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SUMRAD > ABD > Flashcards

ABD Flashcards

1
Q

What are indications for supine KUB?

A

Plain Xray rare: Bowel gas, FB, Calcifications, tubes

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2
Q

What is included in ABD series?

A

KUB, uprdight abdomen, CXR

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3
Q

What are indcations for ABD series?

A

SBO, LBO, perfs, Pneumoperiotoneum, Air fluid level, free air diaphragm, lung patholgy

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4
Q

What if pt cannot stand?

A

LL decubitus- air levels and free air

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5
Q

What is adequat for each view?

A

KUB- lateral walls, CXR- costophrenic angles, Upright- horizontal bean 5-10min. LOOK - white-calcified, black-air- gray- stool organs

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6
Q

This xray of ABD shows little air, NO feces, valvulae conninventes w/ narrow space, width <2.5cm, thin wall <3mm?

A

Small bowel location

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7
Q

This xray of ABD shows more air, feces, Haurstra w/ wider space, width <5cm wide, thin wall <3mm?

A

Large Bowel Locale- peripheral distribution. Transvers colon center and sag

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8
Q

T or F. Gas and air fluid level is ABNORMal in the stomach?

A

FALSE- very normal. Air fluid in UPRIGHT

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9
Q

T or F. Gas and air fluid level is ABNORMal in the Large Instestine?

A

FALSE- gas is NORMAL. NO AIR fluid level

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10
Q

T or F. Gas NORMAL and air fluid is ABNORMal in the SMall intestine?

A

FALSE- VERY little gas and fluid

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11
Q

Pt with calcification will ALWAYS have symptoms?

A

FALSE- calcificaion are abnormal. Pt may or may not have SX

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12
Q

What could move the small and large intestine in higher positions?

A

Organmegaly or MASS- USE CT to DX mass.

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13
Q

Gastropareis is common in DM when they stomach is paralyzed. What will be seen?

A

Air fluid level dialted

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14
Q

IF the SBO is mechanicall obstrcuted what is seen?

A

centered, VCs dilated. Complete, will be no air distal to obstruciton. RECTUM/COLON may have NO Air, collapsed. Proximal= LESS dilated loops. MORE dilated bowels vs. LBO. SBO dilate to >3cm ONLY

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15
Q

WHat is stacked coin and bent fiinger sign?

A

Common in SBO supine view- VCs narrow space. Bent finger look for steps

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16
Q

When is upside down U and string pearls seen?

A

UPright SBO- air w/in VC, U-formed superior and inferior

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17
Q

IF SBO is suspected what is PT CP?

A

Hypotension, TAchy. Risk of perforation.

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18
Q

WHat is seen with LBO?

A

Peripheral, larger haustra. Cecum diated large R. May span 3-4 vertebrae. Few air fluid level in rectum and small bowel.

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19
Q

This LBO starts from LLQ-RUQ?

A

Sigmoid volulus- bowel twisted on itself. Coffe bean shape with long opaque line

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20
Q

This LBO starts from RLQ to LUQ

A

Cecal volvulus- kidney bean shaped

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21
Q

Thes LBO type are not volulus and require fluids for treatment?

A

Toxic megacolon, Ogilvie Syndrome- elderly bedbound, anticholinergics. Entire colon dilated

22
Q

This Pt is post op from tumor removal, that herniated. She also has PMH of IBD?

A

SBO mechanical risk

23
Q

This Pt has a maligant tumor. What are other DDX?

A

LBO risk- hernia, volvulus, divertic, intussuception, fecal impaction

24
Q

Ms. V has large bowel dilated adn inflammed, but not obstructed. What is the condition?

A

Colitis-can see whole bowel. Very sick. DDX- toxic, ischeic, Ulcerative, C. diff.

25
Q

What is risk for Colitis?

A

Perforation- CT IV w/ CON if not emergent

26
Q

What would inidcated inflammed bowel?

A

Thicked bowel walls or haustra.Thumb printing

27
Q

What is dilated single or double loop near inflammed area, related to pancreaitis?

A

Localized illeus (failed bowel)-Sentinel Loop

28
Q

What is DX when both LBO and SBO are dilated, post surgicla. Bowel sound absent?

A

Generalized Adynmaic ileus

29
Q

Where can air be seen if extraluminal?

A

Pneumoperitoneum-btwn lever and diaphram.Lateral, R. Retroperitoneal- CT best. Penumatosis intestinales- KIDS severe. Pneumobilia- biliary system, tublie in RUQ (gas from bacteria)

30
Q

Air under diaphragm, Rigler sign (both side of bowel wall), or see the falciform ligament…mean what and is caused by?

A

Pneumoperitoneum- Cause surgery, perf of hollow organ, periotinitis from organims forming gas

31
Q

WHat is used to study lesion in esophagus, bowel, colon. THe fluid fills space, but avoid masses?

A

Barioum study- Apple core lesion-mass, Achalasia-complete block. DDX dysphagia, perforation, FB, strcitures, motiliy, malignancy, Zenker diverticululm, Barretts, Hiatal Hernia

32
Q

What are the common indentation of the esophagus, not to be confused with masses?

A
  1. Aortic arch. 2. L main bronchus 3. Esophagastric junction-MC Barrets & GERD
33
Q

What is ideal for SB distal portion to see Chrons, IBD?

A

Time Oral contrast flouroscopy w/ Barium enema

34
Q

Mr. T has rectal bleeding but is painless. What is inital test for lesion insdie the bowel?

A

Colonscopy. NOT CT. Bowel prep is key. Screen >50yo. Colitis and malignancy

35
Q

IN order to DX esophagus conditions such as: UGI bleeds, FB, Mallory weiss tear, esophageal varices, boerhaaves, Gastriic: tumors, ulcer, etc.

A

Endoscopy

36
Q

What is used to see gastric ulcers, tumors, obstuction, postop, w/ biopsy including proximal small bowel?

A

Endoscopy

37
Q

What is the position of the NG tube indicated for excessive vomiting, decompress bowel (air out SBO), gastric blood lavage?

A

*10cm below gastric esophageal junction. Confirm w/ Chest xray

38
Q

What is thru skin into stomach, endoscopy and fluroscopy is used to place?

A

Gastrostomy. PEG

39
Q

What is best initial test for gall blader, gallstones, common bile duct?

A

*Abdominal US

40
Q

On ABD US what is important to Dx for Bladder, Kidney, Liver, Aorta?

A
  1. Bladder- retention, cysit, mass, post void residual 2. Kidney- hydronephrosis masses, 3. Liver- free fluid Morrison pouch, liver parenchyma 4. Aorta- Aneurysm
41
Q

Can you DX appendiicits with US?

A

Yes-kids, adults

42
Q

What is preferred to see the biliary tree if available?

A

MRCP- MR cholangiopancreatogram- NO CONTRAST. USE- bilary stones, pancreas, malignancy, cholangitis. Endoscopic Retrograde- secondary

43
Q

What are the three DX criteria for cholecysitis?

A

Gallbladder infection- 1. Gallbladder thickening 2. Peri cholesystic fluid (small black strip) 3. Sonographic Murphy’s sign- push under live. 4. Bile Duct >6mm dilated. 5. Acalculous cholecysitis is possible

44
Q

What study is used for hepatic biliary tree with nuclear medicine?

A

HIDA scan- 1. acute cholecysitis. 2 Chronic Biliary tract dz 3. Congenital dz 4. Post op bile leak fistula 5. Liver transplat fx

45
Q

What study is used for renal parenchyma and kidney failure?

A

US

46
Q

Mr. Kid has painful abdominal pain, w/ h/o dehydration? What is initial study?

A

CT NO CONTRAST- renal/kidney/ureter stone

47
Q

What is outcome if ureteral stone, kidney stone passing downstream, obstructs ureter. Then urine back up into renal pelvis

A

US for Hydronephrois- DX of obstructing renal calculi. Hydroureter-CT best

48
Q

What landmarks and probe is used to DX appendicitis on US?

A

Probe thin linear probe. Obese curvilinear. Landmarks- iliac crest, iliac artery, psoas, cecum.

49
Q

What is DX of pos. Appendiciits?

A
  1. Dilated >6mm 2. Non compressible 3. Thick wall 4. Peri-appendiceal fluid
50
Q

What is used first to dx free fluid in Abdomen?

A

US- ascites d/t cirrhoiss, cancer. Blood-FAST exam. CT w/ oral & IV contracts for cause?

SUMRAD (13 decks)

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