Final: Diagnostic Process in Medicine Flashcards
What should you always verify?
The right study, for the right patient, on the right day.
What are the indications for x-ray?
Bone issues mainly; cortical disruptions
Very commonly ordered and cheap
What are some contraindications for x-ray?
Patient unstable
Unable to stand or stand still
How many views should you take for chest x-ray?
At least two!
PA view (preferred) -distorts the heart the least
Then usually a lateral
Indications for abdominal x-ray?
Obstruction Perf Tube placement Foreign bodies Trauma and stones
Contraindications of abdominal x-ray
Patient too unstable
Cannot stand upright
Not able to take a deep breath to move diaphragm out of the way
Indications for extremity x-ray
Fracture
Focal lesions (tumors or infections)
Soft tissue injuries
In peds patients with open growth plates, what is a smart thing to look at when reviewing an x-ray?
Get comparison radiological studies!
-will tell you what it should look like
What are non-contrast abdominal CT studies best for?
Renal colic (stones) Intra-abdominal fat
What are IV contrast abdominal CTs best for?
to opacifies solid organs, the ball wall, vascular structures
Aortic dissection
When would you do enteric (oral) contrast studies for abdominal CT?
To opacifies bowels
Which imaging studies has greatest diagnostic capabilities?
CT
-highest sensitivity
How does a CT angiography work?
inject IV contrast bolus into vasculature to detect lesions
Advantages of Ultrasound
No radiation Can be used in any plane Inexpensive Can be done at bedside Real time imaging
Cons of Ultrasound?
Less sharp images Takes more time than CT Dependent on operator skills Only great for soft tissue stuff - ie not bone or lung
What is the value of measurement for CT?
Hounsfield Unit
- water is zero
- fat in middle
- Bone is 700+
Indications for abdominal US?
Can identify all gallstones
-more sensitive
Acute cholecystitis
Replaces CT for inconclusive biliary disease
Contraindications for abdominal US?
Really are none
Operator dependent though
Basics of MRI
- how does MRI work
- T1 v T2
Uses radiowaves to vibrate tissues enough to pick up on imaging
T1=Water dark
T2=Water white
Advantages of MRI
Greater differentation of soft tissue
Acquired in any plane
Can get vasc study w/o IV contrast
Disadvantages of MRI
Longer time
Motion artifact is severe on imaging
