GI Diagnostics Flashcards
Abdominal X-Ray findings:
Black?
White?
Grey?
Dark grey?
Intense white?
Black = gas
White = calcification
Grey = soft tissue
Dark grey = fat
Intense white = metal
3-Way View Abd X-Ray Series includes?
1) Ant/Post w/ pt supine (KUB)
2) A/P w/ pt upright (better visual of fluids)
3) Post/Ant (sees air under diaph, chest path)
3-Way View Abd X-Ray Series indicated when?
Abd pain, N/V, distention
suspected intest obstr, perforation, intuss
Abd X-Ray findings w/ Obstruction?
dilated bowel proximal to obstr,
collapsed bowel distal,
air fluid levels
Paralytic Ileus is?
Abd X-Ray findings w/ Paralytic Ileus?
Non-mechanical obstr (bowel doesn’t work but not because of obstruction)
dilated bowel
gas in small and large intest
Abd X-Ray findings w/ Perforation?
free air outside bowel
Abdominal US findings:
Dark?
White?
Dark = hypoechoic
e.g. aorta, bile ducts, abscess, cyst
White = echogenic (solid)
e.g. tumors
Doppler US provides info on what?
blood flow
Abd US indicated when? (7)
Abd pain Elevated LFTs Liver dz Renal fail Pancreas Gallbladder (preferred test for this) S/P (status post) kidney, liver, pancreas transplant
Abd US (P) findings?
cysts, abscess, tumor,
dilated bowel duct,
gallstones/polyps
inflammation
Abdominal/Pelvic CT typically used for what organs?
renal
GU
pelvic
CT contrast?
IV or PO iodine
No contrast used for renal CTs
Ant/Post CT indicated when? (5)
Abd pain/distention N/V Diarrhea/Constipation Rectal bleeed Jaundice Pancreatic (preferred test for this)
Ant/Post CT (P) findings?
similar to US
Spleen tumor, lacer, hematoma, splenic vein thrombosis
Abd Aorta aneurysm
A/P CT findings w/ Pancreatitis?
Acute = inflamm Chronic = calcifications
Other uses for A/P CT? (3)
Virtual colonoscopy/angiography
Visualization during bx or aspiration
Monitor dzs
A/P CT contraindication? (5)
Preggos Unstable pts Obesity Contrast allergy High creatinine
A/P CT complications? (2)
Contrast allergy
Contrast-caused acute renal fail
A/P CT precautions?
Metformin - must hold for 48 hrs post contrast (cause acidosis)
High radiation
HIDA Scan is?
Hepatoiminodiacetic Acid Scan,
gallbladder nuclear scan,
cholescintigraphy
IV radioactive tracer extracted by liver, excreted into bile into gallbladder
HIDA Scan ordered w/ what for best results?
CCK (cholecystokinin) stim test and ejection fraction
HIDA indicated when?
suspected acalculous cholecystitis
non-stone obstruction of cystic duct causing inflamm of gallbladder
HIDA findings w/ acalculous cholecystitis? (3)
No radionuclide in GB w/i 60 min
Ejection fraction < 35%
Test reproduced sxs
HIDA contraindications?
No preggos
Upper GI (UGI) Series is?
Used for?
Fluoroscopy (real-time moving x-ray) w/ barium sulfate contrast
visualization of esophagus, stomach, start of duodenum
Esophagram/Barium Swallow is?
Like UGI but on throat and esophagus only
UGI indicated when? (5)
Dysphagia GERD sxs Early satiety PUD Obst/inflamm
UGI (P) findings?
Hiatal hernia (stom above diaph)
Cancers (strictures, obstr, filling defects, tumors)
Ulcers
Diverticula
Extrinsic compression
Perforation
UGI for perforations, use what contrast?
H2O-soluble Gastrografin
UGI contraindications? (4)
Preggos
Complete bowel obstruction
Suspected upper GI perforation
Unstable vitals
UGI complications? (2)
Aspiration
Constipation from barium
Barium Enema is?
Lower GI series:
barium w/ fluoroscopy of colon and distal small bowel
(P) alternate to colonoscopy
Barium Enema (P) therapeutic use?
reduce non-strangulated intuss
Barium Enema findings?
similar to UGI
Inflamm bowel dz (appears as narrowed colon due to swollen bowel walls)
Barium Enema contraindication? (4)
Preggos
Megacolon
Suspected perf
Unstable vitals
Barium Enema complications? (2)
Perforation
Fecal impact from barium
Esophagogastroduodenoscopy (EGD) is?
Direct visual of up GI w/ fiberoptic scope
Diagnostic and therapeutic
EGD indicated when? (10)
Weight loss/Dysphagia/Early satiety Epigastric pain N/V abd pain GERD Esoph varices (swollen v.v.) Hematemesis/Melena Iron def anemia Abn UGI Enteropathies (e.g. celiac) Obstruction
EGD findings?
similar to UGI Arteriovenous malformations Obstructions Web/Rings (narrowings) Infection
EGD contraindications? (4)
Bleed
Perforation
Esoph diverticula (risk perf)
Recent GI surgery
EGD complications? (3)
Perforation
Bleed if bx
Aspiration of gastric contents
Endoscopic Retrograde Cholangiopancreatography (ERCP) is?
Fiberoptic scope w/ radio dye of Bile and Pancreas
Magnetic Resonance CP is?
MR used to visual biliary tree and pancreatic ducts
ERCP indicated when?
Obstructive jaundice
Obstruction of bile/pancrea ducts
ERCP therapeutic uses?
Sphincterotomies
Stone removal
Stent placement
Biopsy
ERCP contraindications? (2)
Inaccessible ampulla of Vater
Acute pancreatitis
ERCP complications? (4)
Pancreatitis
Perforation
G- blood infect
Aspiration of gastric content
Colonoscopy is?
fiberoptic scope of rectum, colon, terminal ileum
Diagnostic and therapeutic
Requires bowel prep
Flexible Sigmoidoscopy?
Same as colonoscopy but limited to rectum and sigmoid
Colonoscopy indicated when? (6)
CA screen/polyp removal/Bx Inflamm bowel dz Hematochezia/Diarr Abnormal BE or CT Foreign body removal Decompress volvulus (twisted bowel)
Colonoscopy contraindications? (5)
Severe bleeding Perforation Recent colon surgery Toxic megacolon Active diverticulitis
Colonoscopy complications? (2)
Perforation
Bleeding
