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Applied CP 2 > Gastric Emptying > Flashcards

Gastric Emptying Flashcards

1
Q

indications

A
  • rate of gastric emptying
  • quantitate gastric function and motility
  • response to therapy
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2
Q

patient prep

A
  • NPO min 4 hrs
  • good diabetic control
  • d/c non-gastric therapeutic drugs for 48-72 hrs
  • d/c prokinetic agents 48hrs
  • no smoking morning of and throughout the test
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3
Q

examples of pro kinetic agents

A
  • Metoclopramide (Reglan)
  • Domperidone (Motilium)
  • Cisapride (Propulsid)
  • Erythromycin (Motilin Agonist)
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4
Q

RP and dose for SOLID gastric emptying

A

99mTc-SC
18.5-38 MBq

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5
Q

RP and dose for LIQUID gastric emptying

A

99mTc-SC or DTPA
or 111In-DTPA
37 MBq

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6
Q

what’s considered standardized meal?

A
  • 2 toasts
  • 30 g jam
  • 4 oz egg whites
  • 100 ml water
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7
Q

SC and eggs

A

binds to albumin in egg whites during cooking

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8
Q

imaging protocol

A

1 min ANT/POST
immediately, 1 hr, 2 hr, 4 hr

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9
Q

imaging protocol for liquid emptying

A

30 min study at 1 min framing rate
imaging to be done immediately after ingestion of 300 ml H2O + RP

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10
Q

FOV for gastric emptying

A

distal esophagus and proximal duodenum

(stomach at top of FOV)

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11
Q

camera position and geometric mean calculations

ANT/POST

A

geometric mean calculation required

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12
Q

camera position and geometric mean calculations

LAO

A

no geometric mean calculation required

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13
Q

false positive or false negative

patient consumed a hamburger 1 hr ago

A

false pos

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14
Q

false positive or false negative

last solid meal consumed was 28 hrs ago

A

false pos

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15
Q

false positive or false negative

patient is on TPN

A

false pos

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16
Q

false positive or false negative

chronic cholecystitis

A

false pos

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17
Q

false positive or false negative

acalculous cholecystitis

A

false neg

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18
Q

false positive or false negative

hepatocellular dysfunction

A

false pos

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19
Q

false positive or false negative
“nubbin” sign

A

false neg

20
Q

false positive or false negative

partial cystic duct obstruction

A

false pos

21
Q

formula to calculate % empty

A

% emptying at time (t) = [(corrected ct IMMED - corrected ct at t)/corrected ct IMMED] * 100

22
Q

normal emptying rate at 2H

A

> 40% emptying

23
Q

normal retention rate at 2H

A

<60% retention

24
Q

normal retention rate at 4H

A

<10% retention

25
Q

normal emptying rate at 4H

A

> 90%

26
Q

half time emptying for liquid emptying

A

<25 min

27
Q

symptoms of Gastroparesis

A
  • post prandial nausea - early satiety
  • reflux
  • abdominal pain
  • vomiting
  • bloating
28
Q

symptoms of rapid gastric emptying

A
  • post prandial abdominal cramps
  • diarrhea
  • palpitations
  • diaphoresis and weakness
29
Q

treatment for altered gastric emptying rates

A
  • gastrectomy
  • surgical implant to stimulate vagus nerve
  • drug therapy (pro kinetics)
30
Q

causes of abnormal delays

A
  • peptic ulceration
  • surgery
  • diabetic gastroparesis
  • scleroderma
  • amyloidosis
  • smooth muscle disorders
  • mechanical obstruction
31
Q

diabetic gastroparesis (delayed GE)

A

partial paralysis of the stomach due to damage to vagus nerve as it is linked to diabetic neuropathy

32
Q

treatment for delayed GE

A
  • medication
  • diet management
  • feeding tube (jejunostomy)
33
Q

what is the process of gastric emptying?

A

~3 ml of liquid chyme escaping through the pyloric sphincter

34
Q

where are markers placed?

A

iliac crest (+ uah has it on sternal notch)

35
Q

fundus sits more ____.
antrum sits more ____.

A

fundus - posterior
antrum - anterior

36
Q

formula to calculate geometric mean @ Tt

A

geometric mean @ Tt = sqrt(anterior ct x posterior ct)

37
Q

why are counts seen rising over time in the ANT image?

A

food moving from the fundus to antrum over time

38
Q

what %s at 0.5H and 1H indicates
“dumping”?

A

> 30% at 0.5H
70% at 1H

39
Q

what are normal study results?

A

when 2H and 4H % emptying values are met
OR
2H and 4H % retention values are met

40
Q

2H emptying %

A

> 40% emptied

41
Q

4H emptying %

A

> 90% emptied

42
Q

2H retention %

A

<60% retained

43
Q

4H retention %

A

<10% retained

44
Q

why is there a lag phase?

A

time taken for food to grind into small particles

45
Q
A

Applied CP 2 (12 decks)

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