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GI > Session 10 > Flashcards

Session 10 Flashcards

1
Q

Types of GI imaging

A

AXR
Barium swallow
Ultrasound
CT
MRI
Angiography

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2
Q

Interpretation of Abdo X ray

A

A = air
B = bowel (dilation/thickening)
D = dense structures or calcification (bones/kidney stones)
O = organs and soft tissues
X = external objects, line and tubes

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3
Q

What is Rigler sign

A

Double wall sign, free air in peritoneal cavity

Thick white lines on X ray

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4
Q

Differentiating small and large bowel obstruction

A
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5
Q

Difficulty with differentiating between LB and SB dilation

A

Most cases of LB dilation also have SB dilation, ileo-caecal valve allows reflux back

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6
Q

What is this

A

Sigmoid volvulus

Caused by psychotropic meds/constipation

Bowel stretches, more mobile, coffee bean sign

Caecum normal position so not caecal volvulus

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7
Q

What is this

A

Caecal volvulus

Congenital

Rudimentary mesentery

Caecum not in normal position

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8
Q

What does fluoroscopy do

A

Live X ray to produce video

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9
Q

What is this

A

Thumb sign

Epiglottitis

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10
Q

What does a barium swallow investigate

A

Upper GI tract

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11
Q

What does this show

A

Oesophageal carcinoma

Apple core sign, due to strictures

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12
Q

What is this

A

Thickened bumps

Nut cracker oesophagus

marked muscular spasm

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13
Q

What is this

A

Achalasia

LOS narrows at bottom

Dennervation, sustained muscular spasm, weight los

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14
Q

What is ERCP

A

Endoscopic retrograde cholangial pancreatogram

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15
Q

How does ERCP work

A

Ampulla of vater = wire to common bowel duct

Inject contract

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16
Q

What does this show and how can it be treated

A

Defect- stone blocking contrast in common bile duct

Basket used to drag stones out, or nick Ampulla to allow stones out, plastic stent

Rectify jaundice

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17
Q

Ultrasound uses

A

Soft tissues
Abdominal viscera
Blood vessels

Can see reduced peristalsis of bowel = Crohns/inflammation

Doppler: colours, motion depicted though sound waves

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18
Q

CT uses

A

Acute abdo pain/symptoms

Rotating X ray beam

Looking for cancer

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19
Q

Good way to look for disease of ureters/urinary bladder

A

CT scan

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20
Q

Types of contrast in CT

A

Iodine contrast makes it brighter

oral, enema, injected into bladder, artery

21
Q

MRI use

A

Soft tissues of abdomen

22
Q

What does this show

A

gall stones and bile

23
Q

Angiography usage to locate bleeding

A

Feed wires into arterial system
Usually femoral

Inject contrast, leaks out at point of bleeding

Can induce thrombosis at correct area

24
Q

Label

A
25
Q

Types of X rays available

A

Abdominal X ray

Erect chest x ray

26
Q

Types of contrast studies available

A

Barium swallow
Barium enema
Barium meal/follow through
Water soluble contrast studies

27
Q

Why request an AXR

A

Acute abdo pain

Small or large bowel obstruction- CT for SB, abdo x ray for LB

Acute exacerbation of IBD= see toxic mega colon with perforation

Renal colic = CT, abdo x ray to check stone has passed

28
Q

Features of small bowel on x ray

A

Central position
Often dont see
Valvular conniventes: cross entire wall, thin

29
Q

Features of large bowel on X ray

A

Peripheral position
hasutra
Transverse colon hang down to pelvis
Sigmoid can loop and be Long

30
Q

Features of small bowel obstruction

A

CT first line
Identify level and cause of obstruction

Determine whether bowel is strangulated

Central position of gas filled and distended loops of bowel, white lines pass full width

31
Q

Features of large bowel obstruction

A

CT first line

Abdo X ray can see colonic distension, small bowel dilation (dependent on duration of obstruction or incompetence of ileocecal valve)

32
Q

What not to use in small bowel obstruction

A

Plain abdominal radiographs unless CT unavailable

33
Q

Large bowel has the ability to extend up to

A

6cm

34
Q

Sigmoid volvulus cause

A

Twist at base of sigmoid mesentery which is in a fixed position (asterisk) in left iliac fossa

35
Q

Cause of toxic megacolon

A

Acute deterioration with UC or colitis
Colonic dilation
Oedema
Pseudopolyps

Colon dilated with extensive mucosal islands indicating bowel wall inflammation

36
Q

Perforation investigations

A

Erect CXR

Peptic ulcer, diverticular, tumour, obstruction, trauma, iatrogenic

37
Q

Pneumpperitoneum investigations

A

Erect CXR

Show free abdo gas,

38
Q

What has largely replaced barium swallow

A

Upper GI endoscopy for peptic ulcer disease and evaluation of haematemesis

39
Q

How does ultrasound generate image

A

Frequency above audible range of human hearing 20KHz

Usually 2-18 MHz

40
Q

Features of USS

A

Cheap compared to CT and MRI

Portable - fast

Highly user dependent

41
Q

CT scan features at T12

A

Aortic hiatus of diaphragm

42
Q

CT scan features at L1

A

Transpyloric plane

Fundus of gallbladder
Pylorus of stomach
neck of pancreas
SMA
Hilum of kidneys

43
Q

CT scan features at L3

A

Umbilicus
IMA

44
Q

CT scan features at L4

A

Iliac crest
Bifurcation of abdominal arota

45
Q

What level is this from

A

T12

46
Q

What level is this

A

L1

47
Q

What level is this

A

L3

48
Q

MRI and CT comparison

A
49
Q

Features of GI Angiography

A

A way of visualising the vasculature associated with the intestines

CT angiography has replaced conventional angiography for mesenteric vasculature

GI (22 decks)

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