Ct Colonography Flashcards

1
Q

Which cancer is The second most common in europeeurope

A

Colorectal cancer

Around 447,000 new cases in 2012

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2
Q

Which are the 4 most common cancers in the UK

A
  1. Breast
  2. Lung
    3 prostate
  3. Colorectal
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3
Q

why is colorectal cancer under diagnosed? Leaning to death

A

Embarrassment, misdiagnosis, difficulty with treatment due to location, age at diagnosis

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4
Q

where are the 5 areas that referrals come from?

A
  1. GI
  2. Colorectal
  3. GP
  4. Failed colonoscopy
  5. BCSP - bowel cancer screening program
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5
Q

What is included in the referral/ prep pack?

A
  • Colon prep pack
  • appointment letter
  • 100 ml gastrografin with instructions
  • Diet sheet
  • sachet of picolax
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6
Q

What do patients need to do 2 days before the exam?

A

Low fibre and fat diet

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7
Q

What do patients need to do 1 day before the exam?

A

Drink 1/3rd of the gastrografin at 3 intervals during the day

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8
Q

What are patients advised not to do on the day of the exam?

A

Not to eat - they can drink clear fluids

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9
Q

When wouldn’t we give contrast?

A
  • Poor eGFR
  • Poor eGFR and on Metformin
  • allergy to iodine or the contrast
  • severe uncontrolled asthma
  • Innterleukin treatment (immunotherapy)
  • thyroid condition
  • BSCP
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10
Q

When wouldn’t we give Buscopan?

A

~ allergy to Buscopan or any of the ingredients
~ heart conditions - eg: AP, angina etc
~ Hypertension
~ particularly frail patients
~ any blood thinners
~ poor historian

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11
Q

What are the normal side effects of Buscopan?

A

Dry mouth
Blurred vision
Constipation
An increased HR

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12
Q

Why is it important for the patient to have followed the diet?

A

Fat and fibre can show up on the scan.

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13
Q

What slice thickness is used for the cT colon scan?

A

1.25mm

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14
Q

What phase is the CT colon scan in?

A

Portal venous

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15
Q

What position is the patient in for the scan?

A

Ideally prone

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16
Q

Why do we do second and third scans?

A

To ensure the full lumen is visualised

17
Q

In what positions the second and third projections completed

A

Lateral decubitus and supine

18
Q

Why are second and third scans are lower dose?

A

Because we dont need to see any soft tissue detail as it has already been seen on the first scan.

Generally 1/3 of the dose of a regular Abdopelvis scan

19
Q

What properties do the 2nd and 3rd scans have?

A

Higher noise index

20
Q

What’s special about the post processing of CT colons?

A

The radiographer submit a provisional report

21
Q

What are common findings on CT colonography?

A

Diverticulitis
Diverticulosis
Polyps
Colorectal cancer
Extracolonic pathology

22
Q

What is diverticulitis?

A

Inflammation in the bowel

23
Q

What is diverticulosis?

A

Pockets in the bowel wall

24
Q

What are polyps?

A

Mucosal outgrowths of the bowel wall

Can lead to colon cancer

25
Q

What presents with symptoms similar to diverticulitis?

A

Colon cancer - A disease of the elderly

26
Q

What do we need to do if colorectal cancer is initially found?

A

Include a CT chest