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1. Clin Med III > 1- GI Diagnostics > Flashcards

1- GI Diagnostics Flashcards

1
Q

Abd pain, N/V, and/or distention are indications for what GI imaging?

A

3 way view abdominal XR

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2
Q

What is the initial imaging for evaluating a distended bowel?

A

Supine A/P view (KUB)

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3
Q

What GI imaging will best evaluate air fluid levels?

A

Upright Abd XR

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4
Q

A CXR will be able to identify what with respect to the abdomen?

A

subdiaphragmatic air due to perforation

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5
Q

On 3 way view abd XR what would you expect to see with a bowel obstruction?

A

dilated bowel proximal to obstruction w/ collapsed bowel distally

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6
Q

On 3 way view abd XR what would you expect to see with a ileus?

A

dilated bowel with air present in both small & larg intestines w/o air fluid levels

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7
Q

On 3 way view abd XR what would you expect to see with a perforation?

A

free air outside of the bowel

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8
Q

A 3 way abd XR is contraindicated in what pt population?

A

Pregnancy

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9
Q

What is the abdominal imaging of choice for pt w/ contrast allergy, poor renal function or pregnancy?

A

Abdominal US

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10
Q

What is the dx imaging of choice for cholithiasis?

A

Abdominal US

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11
Q

What are the indications of an abdominal US?

A

Abd pain, elevated liver tests, nephrolithiasis or cholelithiasis, cholecystitis, hepatic steatosis, AAA,

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12
Q

Abd pain, constipation, rectal bleeding are the indications for what abdominal imaging study?

A

CT abdomen and pelvis

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13
Q

When would you not use contrast in a CT abd & pelvis?

A

If suspected nephrolithiasis (sx: flank pain and hematuria)

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14
Q

What is the preferred imaging study for evaluating pancreatitis?

A

CT abdomen and pelvis

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15
Q

CT abd & pelvis will show what for acute pancreatitis?

A

Inflammation and swelling of pancreas

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16
Q

CT abd & pelvis will show what for chronic pancreatitis?

A

Calcifications

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17
Q

What are the contraindications for CT abd & pelvis?

A

Pregnancy, unstable vitals, morbidy obesity contrast allergy and elevated creatinine

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18
Q

A reaction to contrast or AKI are complications to what GI imaging study?

A

CT abdomen and pelvis

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19
Q

What is the protocol for T2DM pt on metformin needing a CT abd and pelvis w/ contrast?

A

Hold metformin for 48 hrs post-contrast

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20
Q

What GI imaging will best evaluate diverticulitis, appendicitis and pancreatitis?

A

CT abdomen and pelvis

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21
Q

What GI imaging will best evaluate hepatobilliary disease?

A

Abdominal US

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22
Q

What GI imaging will best evaluate billiary dysfunction?

A

HIDA scan

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23
Q

What Gi imaging uses an IV tracer to assess bile excreting function of the liver and galbladder?

A

HIDA scan

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24
Q

What does an abnormal or positive HIDA scan show?

A

Unable to visualize GB due to cystic duct obstruction

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25
Q

If using a HIDA scan to evaluate cholecystitis what should also be ordered for best results?

A

Ordered w/ CCK

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26
Q

What is a normal ejection fraction for HIDA scan ordered with CCK?

A

> 35% (abnormal = < 35%)

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27
Q

What is a contraindication to a HIDA scan?

A

Pregnancy

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28
Q

What GI imaging will best evaluate luminal GI disorders (mucosa and peristalsis)?

A

Barium studies (per anatomic section of interest)

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29
Q

What are the two components of a barium study?

A

Barium sulfate contrast and fluoroscopy (XR movie to see internal organs in motion)

30
Q

How does a barium study change if you suspect perforation?

A

Use water-soluble Gastrografin (not barium)

31
Q

What are the four types of barium studies?

A

Esophagram, UGI series, SBFT, Enema

32
Q

What portions of the GI tract does an esophagram evaluate?

A

Esophagus, gastroesophageal junction (GEJ) into proximal stomach

33
Q

What are the indications for an esophagram?

A

dysphagia/ odynophagia, hiatal hernia, achalasia

34
Q

What portions of the GI tract does an UGI evaluate?

A

Esophagus, stomach and 1st part of duodenum

35
Q

What are the indications for an UGI barium stud?

A

Early satiety, PUD, perforation

36
Q

What are the complications to an UGI barium study?

A

Espiration, constipation from barium

37
Q

What are the contraindications for an UGI barium study?

A

Pregnancy, complete bowel obstruction, upper GI perf

38
Q

What portions of the GI tract does a SBFT evaluate?

A

Esophagus, stomach, duodenum, jejunum, ileum

39
Q

What are the indications for a SBFT?

A

Crohn Disease, small bowel tumors, mucosal abns

40
Q

A barium enema is aka what?

A

Lower GI series

41
Q

T or F: A barium enema is an acceptable test for colorectal CA screening?

A

FALSE. No longer acceptable for colorectal CA screening

42
Q

What barium study can be an alternative for a colonoscopy?

A

Enema

43
Q

What are the inidcations for a brium enema?

A

change in bowel habits, constipation, assess for polyps

44
Q

“Apple core” lesions are found on what Gi imaging study and what can they indiciate?

A

Barium enema. Concerning for CA?

45
Q

What are the contraindication for a barium enema?

A

Pregnancy, megacolon, suspected perforation, unstable vitals

46
Q

Performation and fecal impaction are complications of what Gi imaging study?

A

Barium enema

47
Q

Is EGD performed under conscious sedation?

A

Yes

48
Q

What GI imaging study is direct visualization of the upper GI and is both Dx and therapeutic?

A

EGD

49
Q

Weight loss, FB, hematemesis/melena, and celiac disease are indications for what GI imaging?

A

EGD

50
Q

What GI imaging can idenity Barrett’s esophagus?

A

EGD

51
Q

What GI imaging can identify strictures (schatzki’s ring)?

A

EGD

52
Q

What are the contraindications to an EGD?

A

Uncooperative pt, bleeding, esophageal diverticula, suspected perforation, recent upper GI tract surgery

53
Q

Perf, bleeding from biopsy, aspiration of gastric contents, and oversedation are complications of what GI imaging?

A

EGD

54
Q

An EGD is recommended with caution in pts w/ what disease process?

A

Cardiopulmonary disease

55
Q

What Gi imaging will best evaluate pancreaticobiliary disorders?

A

ERCP/MRCP

56
Q

Is an ERCP or MRCP invasive, dx, and therapeutic?

A

ERCP

57
Q

Will an ERCP or MRCP allow for spincterotomies/stone removal)

A

ERCP

58
Q

Is an ERCP or MRCP performed under conscious sedation/anesthesia?

A

ERCP

59
Q

Acute pancreatitis and sepsis are complication to what GI imaging?

A

ERCP

60
Q

An uncooperative pt or inaccessible ampulla of Vater are contraindicatios to what GI imaging?

A

ERCP

61
Q

What are the indications for an ERCP?

A

Obstructive jaundice, obstruction of bile/pancreatic ducts, cholangitis (ascending bacterial infection)

62
Q

Is an ERCP or MRCP non-invasive and dx (not therapeutic)?

A

MRCP

63
Q

What GI imaging will visualize the liver, gallbladder, biliary tree, pancreas, pancreatic ducts?

A

MRCP

64
Q

Is a colonoscopy performed under conscious sedation?

A

Yes

65
Q

What GI imaging is both DX and therapeutic and will visualize the rectum, colon and terminal ileum?

A

Colonoscopy

66
Q

What is required prior to a colonoscopy?

A

Bowel prep

67
Q

What Gi imaging is gold standard for colon CA screening?

A

Colonoscopy

68
Q

What are the indications for a colonoscopy?

A

Colon cancer (gold standard), inflammatory bowel disorders (Crohn’s, UC), diverticulosis, decompression of volvulus

69
Q

Active diverticulitis and toxic megacolon are contraindication to what GI imaging study?

A

Colonoscopy

70
Q

Perforation, bleeding and oversedation are complications of what Gi imaging?

A

Colonoscopy

71
Q

What GI imaging study will allow for visualization of just the rectum and sigmoid colon?

A

Flex sigmoidoscopy

1. Clin Med III (29 decks)

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