Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med III Unit I > 1 GI Diagnostics > Flashcards

1 GI Diagnostics Flashcards

1
Q

What different views can you order for abdominal xrays?

A

AP projection while patient supine

Upright

PA chest xray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When would you want an AP abdominal view xray?

A

Aka KUB (kidney ureter bladder)

Done while patient is supine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Upright abdominal xrays are better for …

A

Visualization of air-fluid levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

PA chest X-rays can be used to visualize…

A

Free air underneath hemidiaphragm and check chest pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Indications for abdominal xray

A

Abdominal pain, N/V, distention (can see on CT too but xray is faster, cheaper, less radiation)

Intestinal obstruction

Perforation (will see air in places it shouldn’t be)

Intussusception (peds usually)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Dilated bowel proximally with collapsed bowel distally indicates…

A

Obstruction

Will also see air fluid levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Abdominal xray showing generalized dilated bowel and gas in both small and large intestines indicates…

A

Paralytic ileum (non-mechanical bowel obstruction) - frozen bowel, common after surgery, but NO clear obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Abdominal xray shows free air outside the bowel. You suspect…

A

Perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Thickened and edematous bowel wall on xray is indicative of…

A

Small bowel obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

A loop of bowel slipped into another section of bowel, creating swelling, decreased blood flow, obstruction, and tissue damage

A

Intussusception

Requires emergency treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Risks/complications of abdominal xrays

A

Contraindicated in pregnancy

Radiation exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

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

A

Abdominal ultrasound

Doppler US provides additional info re: blood flow

Can be ordered for specific location/organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dark areas on U/S are…

A

Hypoechoic

Examples: aorta, bile ducts, abscesses, cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

White areas on U/S are …

A

Echogenic (solid)

Examples: tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is an abdominal U/S indicated?

A

Abdominal pain

Elevated LFTs

Known/suspected liver disease

S/p kidney, pancreas, or liver transplant

Acute/chronic renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What kind of abnormalities can you see on a liver u/s?

A

Cysts, abscesses, tumors, cirrhosis

Dilated bile ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What kind of abnormalities can you see on a gallbladder u/s?

A

Tumors, polyps, stones, sludge, inflammation (wall thickening)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What kind of abnormalities can you see on a pancreatic u/s?

A

Cysts, abscesses, tumors, inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Risks/complications of U/S?

A

There aren’t really any - No contrast, no radiation

Useful study in patients with contraindications to other diagnostic tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Computerized xrays that produce cross-sectional images of the body layer by layer

A

CT scan

Used to evaluate abdominal and pelvic organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CT images can be enhanced with …

A

IV or PO iodine contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the exception to using contrast for abdominal CTs?

A

Renal stone study - because calcium stones are radiopaque, you won’t see them if you have contrast added

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Indications for abdominal CT

A 
Abdominal pain
Abdominal distention
N/V
Diarrhea
Constipation
Rectal bleeding
Jaundice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Can you use CT to diagnose cholecystitis or cholelithiasis?

A

You can but US is preferred over CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the preferred test for evaluating the pancreas?

A

CT preferred over US for pancreatitis

Can also use CT to evaluate pancreatic cysts, abscesses, tumors, or calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

US is preferred over CT for ________, but CT is preferred over US for __________

A

US for cholecystitis/cholelithiasis

CT for pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

If you do use CT to evaluate cholecystitis, what will you see?

A

Distended gallbladder with an edematous and hyperemic wall and inflammatory induration in the fat surrounding the gallbladder

Calcified stones can also be visualized on CT

28
Q

Contraindications for abdominal CT

A

Pregnancy

Unstable vitals

Morbid obesity

IV contrast - allergy to iodine or SHELLFISH (in some cases, can premedicate)

Elevated creatinine

29
Q

Complications of CT scans

A

Reaction to contrast (ranges from flush/itch —> anaphylaxis)

Acute renal failure from contrast

30
Q

What precautions are important to remember with CT scans

A

Hold metformin for 48 hours post-contrast administration

Radiation risks - 1 abdominal CT = 250-500 CXRs (avoid unnecessary CTs)

31
Q

What is a HIDA scan?

A

Hepatoiminodiacetic Acid Scan aka GB nuclear scan aka cholescintigraphy

Patient receives IV technetium labeled hepatic iminodiacetic acid —> taken up by liver and excreted in bile

Nuclear scanner tracks flow of tracer

If cystic duct is patent, tracer will go to GB, where it can be visualized

32
Q

A HIDA scan is considered positive if…

A

Gallbladder does not visualize due to cystic duct obstruction in the setting of obstructing stone or edema

33
Q

HIDA scans provide best information when ordered concurrently with…

A

CCK stimulation and ejection fraction (tests pumping ability of the gallbladder)

34
Q

What is the primary indication for HIDA scans?

A

To diagnose suspected acalculous cholecystitis (though you would start with U/S)

35
Q

What findings would you expect on a HIDA scan in the case of cholecystitis?

A

No radionuclide seen in gallbladder within 15-60 min

Ejection fraction <35%

Test reproduces patient’s symptoms

36
Q

When is a HIDA scan contraindicated?

A

Pregnancy

37
Q

If you want to do a HIDA scan, what do you need to remember to do?

A

DO NOT give pain meds!

Morphine will effect results

38
Q

How is an Upper GI series performed?

A

Patient drinks barium sulfate contrast (or gastrografin) and fluoroscopy is used to visualize esophagus, stomach, and first part of the duodenum

Esophageal/barium swallow is a variation that shows throat and esophagus only

AKA esophageal, barium swallow

39
Q

When is an upper GI indicated?

A

Dysphagia

GERD symptoms

Early satiety

Suspected PUD

Suspected obstruction/inflammation

40
Q

Portion of stomach above diaphragm on UGI?

A

Hiatal hernia

41
Q

What UGI findings suggest potential cancer?

A

Strictures, obstructions, filling defects, tumors, ulcerations

Filling defect = displacement of contrast medium by a space-occupying lesion in a radiographic study of a contrast-filled hollow viscous

42
Q

Leakage of barium outside of UGI tract indicates…

A

Perforation

USE WATER-SOLUBLE GASTROGRAFIN

43
Q

If you suspect perforation, UGI should be performed with…

A

Water soluble gastrografin rather than barium contrast

44
Q

If you suspect a gastric ulcer, or see one on UGI, what else do you need to order?

A

EGD!!!!

45
Q

Contraindications for UGI series

A

Pregnancy
Complete bowel obstruction
Suspected upper GI perforation (use gastrografin not barium!!!)
Unstable vital signs

46
Q

Possible complications for UGI series

A

Aspiration (esp if dysphagia)

Constipation from the barium

47
Q

Barium enemas are AKA…

A

Lower GI series

Patient receives a barium enema and fluoroscopy is used to visualize the colon and distal SB

Can be an alternative to colonoscopy

48
Q

When would a barium enema be therapeutic?

A

To reduce a non-strangulated ileocolic intussusception

49
Q

Contraindications for barium enemas

A

Pregnancy
MEGACOLON
Suspected perforation (must use GASTROGRAFIN)
Unstable vitals

50
Q

Complications of barium enemas

A

Perforation

Fecal impaction due to barium

51
Q

Direct visualization of the upper GI tract via a long, flexible, fiber optic lighted scope

A

EGD (esophagogastroduodenoscopy)

Performed under conscious sedation (not full anesthesia)

Can be both diagnostic and therapeutic

52
Q

Indications for EGD

A 
Alarm Sx (DYSPHAGIA, WEIGHT LOSS, EARLY SATIETY, EPIGASTRIC PAIN)*******
N/V, abdominal pain
Dyspepsia
Chronic GERD
Suspected esophageal varies
Hematemesis or melena
Fe deficiency anemia 
Abnormal UGI
Suspected enteropathies (ie celiac)
Foreign body/food bolus
53
Q

Contraindications for EGD

A

Uncooperative patient
Bleeding
Esophageal diverticula (b/c inc risk of perforation)**
Suspected perforation (b/c can be worsened)**
Recent upper GI tract surgery (weak anastomoses site)**

54
Q

Complications of EGD

A

Perforation
Bleeding from biopsy
Aspiration of gastric contents
Oversedation

55
Q

What is an ERCP?

A

Endoscopic retrograde cholangiopancreatography

Involves use of fiber optic endoscope to obtain radiographic visualization of BILE AND PANCREATIC DUCTS

Similar to MRCP (Magnetic Resonance Cholangiopancreatography)

56
Q

Indications for ERCP

A

Obstructive jaundice

Investigation/treatment of obstruction of bile and pancreatic ducts (mass, choledocholithiasis, cholangitis)

57
Q

Therapeutic uses for ERCP

A

Can perform sphicterotomies, remove stones, place stents, and obtain brushings/biopsies

Incision in ampulla of vater to widen common bile duct and gallstones can be removed

58
Q

Contraindications for ERCP

A

Uncooperative patient

Previous GI surgery with inaccessible ampulla of vater

59
Q

Complications of ERCP

A 
Pancreatitis
Perforation
Gram-negative bacteremia/sepsis (from translocation of bacteria into Biliary —> blood system)
Aspiration of gastric contents
Oversedation
60
Q

Procedure that allows for direct visualization of the rectum, colon, and terminal ileum via a long, flexible, fiber optic-lighted scope

A

Colonoscopy

Usually performed with conscious sedation

Both diagnostic and therapeutic

Requires bowel prep

61
Q

Procedure with visualization limited to rectum and sigmoid colon

A

Flexible sigmoidoscopy

62
Q

Indications for colonoscopy

A

Colon cancer screen (remove polyps, biopsy)

Potential colon cancer symptoms (change in BMs, hematochezia, iron deficiency anemia)

SSx of IBD

Hematochezia

Diarrhea

Prior abnormal test (BE, CT)

Foreign body removal

Decrompression of volvulus

63
Q

Contraindications for colonoscopy

A 
Uncooperative patient
Severe rectal bleeding
Suspected perforation
Recent colon surgery
Toxic MEGACOLON
Active diverticulitis or colitis
64
Q

Complications of colonoscopy

A

Perforation
Bleeding
Oversedation

65
Q

Non-invasive stool test with DNA markers and immunochemical test for hemoglobin in the stool

A

Cologuard

Alternative to colonoscopy for colon cancer screening

Frequency of testing not yet established (Q3years?)

Clin Med III Unit I (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions