneumoperitoneum?
- pain
- Tenderness
- Rigid abdomen
- Loss of bowel sounds
87
What is the rad exam for pneumoperitoneum?
- abdominal series
| - CT
88
What is the rad appearance for pneumoperitoneum?
- 1cc of air can be identified
- Upright or decub for 10 mins
- Gas rises to the highest point
- Sickle shaped lucency
- Can also be detected along the flank to the pelvis
89
What is the treatment for pneumoperitonuem?
-immediate surgery
90
What are the signs and symptom of hiatal hernia?
reflux may produce esophagitis, esopgaeal ulcer, esophageal stenosis as a result of the hernia, but the hernia itself is basically asymptomatic
91
What are the rad exams for hiatal hernia?
- x-ray
| - Upper GI
92
What are the rad appearance for hiatal hernia?
- protrusion of stomach contents into the thoracic cavity sometimes with volvulus
- Mucosal folds are used to determine which structure has herniated: linear and paralell in esophagus, nuumerous and thick with no parallel in stomach
93
what is the treatment for hiatal hernia?
usually condition resolves, if not surgery to hold contents in place
94
Where does FB usually become lodged in?
cervical esophagus
95
What are the signs and symptoms of FB?
- patient is sometimes unable to swallow
- Choking
- Sometimes asymptomatic
96
What are the rad exams for FB?
- x-ray
- Fluro
- Endoscopy if not seen on x-ray
97
What is the rad appearance for FB?
- metallic objects are easily visualized
- some objects may not appear on x-rays
- 2 projections are needed
98
What is the treatment for FB?
- surgical retrieval
- Endoscopy
- Child may pass object
99
what may cause perforation in the esophagus?
- esophagitis, peptic ulcer, neoplasm, external trauma or instrumentation
- severe coughing or vomiting attack
- Mallory-Weiss syndrome: after alcoholic bout of vomiting can produce a severe hemorrhage
100
What causes bowel obstruction?
any stenosis, lesion, volvulus, intussusception, that obstructs the bowel lumen
101
What are the signs and symptoms of bowel obstruction?
- pain
- distension
- Problem having bowel movement
102
What are the rad exams for bowel obstruction?
3 view abdomen
103
What are the rad appearance of bowel obstruction?
- massive distension of lucent, air filled bowel (LBO)
| - classic stepladder appearance (SBO)
104
What is the treatment of bowel obstruction?
- therapeutic enema
| - Surgery
105
What is adynamic ileus?
fluid and gas do not progress normally through a non-obstructed small and large bowel
106
What causes adynamic ileus?
abdominal surgery, peritonitis, meds that decrease motility, electrolyte and metabolic disorders, trauma
107
What are the signs and symptoms of adynamic ileus?
- abdominal distension
- Pain
- Vomiting
- Risk of perforation
108
What are the rad exam for adynamic ileus?
x-ray
109
what are the rad appearance for adynamic ileus?
appears as a large area of retained gas/fluid in dilated sm and lg bowel
110
What is the treatment for adynamic ileus?
- surgical repair
| - Therapeutic Barium Enema
111
What is volvulus?
twisting of the bowel upon itself may lead to intestinal obstruction
112
What does volvulus involve?
mostly the cecum and sigmoid
113
What causes volvulus?
mostly found in elderly that consume a high-residue diet causing constipation
114
What is cecal?
can develop from a fault in embryonic development
115
What are the signs and symptoms of volvulus?
- Nausea
- Vomiting
- Lack of stool
116
What is the rad exam for volvulus?
x-ray
117
what is the radiographic appearance for volvulus?
- cecal: kidney shaped mass (from the twisted bowel)
- Sigmoid: app as inverted 'U' shape, devoid of haustra and inflated balloon app
- on BaEn exams, barium will flow and stop at sight of twist
118
What is the treatment for volvulus?
surgery, or BaEn may resolve
119
What is intususception?
telescoping of the bowel upon itself because of peristalsis
120
What are the signs and symptoms of intussusception?
- severe abdominal pain 'currant jelly' (blood in stool)
| - Often a palpable right sided mass
121
What is the rad exam of intussusception?
- x-ray
- barium enema
- CT
122
What are the rad appearance for intussuscpetion?
-'coiled spring' appearance of barium filled colon
123
What is the treatment for intussusception?
- reduction of telescoping bowel
| - Therapeutic enema
124
What is esophageal atresia?
- discontiuation of the esophagus because it fails to develop
- in ability pass NG tube into stomach with terminal end shown y chest x-ray
125
What causes esophageal atresia?
congenital
126
What is the rad appearance for esophageal atresia?
lack of gastrointestinal air below the diaphragm
127
What is the treatment for esophageal atresia?
immediate surgery required
