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Clinical Medicine LAB - Professor Sample > Gastro II > Flashcards

Gastro II Flashcards

1
Q

Gastric Emptying Scan measures what?

A

determines rate of gastric emptying ( mostly through the stomach to the small intestine)

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2
Q

Types of GI Imaging?

A 
Gastric Emptying Scan 
Gastroesophageal reflux scan
Barium swallow
EGD
Abdominal Scintigraphy
Arteriography
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3
Q

Indications for Gastric Emptying Scan?

A

Determines the rate of gastric emptying

Delays show pathology

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4
Q

Gastric Emptying Scan is useful in diagnosing?

A

Gastroparesis ( surgery or DM)

Postprandial nausea

Vomiting

Early satiety

Abd pain (unexplained and related to food)

Post- GI anastamosis

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5
Q

Gastric emptying scan: Test Explanation?

A
  1. ) Pt eats meal containing radionuclide (Tc)
  2. ) Pt lies supine under gamma camera that takes images for 2 minutes Q 30-60 minutes until stomach is empty or up to 2 hours ( which ever occurs first)
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6
Q

Gastric emptying scan NL?

A

NL = 40% retained after 2 hours and 60% is left in the stomach

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7
Q

Gastric emptying scan: Contraindications?

A

Pregnant or lactating females

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8
Q

Gastric emptying scan: interfering factors?

A

Anticholinergics ( slows everything down), opiates ( constipation), sedatives ( constipation = slow down GI transit )

Should be withheld for 2 days before testing

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9
Q

Indications for Gastresophageal Reflux Scan?

A

Heartburn

Reflux symptoms

Aspiration

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10
Q

GE Reflux Scan: Test explanation?

A

Pt in supine position and drinks tracer (ie; Tc)

Images are taken of the esophageal area in different positions and at various times

**other tests come up negative then you might want to consider a reflux scan

GERD scan looks at esophagus

even when you are laying flat everything should move down the stomach *

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11
Q

Aspiration Scan: Test explanation?

A

Done overnight while pt is sleeping

Images taken over lung fields

Infants being evaluated for reflux

** Aspiration scan looks at the lungs to see if there has been an aspirate entered into the lung tissue from vomitting *

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12
Q

Contraindications to GE reflux scan?

A

Pregnant or lactating females

Pts that cannot tolerate abdominal compression

**compression = induce reflux, if patients can not handle this then they can not do the scan *

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13
Q

Indications for Barium Swallow?

A

Provides visualization of the lumen of the esophagus

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14
Q

Barium swallow is used to investigate what?

A

Dysphagia
Noncardiac CP
GERD
Swallowing abnormalities

**upper GI series = lower esophagus, proximal small bowel and the stomach

barium is radiopaque

barium swallow is just esophagus *

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15
Q

Test explanation for barium swallow?

A

More thorough exam for the esophagus than the upper GI series

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16
Q

Anatomic abnormalities seen on barium swallow?

A 
Hiatal hernia ( lower esophagus)
Zenker diverticulum
Schatzki ring ( rings where people get strictures)
17
Q

Defects in filling examples seen on a barium swallow?

A

Tumor

Strictures

Extrinsic compression - tumor outside the esophagus putting pressure on it

Enlarged heart - inducing pressure on the esophagus

18
Q

Considerations when using Barium?

A

Use Barium after other xray studies - cause it will occlude different structures

Cathartics should be administered after tests to prevent barium or fecal impaction

No administration with acute colitis

No administration with GI perforation

19
Q

Contraindication to a Barium Swallow?

A

Bowel obstruction - barium may cause fecal impaction

Perforated viscus

Unstable vital signs

Pts unable to cooperate during the exam

20
Q

Complications with Barium swallow?

A

Could include barium-induced fecal impaction

21
Q

Indications for upper GI series?

A

Visualizes the lower esophagus, stomach, duodenum

Can be performed in conjunction with a barium swallow

**Upper GI series is going to show you the lower esophagus and “everything”

Barium swallow is more for the esophagus ( same test just looking at different views)**

22
Q

Indications for Esophagogastroduodenoscopy
(EGD)? to evaluate for ?

A

Dysphagia

Weight loss

Early satiety - big red flag for CA

Upper abd pain

Dyspepsia

Suspected varices

Abnl barium swallow

**numb back of throat and sedate them but not completely
*

23
Q

EGD test explanation?

A

Direct visualization of the upper GI tract

Electrocautery can be used

Biopsies can be taken

Some surgical procedures can be done

**good thing about EGD is that Bx can be completed during process*

24
Q

EGD Procedure?

A

Left lateral decubitus position (LLD)

Throat is anesthetized with topical lidocaine ( spray)

Sedate patient

Bite block placed - so they cannot bite the tubing

25
Q

Abdominal Scintigraphy 
(GI Bleeding Scan) Indications?

A

“try and find the location of bleeding in the Gi system” - more for a slow persistent bleed

Used to localize the site of a GI bleed

Pictures taken with gamma camera at different time intervals.

**know when we go back in for the colonoscopy and endoscopy then we kinda know were to look better cause we sort of have an idea where the bleed it at
*

26
Q

Abdominal Scintigraphy 
(GI Bleeding Scan) is used for ____ but __________ GI hemorrhage?

A

✪ slow but persistent GI hemorrhage

27
Q

Abdominal Scintigraphy 
(GI Bleeding Scan) uses __-_______ RBCs or ______ _______ injected into the vascular system.

A

Uses Tc-labeled RBCs or sulfur colloid injected into the vascular system

28
Q

Contraindications to Abdominal Scintigraphy?

A

Pregnant or lactating females

Medically unstable patients

29
Q

Implications for Abdominal Scintigraphy ?

A

Used for bleeding between 0.03 mL/min and up to 1mL/min

30
Q

Abdominal Scintigraphy can find possible causes of bleeding like what?

A

Ulcers

Tumors

Vascular malformations

Diverticulosis

Inflammatory Bowel Disease

31
Q

Indications for Arteriography?

A

GI bleeding at a rate > 1mL/min

Uses contrast dye injected into an artery to look for arterial bleed

Try and use a selective artery to identify the most likely site of bleeding

**Find an artery close to the bleeding site and inject it with contrast dye *

32
Q

Contrindications to Arteriography?

A

Allergic to shellfish or iodinated dye

Pregnant patients

Renal disorders

Pts at risk for bleeding

Dehydrated patients

Coiled and catheters - maybe a low INR then u need to weight the risk / benefits

33
Q

A 45 year old female with hx of IDDM presents to GI office with complaints of early satiety and abdominal bloating. What is the best test?

A

she might have gastropuresis - so start with gastric emptying scan if it is normal then do an EGD

Clinical Medicine LAB - Professor Sample (36 decks)

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