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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
If using a HIDA scan to evaluate cholecystitis what should also be ordered for best results?
Ordered w/ CCK
26
What is a normal ejection fraction for HIDA scan ordered with CCK?
> 35% (abnormal = < 35%)
27
What is a contraindication to a HIDA scan?
Pregnancy
28
What GI imaging will best evaluate luminal GI disorders (mucosa and peristalsis)?
Barium studies (per anatomic section of interest)
29
What are the two components of a barium study?
Barium sulfate contrast and fluoroscopy (XR movie to see internal organs in motion)
30
How does a barium study change if you suspect perforation?
Use water-soluble Gastrografin (not barium)
31
What are the four types of barium studies?
Esophagram, UGI series, SBFT, Enema
32
What portions of the GI tract does an esophagram evaluate?
Esophagus, gastroesophageal junction (GEJ) into proximal stomach
33
What are the indications for an esophagram?
dysphagia/ odynophagia, hiatal hernia, achalasia
34
What portions of the GI tract does an UGI evaluate?
Esophagus, stomach and 1st part of duodenum
35
What are the indications for an UGI barium stud?
Early satiety, PUD, perforation
36
What are the complications to an UGI barium study?
Espiration, constipation from barium
37
What are the contraindications for an UGI barium study?
Pregnancy, complete bowel obstruction, upper GI perf
38
What portions of the GI tract does a SBFT evaluate?
Esophagus, stomach, duodenum, jejunum, ileum
39
What are the indications for a SBFT?
Crohn Disease, small bowel tumors, mucosal abns
40
A barium enema is aka what?
Lower GI series
41
T or F: A barium enema is an acceptable test for colorectal CA screening?
FALSE. No longer acceptable for colorectal CA screening
42
What barium study can be an alternative for a colonoscopy?
Enema
43
What are the inidcations for a brium enema?
change in bowel habits, constipation, assess for polyps
44
"Apple core" lesions are found on what Gi imaging study and what can they indiciate?
Barium enema. Concerning for CA?
45
What are the contraindication for a barium enema?
Pregnancy, megacolon, suspected perforation, unstable vitals
46
Performation and fecal impaction are complications of what Gi imaging study?
Barium enema
47
Is EGD performed under conscious sedation?
Yes
48
What GI imaging study is direct visualization of the upper GI and is both Dx and therapeutic?
EGD
49
Weight loss, FB, hematemesis/melena, and celiac disease are indications for what GI imaging?
EGD
50
What GI imaging can idenity Barrett's esophagus?
EGD
51
What GI imaging can identify strictures (schatzki's ring)?
EGD
52
What are the contraindications to an EGD?
Uncooperative pt, bleeding, esophageal diverticula, suspected perforation, recent upper GI tract surgery
53
Perf, bleeding from biopsy, aspiration of gastric contents, and oversedation are complications of what GI imaging?
EGD
54
An EGD is recommended with caution in pts w/ what disease process?
Cardiopulmonary disease
55
What Gi imaging will best evaluate pancreaticobiliary disorders?
ERCP/MRCP
56
Is an ERCP or MRCP invasive, dx, and therapeutic?
ERCP
57
Will an ERCP or MRCP allow for spincterotomies/stone removal)
ERCP
58
Is an ERCP or MRCP performed under conscious sedation/anesthesia?
ERCP
59
Acute pancreatitis and sepsis are complication to what GI imaging?
ERCP
60
An uncooperative pt or inaccessible ampulla of Vater are contraindicatios to what GI imaging?
ERCP
61
What are the indications for an ERCP?
Obstructive jaundice, obstruction of bile/pancreatic ducts, cholangitis (ascending bacterial infection)
62
Is an ERCP or MRCP non-invasive and dx (not therapeutic)?
MRCP
63
What GI imaging will visualize the liver, gallbladder, biliary tree, pancreas, pancreatic ducts?
MRCP
64
Is a colonoscopy performed under conscious sedation?
Yes
65
What GI imaging is both DX and therapeutic and will visualize the rectum, colon and terminal ileum?
Colonoscopy
66
What is required prior to a colonoscopy?
Bowel prep
67
What Gi imaging is gold standard for colon CA screening?
Colonoscopy
68
What are the indications for a colonoscopy?
Colon cancer (gold standard), inflammatory bowel disorders (Crohn’s, UC), diverticulosis, decompression of volvulus
69
Active diverticulitis and toxic megacolon are contraindication to what GI imaging study?
Colonoscopy
70
Perforation, bleeding and oversedation are complications of what Gi imaging?
Colonoscopy
71
What GI imaging study will allow for visualization of just the rectum and sigmoid colon?
Flex sigmoidoscopy

1. Clin Med III (29 decks)

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