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Y3 - CLASP anatomy and radiology > Abdomen > Flashcards

Abdomen Flashcards

1
Q

benefits of x-ray

A

widely available
easy
excludes bowel obstruction/perforation

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2
Q

types of abdo X-ray

A

supine AXR

erect CXR

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3
Q

benefits of USS

A

easy, safe
clear visualisation of solid organs, free fluid, aorta, pelvis
Bowel – occasionally helpful
Correlate imaging with tenderness

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4
Q

benefits of CT

A

quick
accurate
allows better planning of surgery or intervention

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5
Q

drawbacks of CT

A

radiation exposure

renal impairment

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6
Q

benefits of MRI

A

no radiation

good soft tissue delineation esp in pelvis

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7
Q

drawbacks of MRI

A

takes a long time

contraindications/claustrophobia

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8
Q

when would you use MRI

A

use as a second line test in hepatic-biliary, small bowel and pelvis issues

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9
Q

key symptoms of acute appendicitis

A

periumbilical pain

nausea and vomiting

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10
Q

where does appendicitis pain localise

A

RIF

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11
Q

imaging in appendicitis

A

no role for X-ray
CT and USS are diagnostic
USS 1st, CT if this is inconclusive

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12
Q

incidence of acute diverticulitis decreases with age

A

false, increases with age

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13
Q

complications of acute diverticulitis

A

abscess
obstruction
perforation
fistulae

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14
Q

imaging acute diverticulitis

A

xray - exclude obstruction/perforation

CT with IV contrast = gold standard

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15
Q

CT findings acute appendicitis

A

appendiceal dilatation
wall thickening
thickening of the caecal apex

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16
Q

ureteric calculus presentation

A

loin to groin pain

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17
Q

imaging for ureteric calculus

A

non contrast CT - stones >1mm in size are visualised along with assoc changes

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18
Q

presentation of acute diverticulitis

A

left iliac fossa pain
unremitting pain with tenderness
possibly ill-defined mass
symptoms become more generalised with progression

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19
Q

what causes acute cholecystitis?

A

almost always secondary to gallstones

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20
Q

diagnosis of cholecystitis

A

one sign of inflammation (fever, WCC, CRP)
one local sign of inflammation (RUQ pain etc)
confirmatory imaging

21
Q

imaging in acute cholecystitis

A

USS
CT can be false -ve
MRI if biliary tree dilatation

22
Q

USS in acute cholecystitis

A

gallstones
GB wall thickening
local fluid

23
Q

MR cholangiopancreatohraphy in cholecystitis

A

shows stone in common bile duct causing obstruction

stones in GB

24
Q

what is emphysematous cholecystitis

A

air in gall bladder wall

diabetics

25
Q

treatment options for cholecystitis

A

medical/conservative
interventional radiology (percutaneous)
ERCP if obstructed biliary tree
surgery

26
Q

causes of small bowel obstruction

A

adhesions
cancer
hernia
gallstone ileus

27
Q

pancreatitis presentation

A

acute onset of severe central epigastric pain
poorly localised tenderness and pain
exacerbated by supine positioning
radiates through to the back in some

28
Q

blood test for pancreatitis

A

elevation of serum amylase

29
Q

pancreatitis imaging

A

clarify diagnosis
assess severity and determine prognosis
detect complications
determine causes

30
Q

US pancreatitis

A

identifies gallstones as cause

assess for other aetiologies

31
Q

CT pancreatitis

A

shows complications but only 7-10 days after diagnosis

should only be taken acutely if patient is very unwell

32
Q

perforation causes

A

perf ulcer
diverticular
cancer
ischaemia

33
Q

perforation imaging

A

AP erect xray

CT

34
Q

symptoms of small bowel obstructions

A

vomiting
pain
distension

35
Q

signs of small bowel obstruction

A

increased bowel sounds
tenderness
palpable loops

36
Q

imaging in bowel obstruction

A

xray

CT

37
Q

xray S bowel obstruction

A 
valvular conniventes 
loops are central 
dilatation 
paucity of gas distally 
can miss fluid filled loops
38
Q

CT S bowel obstruction

A 
dilated small bowel loops 
normal calibre or collapsed loops distally 
small bowel faeces sign 
may identify mass 
rare - gall stone ileum
39
Q

causes of L bowel obstruction

A

colorectal cancer
volvulus
diverticulitis

40
Q

x ray L bowel obstruction

A

helpful but may not diagnose underlying cause

41
Q

appearance of L bowel obstruction x ray

A 
colonic distention 
collapsed distal colon 
small bowel dilatation 
rectum has no or little air 
assess for complications such as ischaemia or perforation
42
Q

bowel ischaemia

A

if <10% GI blood flow

43
Q

causes of bowel ischaemia

A

arterial occlusion
venous occlusion
non-occlusive hypo perfusion

44
Q

bowel ischaemia presentation

A 
severe abdo pain 
vomiting 
diarrhoea 
distension inconsistent 
borderline amylase, raised WCC, acidotic 
patient very unwell
45
Q

imaging bowel ischaemia

A

CT

46
Q

CT appearances bowel ischaemia

A

lack of enhancement of the lumen of the affected vessel
mucosal/serosal enhancement reduced or increased
ileus/dilated loops of bowel
pneumatosis intestinal

47
Q

leaking AAA presentation

A

pain
hypotension
pulsatile abdo mass

48
Q

CT leaking AAA

A

retroperitoneal haemorrhage adjacent to the aneurysm

Y3 - CLASP anatomy and radiology (4 decks)

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