Exam 1 - GI Diagnostics Flashcards
What is often the initial test to evaluate for abdominal problems?
Supine abdominal x-ray
What does a supine abdominal x-ray assess for?
Dilated bowel
What does an upright abdominal x-ray assess for?
Air-fluid levels (obstruction)
What does a PA chest x-ray typically assess for in regards to abdominal pathology?
Perforation
What can be seen on an abdominal x-ray which may cause suspicion for a small bowel obstruction?
- Dilated bowel proximal to obstruction with collapsed bowel distally
- Air fluid levels
What can be seen on an abdominal x-ray which may cause suspicion for an ileus?
- Dilated bowel BUT air present in both small bowel and colon
- NO air fluid levels
What can be seen on an abdominal x-ray which may cause suspicion for a perforation?
Free air outside the bowel
What is the initial diagnosed test of choice in a patient with suspected cholelithiasis?
RUQ/Gallbladder Ultrasound
What is the test of choice for evaluating nephrolithiasis?
CT abdomen/pelvis without contrast
When assessing the gallbladder for pathology, is CT or US preferred?
US
When assessing for pancreatitis, is CT or US preferred?
CT
What is the purpose of a HIDA scan?
Assess bile excreting function of liver and gallbladder
What is indicative of an abnormal HIDA scan?
If gallbladder does not visualize due to cystic duct obstruction (no radionuclide seen in gallbladder)
What are barium studies used for?
- Helpful in assessing for luminal GI tract disorders
- Evaluates for anatomic and functional abnormalities
What is the purpose of a esophagram/barium swallow study?
Visualizes esophagus and gastroesophageal junction into proximal stomach
What is the purpose of a UGI series?
Visualizes esophagus, stomach, and first part of the duodenum
What is a major contraindication to obtaining a UGI series?
Suspected upper GI perforation as barium is contraindicated
***must use water-soluble Gastrografin
What is the purpose of a SBFT (Small Bowel Follow Through)?
- Visualizes esophagus, stomach, duodenum, jejunum, ileum.
- Evaluation of Crohn Disease, small bowel tumors
What are some indications to obtain a barium enema?
Change in bowel habits, constipation, diarrhea, assess for polyps/tumors
What is the purpose of an EGD?
Direct optical visualization of the upper GI tract (esophagus, stomach, and first part of duodenum)
In what populations should you use caution with an EGD?
Patients with cardiopulmonary disease
What are some indications to obtain an EGD?
- Alarm symptoms (dysphagia, weight loss, early satiety)
- Dyspepsia
- Chronic GERD
- Foreign body/food bolus
- Suspected esophageal varices
- Hematemesis or melena
- Iron deficiency anemia
What are some contraindications to obtaining an EGD?
- Esophageal diverticula
- Suspected perforation
- Recent upper GI tract surgery
What is the purpose of an ERCP?
Visualization of bile and pancreatic ducts
What can be ordered prior to performing an ERCP as it is non-invasive?
MRCP
What is a major complication of ERCP?
Pancreatitis
What is the purpose of a colonoscopy?
Direct visualization of the rectum, colon, and terminal ileum
What is the purpose of a sigmoidoscopy?
Visualization limited to rectum and sigmoid colon
What is the gold standard study for colon cancer screening?
Colonoscopy
What is a major contraindication of a colonoscopy?
Active diverticulitis
Patient presents with severe abdominal pain and constipation. Abdominal x-ray reveals dilated bowel with air fluid levels. What do you suspect?
Small bowel obstruction
Patient presents to the ER with abdominal pain. Abdominal x-ray reveals dilated bowel with air present in both the small bowel and colon. There is no air fluid levels. What do you suspect?
Ileus
Patient presents to the ER with severe abdominal pain. Abdominal x-ray reveals free air outside the bowel and bilaterally under the diaphragm. What do you suspect?
Bowel perforation
