10 - AXR Flashcards

1
Q

Why might you request an abdominal x-ray?

A
  • Acute abdominal pain
  • Suspected bowel obstruction
  • Exacerbations of IBD
  • Renal colic (CT first line)

DONE AP

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2
Q

What system should you use to assess an abdominal x ray?

A

ABDO X

  • Air
  • Bowel
  • Dense structures/bones
  • Organs and soft tissues
  • External
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3
Q

Which bowel shouldn’t you see gas in?

A
  • Small bowel, has a fast transit time so will only see fluid
  • Colon will have lots of gas as slower transit time
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4
Q

Why is an AXR a higher radiation dose than a CXR?

A

Has to go through more structures to produce an image

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5
Q

How do the large and small bowel differ on x-ray?

A

- Small: central position and have lines that cross the entire wall (valvulae conniventes)

- Large: peripheral and have incomplete lines (haustra). faeces is visible as slow transit time

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6
Q

What diameter indicates bowel obstruction on x-ray?

A
  • Small: >3cm
  • Large: >6cm
  • Caecum: >9cm
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7
Q

What is the presentation and common causes of small bowel obstruction?

A

ASHVITA

  • Adhesions (most common)
  • Stenosis
  • Hernia
  • Volvulus
  • Inturssusception
  • Atresia
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8
Q

What is the presentation and common causes of large bowel obstruction?

A
  • Colorectal carcinoma (60%)
  • Diverticular stricture (20%)
  • Volvulus (5%)
  • Hernia
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9
Q

What is this abdominal x-ray showing?

A
  • Sigmoid volvulus coffee bean sign
  • Starts in LIF and goes to RUQ
  • Can be ischaemic or perforate
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10
Q

What is this abdominal x-ray showing?

A
  • Toxic megacolon
  • Colonic dilation, oedema (thumbprinting thick haustra due to inflammation) and pseudopolyps
  • Common in UC and C.Diff
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11
Q

What is being shown on this abdominal x-ray?

A
  • Lead pipe colon
  • Loss of haustra
  • Common in UC due to chronic inflammation
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12
Q

Label the viscera on the abdominal x-ray.

A
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13
Q

X-rays can identify calcification, what are som examples of calcification you may see on an abdominal x-ray?

A
  • Renal calculi
  • Vascular calcification
  • Pancreatic calcification following chronic inflammation
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14
Q

What is this abdominal x-ray showing?

A

Cannot see psoas so AAA

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15
Q

What is the abnormality on this x-ray?

A

Foreign body (cholecystectomy clip)

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16
Q

What are some causes of bowel perforation?

A
17
Q

How can you image for a bowel perforation?

A
  • Erect CXR
  • Will see free gas under the diaphragm
18
Q

How can we view hollow viscera on abdominal x-ray?

A
  • Water or barium contrast
  • Swallow test and dollow through
19
Q

How can we view the large intestine clearer on an AXR?

A

Contrast Enema

20
Q

How can we get a high resolution picture of the abdomen, but why may this method not be chosen?

A
  • Abdominal CT which can be augmented with contrast
  • High radiation dose
21
Q

What can be some issues with using IV contrast for CT?

A
  • Risk of contrast induced nephropathy
  • Allergy
22
Q

How can CTs replace a colonoscopy?

A
  • Images from CT scan can be reformatted and produce a 3D image of the anatomy so virtual colonoscopy
23
Q

Why may we use an MRI to image the abdomen?

A
  • Very detail high contrast images
  • No radiation
  • However very time consuming
24
Q

Why is an ultrasound used for abdominal imaging, and what is it most commonly used to image?

A
  • Cheap and portable
  • User dependant
  • Often used to visualise the biliary tree for gallstones and dilated bile ducts or guided biopsy
25
Q

What is being displayed here

A
  • GI Angiography using contrast CT
26
Q

Label the following parts of this MRI.

A
27
Q

What is the most common extra-intestinal manifestation of IBS?

A

Arthritis

28
Q

A 5 year old develops diarrhoea which is full of mucus and blood, what is the most likely gram negative bacteria causing this?

A

Shigella

29
Q

Do adults get rotavirus?

A

Not as common as children as adults tend to acquire an immunity to it as only a few strains unlike norovirus

30
Q

What parasite causes persistent diarrhoea?

A

Giardia!

Causes villous atrophy due to damage of small intestine, goes back into cyst stage to start the cycle again