Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med III > Exam 1 GI diagnostics > Flashcards

Exam 1 GI diagnostics Flashcards

1
Q

On xray, dark areas are what? Permit what? represent what?

A

dark areas are radiolucent, permit penetration of xrays, indicate air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

On Xray, lighter areas (white, grey) are what? Block what and represent what?

A

lighter areas are radiopaque, they block the penetration of xrays and represent bone or organ tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q 
on abdominal xray...
Black = 
White =
Grey = 
Darker grey = 
Intense white =
A

Black = air
white = calcification (ie vertebrae, pelvic bone)
Grey = soft tissue (ie liver)
darker grey = fat
Intense white = metallic objects/ foreign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what series of xrays are common to obtain

A
  1. AP while pt supine (aka KUB)
  2. Upright (better to see air fluid levels)
  3. PA chest xray (see free air underneath hemidiaphrams and check chest path)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When would you order and xray

A

pt has abdominal pain, N/V, distension

*would tell us if there is intestinal obstruction, perforation, intussusception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can you dx from xray

A

intestinal obstruction, perforation, intussusception, ileus etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is one thing you should generally look for on xray

A

gas pattern, bowels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what xray findings indicate bowel obstruction

A

dilated bowel proximal to obstruction with collapsed bowel distally. Air fluid levels (fluid you normally would expect is backed up)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what xray finding indicate paralytic ileus

A

paralytic ileus (non mechanical bowel obstruction) indicated by dilated bowel, gas in both mall and large intestine

*ilus is when bowel gets paralyzed, can happen after surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What xray findings are indicative of abdominal perforation

A

Free air outside the bowel (air where it shouldn’t be ie in the peritoneal cavity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What xray findings are indicative of intussusception

A

signs of obstruction (hard to see)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Most obstructions you see are

A

SBO (small bowel obstructions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Upright radiograph description of complete small bowel obstruction:

A

multiple air fluid levels of varying size arranged in inverted Us

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Supine radiograph description of pt with complete small bowel obstruction

A

distended small bowel loops; bowel walls bw the loops is thickened and edematous; no air seen in colon or rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

example radiograph description of pt with ileus

A

massive gastric distention, distended small bowel loops, air throughout colon, mild dilation of sigmoid colon with air mixed with stool and haustral fold in apex of sigmoid colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

example radiograph description of pt with perforation

A

free air on both sides under diaphragm, crescents of air seen beneath each hemidiaphragm and both sides of bowel wall
*black line, free air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

example radiograph description of pt with intussusception

A

loop of bowel slipped into another section of both, creates swelling, decreased blood flow, obstruction and tissue damage. Requires EMERGENCY TX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What lab values are consistent with a backed up bowel/ obstruction

A

elevated white count, elevated lactate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are complications/risks of abdominal xrays

A

contraindicated in preg

radiation exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

toxic megacolon is associated with

A

massive diarrhea and c diff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is an abdominal ultrasound

A

use of reflected sound waves to visualize the abdominal aorta, liver, gallbladder, pancreas, bile ducts, spleen, kidneys, ureters, bladder

  • doppler US provides blood flow info
  • can order US of specific location or organ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are dark areas of US? ex?

A

dark areas are hypoechoic

ex: aorta, bile ducts, abscesses, cysts (areas where you expect to see air)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

White areas of abdominal US are what?

A

echogenic (solid)

ie tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

when would you order abdominal US

A 
abdominal pain
elevated LFT (look for liver cirrhosis)
known/suspected liver dz (look for abscess, cyst)
s/p kidney, pancreas or liver transplant
acute/chronic renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what can you find on a liver US

A

can see cysts, abscesses, tumors, cirrhosis
can see dilated bile ducts
*remember tumor is white/echogenic/solid
*cysts, abscesses, bile ducts are hypoechoic/air/dark

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What can you see on a gallbladder US?

A

tumors (echogenic/white/solid), polyps, stones, sludge, inflammation (wall thickening)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What can you see on pancreas US?

A

cysts, abscesses (both hypoechoic/dark),
tumors (echogenic/white/solid),
inflammation (wall thickening)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Risks/complications of Abdominal US?

A

no contrast, no radiation

*useful study in pt with contraindications to other dx tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is a CT scan

A

computerized xrays that produce cross sectional images of the body layer by layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is a CT scan used for GI wise

A

used to evaluable abdominal and pelvic organs
*imaged enhanced with IV and PO iodine containing contrast, exception is for renal stone study
NO CONTRAST FOR NEPHROLITHIASIS/stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Indications for CT

A

abdominal pain, distention, N/V, diarrhea, constipation, rectal bleeding, jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What CT findings for liver are possible

A

cyst abscess, tumor, bile duct obs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

US is preferred test over CT for

A

cholecystitis, cholelithiasis of gallbladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What CT findings of pancreas are possible

A

cyst, abscess, tumor, calcification, pancreatitis

  • CT preferred test over US for pancreatitis
  • calcification in pt with chronic pancreatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Preferred test for pancreatitis

A

CT

36
Q

What GI tract/bowel findings can you see on CT

A

tumor, obstruction, perforation, inflammation (incl appendicitis), bleeding

37
Q

What spleen CT findings are possible

A

Tumor, laceration, hematoma, splenic vein thrombosis

38
Q

CT of abdominal aorta?

A

can help visualize for aneurysm

39
Q

What CT findings are consistent with acute pancreatitis

A

inflammation and swelling of pancreas

40
Q

What findings are consistent with chronic pancreatitis

A

multiple white colored calcifications

41
Q

What CT findings are consistent with laceration of liver

A

linear low attenuation defect

42
Q

interpret CT that has grey snowstorm with pockets of black in large bowel …

A

grey snowsotrm is stool, black is air

43
Q

CT of mets liver disease could show

A

areas of white on liver

44
Q

CT pelvis without contrast is specifically used to dx what? what will they come up as?

A

CT w/o contrast for renal stone will show bright white

45
Q

what are some other uses of CT scan

A
  • virtual colonoscopy or angiography (3D)
  • visualization during invasive procedures (ie biopsy or aspiration)
  • used to monitor disease
46
Q

CI and complications for CT scan

A

CI: preg, unstable vitals, morbid obesity, contraindications to IV contrast (allergy to iodine or shellfish; sometimes can premedicate with benadryl or prednisone), elevated Cr

Complications: rxn to contrast (range from flush/itch –> anaphylaxis), acute renal failure form contrast

47
Q

Precautions/instructions for pt for CT scan

A

Metformin pt: hold for 48 hr post contrast admin

Radiation risks: 1 CT abdomen ~250-500 CXRs so avoid unnecessary CTs

48
Q

what is a HIDA scan (Hepatoiminodiacetic Acid scan aka GB nuclear scan or cholescintigraphy)

A

similar to V/Q scan used for PE; used to dx pt suspected ACALCULOUS CHOLECYSTITIS

  • pt receives IV radioactive tracer, tracer extracted by liver and excreted into bile white is stored in GB, nuclear scanner tracks flow of tracer
  • best info obtained when test ordered with CCK stimulation and ejection fraction
49
Q

What HIDA scan findings are suggestive of Cholecystitis

A
  1. no radionuclide seen in GB within 15-60 min
  2. Ejection fraction <35%
  3. Test reproduces pt sx
50
Q

Contraindications to performing HIDA scan (to dx cholecystitis)

A

pregnancy

51
Q

What is a UGI (upper GI) series

A

Pt drinks barium sulfate contrast and fluoroscopy is used to visualize esophagus, stomach and first part of the duodenum

*fluoroscopy = “xray movie”: continuous xray passed through/over body part and image is transferred to monitor

  • esophagram/barium swallow: throat& esoph only
  • small bowel follow through (looks more distally)
52
Q

when to order UGI

A

dysphagia, GERD sx, early satiety, suspected PUD, suspected obstruction/inflammation

53
Q

what types of things can you dx or signs of dx can you see with UGI series

A 
hiatal hernia
Potential CA (can't dx, just signs)
ulcers
Diverticula
Extrinsic compression
Perforation (use gastrografin)
54
Q

Perforation shows in UGI as

A

leakage of barium outside UGI tract

*use water soluble Gastrografin

55
Q

Hiatal hernia shows in UGI as

A

portion of stomach above diaphragm

56
Q

Potential cancer indications in UGI

A

Stricture, obstructions, filling defects, tumors, ulcerations

*filling defect: displacement of contrast medium by space occupying lesion in radiographic study of a contrast filled hollow viscus

57
Q

what is a bezoar

A

some sort of foreign body

58
Q

description of large filling defect due to bezoar

A

barium remaining in bezoar while exiting rest of the stomach

59
Q

UGI contraindications and complications

A

CI: pregnancy, complete bowel obstruction, suspected upper GI perforation (can do UGI but use water soluble Gastrografin not barium), unstable vital signs

complications: aspiration, constipation from barium

60
Q

What is a Barium Enema

A

aka lower GI series
*pt receives barium enema and fluoroscopy is used to visualize the colon and distal small bowel

  • can be alt to colonoscopy
  • may be threrapeutic to reduce non-strangulated ileocolic intussusception
  • can’t biopsy though
61
Q

Barium Enema: Findings indicative of Inflammatory bowel disease

A

narrowing of barium column due to inflammation of surrounding colon; some associated strictures

62
Q

Barium Enema: findings indicative of CA

A

strictures, obstructions, filling defects, tumors, ulcerations

63
Q

Barium Enema: findings indicative of benign tumors

A

may be seen as filling defects

64
Q

Barium Enema: findings indicative of Perforation

A

Leakage of barium outside of colon (use water soluble Gastrografin)

65
Q

what types of things does a Barium Enema help dx?

A

IBD, CA, ulcers, Diverticula, Benign tumors, extrinsic compression, perforation

66
Q

Contraindications to BE?

A

pregnancy, Megacolon, suspected perforation (use gastrografin instead of Barium), unstable vitals

67
Q

Complication of BE?

A

perforation, fecal impaction due to barium

68
Q

what is an EGD?

A

esophagogastroduodenoscopy!!!

direct visualization of Upper GI tract (esophagus, stomach, and first part of duodenum) via long, flexible, fiberoptic lighted scope

  • performed with conscious sedation
  • dx and therapeutic (ie can cauterize, dilate if stricture; but more risk)
69
Q

What are various indications for EGD?

A
  • alarming sx (dysphagia, wt loss, early satiety, epigastric pain)
  • N/V, abdominal pain
  • dyspepsia
  • chronic GERD
  • dysphagia
  • suspected esophageal varices: assoc w/ liver dz
  • Hematemesis or melena
  • Iron def anemia
  • abnormal UGI
  • suspected enteropathies (ie celiac dz)
  • foreign body/food bolus
70
Q

EGD findings include

A

hiatal hernia, tumor/CA, polyps, varices, mucosal inflammation, ulcers, Barrett’s esophagus, obstructions, webs/rings (eg Schatzkis ring), infection (candida, HSV), AV malformation

71
Q

Contraindications to EGD

A
  • Uncooperative pt
  • Bleeding
  • esophageal diverticula (^risk perforation)
  • Suspected perforation: can be worsened by insufflation of pressurized air
  • Recent upper GI tract surgery (weak anastomosis site)
72
Q

Complications of EGD

A

Perforation, bleeding from biopsy, aspiration of gastric contents, oversedation

73
Q

What is ERCP test?

A

endoscopic retrograde cholangiopancreatography

  • like EGD but more
  • fiberoptic endoscope to obtain radiographic visualization of bile and pancreatic ducts
74
Q

How is an ERCP test performed

A

endoscopic retrograde cholangiopancreatography

  1. endoscope passed into duodenum and small catheter is inserted into biliary duct
  2. Radiographic dye inj into ducts, x-rays taken
    * Performed with conscious sedation or anesthesia

*dx and therapeutic

75
Q

What is MRCP

A

magnetic resonance cholangiopancreatography

  • MR visualization of biliary tree & pancreatic ducts
  • may be ordered before ERCP bc not invasive

*dx but not therapeutic

76
Q

when would you order an ERCP

A
  • Obstructive jaundice,

* Investigation/ tx of obstruction of bile & pancreatic ducts (mass, choledocholithiasis)

77
Q

Is an ERCP therapeutic or dx?

A

BOTH!
can perform sphincterotomies, remove stone, place stent, obtain brushings/biopsies
*incision in ampulla of Vater to widen common bile duct and gallstones can be removed

78
Q

When should you not order ERCP

A
  • Uncooperative pt,
  • Prev GI surgery w/ inaccessible ampulla of Vater
  • Acute Pancreatitis
79
Q

What are some complications of ERCP?

A 
Pancreatitis
Perforation
G- bacteremia/sepsis
Aspiration of gastric contents
oversedation
80
Q

What is a colonoscopy

A

visualization of rectum, colon, terminal ileum via long flexible fiberoptic lighted scope

  • conscious sedation
  • dx and therapeutic
  • requires bowel prep (go lightly, miralax)
81
Q

what is flexible sigmoidoscopy

A

colonoscopy with visualization limited to rectum and sigmoid colon

  • does not require conscious sedation
  • only need enema prep
82
Q

Indications for Colonoscopy

A
  • Colon CA screen (removes polyps, biopsy)
  • Potential colon CA sx (change bowel habits, hematochezia, IDA)
  • signs/sx IBD (crohns, ulcerative colitis)
  • hematochezia
  • diarrhea
  • prior abnormal test (BE, CT)
  • foreign body removal
  • decompression of volvulus
83
Q

can you treat a bleeding diverticulum with colonoscopy? if so, how?

A

Yes

Inject oozing vessel at diverticulum with EPI to stop bleeding, then cauterize and tattoo with India ink

84
Q

When should you not order a colonoscopy

A 
Uncooperative pt
Severe rectal bleeding
suspected perforation
Recent colon surgery
Toxic megacolon
Active diverticulitis or colitis (need to recover first)
85
Q

Complications with colonoscopy

A

Perforation, Bleeding due to biopsy or polypectomy, oversedation

Clin Med III (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions