Common Diagnostics In Gastroenterology Flashcards
Microcytic hypo chromic anemia can be seen in the ff conditions
Chronic blood loss or chronic disease
Iron deficiency anemia
Megaloblastic anemia can be seen in
Vit B12 deficiency
From small-intestinal, gastric or pancreatic disease
Leukocytosis is seen in
Inflammatory conditions
Leukopenia can be seen in
Viremic illness
Elevated transaminases in
Hepatic inflammation
Elevated lipase and amylase in
Pancreatic inflammation
Obtained to exclude endocrinologic causes of GI symptoms of chronic diarrhea and constipation
Thyroid tests
Cortisol
Assess for intraabdominal malignancies
Tumor markers
CA19-9
AFP
Indication for serum electrolytes in GI
Severe diarrhea or vomiting
Best method of examining the upper gastrointestinal mucosa
EGD
Esophagogastroduodenoscopy
Upper endoscopy
Endoscope inserted through the mouth into the esophagus, stomach, duodenal bulb, second part of the duodenum
EDG
Gold standard for diagnosis of colonic mucosal disease
Colonoscopy
Scope inserted through anal canal into rectum and colo
Colonoscopy
Visualizes only the rectum and a portion of the left colon
Typically up to 60 cm from the ana verge
Flexible sigmoidoscopy
Capsule endoscopy
Push enteroscopy
Single- or double- balloon enteroscopy or spiral enteroscopy
Small bowel endoscopy
ERCP stands for
Endoscopic retrograde Cholangiopancreatography (ERCP)
Scope passed through the mouth to the duodenum; ampulla of Vater is identified and cannulated
Contrast material is injected into the bile duct and pancreatic duct under fluoroscopic guidance
ERCP
High-frequency ultrasound transducers incorporated into the tip of a flexible endoscope
Endscopic ultrasound (EUS)
Obtains images of the gut wall and adjacent organs, vessels, and lymph nodes
EUS
Common indications for EGD
Dyspepsia despite treatment Or With symptoms or signs of ALARM Age >55 years Family hx of upper GI cancer UGIB Anemia Jaundice Left supraclavicular lymhadenopathy Palpable abdominal mass Progressive dysphagia Refractory vomiting Weight loss
Colonoscopy indications
Cancer screening
LGIB
Anemia
Diarrhea, obstruction
Flexible sigmoidoscopy indications
Evaluation of diartrhea
Rectal outlet bleeding
Small bowel endoscopy indications
Obscure GI bleeding
Suspected small intestinal pathology (tumors, Meckel’s diverticulum)
Suspected chron’s diease
ERCP indications
Jaundice
Cholangitis
Gallstone pancreatitis
Pancreatic/ biliary tumor
Indications for EUS
Staging of malignancy
Provides mucosal definition and assessment of gut transit and pelvic floor dysfunction
Oral and rectal contrast studies
Initial procedure to order for evaluation of dysphagia ( can detect subtle rings, strictures , and achalasia)
Barium swallow
Reliably diagnoses small diagnoses small intestinal tumors and Chron’s ileitis
(Radiography)
Small-bowel contrast radiography
Evaluates regions not accessible by endoscopy or contrast studies such as liver, pancreas, gall bladder, kidneys and retroperitoneum
Ultrasound and CT scan
Used for diagnoses of mass lesions, fluid collections and organ enlargementq
Ultrasound and CT scan
Evaluates pancreaticobiliary ducts to exclude neoplasm, stones, and sclerosing cholangitis
MRI
Evaluates the liver to characterize benign and malignant tumors
MRI imaging
Evaluates the mesenteric ischemia/ occlusion and patency of biliary tree
Angiography
Angiography
Localizes sites of bleeding when the rate of arterial bleeding is at least
0.5 mL / min
Can facilitate differentiation of malignant from benign diseas
Used for restaging after neoadjuvant therapy for certain tumors (esophageal cancer)
Positron emission tomography
Evaluates both structural abnormalities and quantifies luminal transit
Scintigraphy
Localizes bleeding rate of 0.04mL/ min
Radionuclide bleeding scans ( scintigraphy)
Searches for intraabdominal abscesses not seen on CT scan
Radiolabeled leukocyte scans
Complements ultrasound in assessment of cholecystitis by demonstrating patency of cystic duct
Biliary scintigraphy
Basic patterns of liver disease
I. Hepatocellular
II. Cholestatic
III. Mixed
Hepatocellular examples
Viral h
