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Foundations III-GI > GI Diagnostics > Flashcards

GI Diagnostics Flashcards

1
Q

What is included on 3 way abdomen x-ray?

A

Ant/post (KUB)

upright- better visualize air fluid levels

PA CXR-visualize free air

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2
Q

Indications for 3 way abd x-ray?

A

Intestinal obstruction

Perforation

Intussusception

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3
Q

What do you see on abd x-ray?

A

Black → gas

White → calcification

Grey → soft tissue

Darker grey → fat

Intense white → metallic objects

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4
Q

What is an bowel obstruction? What will you see on abd xray?

A

Dilated bowel proximal to obstruction with collapsed bowel distally

Air fluid levels

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5
Q

What is a paralytic ileus? What will you see on xray?

A

non-mechanical bowel obstruction

Dilated bowel

Gas in both small & large intestines

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6
Q

Xray findings with bowel perforation?

A

Free air outside of the bowel

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7
Q

xray findings for intussusception?

A

Signs of obstruction

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8
Q

How can you tell the difference btwn SBO and LBO on xray?

A

can see valvulae conniventes with SBO

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9
Q

What is an illeus?

A

air throughout; small & large bowel look “the same”

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10
Q

What does free air look like on xray? What does this indicate?

A

Sickle-shaped free air on both sides under the diaphragm.

perforation

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11
Q

What is intussusception?

A

A loop of bowel has slipped into another section of bowel.

Creates swelling, decreased blood flow, obstruction & tissue damage.

Requires emergency tx: (barium enema or surgery).

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12
Q

Abdominal x-ray contraindication?

A

pregnancy

if risks > benefits

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13
Q

What is an UGI series?

A

pt drinks barium & fluoroscopy is used to visualize esophagus, stomach and 1st part of duodenum

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14
Q

What is a fluoroscopy?

A

“xray movie”

Continuous x-ray is passed through the body part, & the image is transferred to a monitor

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15
Q

What test can you order if you just want to eval swallowing?

A

Esophagram (aka barium swallow)

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16
Q

Indications for UGI?

A

Dysphagia, Dyspepsia

GERD sxs

Early satiety

Suspected PUD

Suspected obstruction / inflammation

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17
Q

What may be detected on UGI?

A

hiatal hernia

CA

ulcers

Diverticula (outpouching)

benign tumors

extrinsic compression

perforation

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18
Q

What is a hiatal hernia?

A

portion of stomach above diaphragm (through hiatus)

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19
Q

What may be seen on UGI in pt with CA?

A

Strictures, obstructions, filling defects, tumors, ulcerations

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20
Q

What is a filling defect?

A

displacement of contrast medium by a space-occupying lesion in a radiographic study of a contrast-filled hollow viscus

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21
Q

What may be seen on UGI in benign tumors?

A

filling defects

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22
Q

What do you need to order for UGI if you are concerned for perforation?

A

water-soluble Gastrografin

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23
Q

What is a bezoar?

A

clump or wad of swallowed food &/or hair

can look like a large filling defect

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24
Q

Contraindications for UGI series?

A

pregnancy

complete bowel obstruction

suspected upper GI perforation - use water soluble gastrografin

unstable vitals

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25
Q

potential comps of UGI series?

A

aspiration

constipation or partial obstruction

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26
Q

What is a barium enema?

A

Patient receives a “barium enema,” then fluroscopy used to visualize colon, distal small bowel (occasionally appendix)

may also be therapeutic for ileocolic intussusceptin

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27
Q

What is an Air contrast Barium Enema?

A

Often, air insufflated into colon after the barium – provides air contrast to barium = better visualization.

28
Q

What does inflammatory bowel disease look like on barium enema?

A

Narrowing of the barium column due to inflammation surrounding colon

29
Q

What can be seen on barium enema?

A

inflammatory bowel disease

CA

ulcers

diverticula

benign tumors

extrinsic compression

perforation

30
Q

What can an “apple core” lesion on barium enema indicate?

A

adenocarcinoma

31
Q

Contraindications to barium enema?

A

pregnancy

megacolon

suspected perforation

unstable vitals

32
Q

Potential comps of barium enema?

A

perforation

barium fecal impaction

33
Q

What is an abd US used to visualize?

A

reflected sound waves to visualize the abdominal aorta, liver, gallbladder, pancreas, bile ducts, spleen, kidneys, ureters, bladder

34
Q

Liver US can use to screen for..

A

Fatty liver

For patients with chronic hepatitis, screen for CA

35
Q

Gallbladder US is initial dx test of choice for suspected?

A

cholelithiasis or cholecystitis

36
Q

dark areas on US..

white areas on US..

A

hypoechoic
ex. aorta, bile ducts, cyst

echogenic = solid
ex. tumors

37
Q

What do cysts/abscess look like on US?

A

Hypoechoic (dark) areas

38
Q

What do tumors look like on abd US?

A

Hyperechoic or Echogenic (solid / white) areas

39
Q

What do bile ducts look like on abd US?

A

Biliary tree seen as hypoechoic (dark) tube in the liver

40
Q

What do gallstones look like on abd US?

A

Echogenic (solid / white) masses with “shadowing” behind (mobile)

41
Q

What is a HIDA scan?

A

aka GB nuclear scan or cholescintingraphy

pt receives radionuclide injection > visualization of biliary tress

best if ordered with CCK and EF

42
Q

Indications for HIDA scan?

A

to diagnose suspected acalculous cholecystitis

-test reproduces pt sxs

43
Q

For abd, which is more accurate: CT or MRI?

A

CT

44
Q

What is the only test where you usually get better results from US than from CT?

A

gallbladder- to detect stones

45
Q

CT findings for acute pancreatitis? chronic pancreatitis?

A

edema, fluid assoc. w/ inflammatory process

calcifications, contracted pancreas

46
Q

CT findings for GI tract inflammation?

A

edema , thickened wall, pericolonic fat stranding

47
Q

Contraindications for abd CT?

A

preg

unstable vitals

morbid obesity

48
Q

Contraindications to IV contrast?

A

allergy to iodine or shellfish
(premed with steroids for some pts)

elevated Cr, renal failure

Precaution: Metformin

49
Q

Complications of CT ?

A

rxn to contrast

50
Q

What is an EGD?

A

involves direct visualization of the upper GI tract
via a long, flexible, fiberoptic-lighted scope
-usually performed with conscious sedation

51
Q

Indications for EGD?

A

Alarm sxs: dysphagia, weight loss, early satiety, epigastric pain

Upper abd pain
Dyspepsia
Chronic GERD
Suspected esophageal varices
Investigate abnormal UGI
Investigate suspected enteropathies (eg. celiac disease)
52
Q

Which is more sensitive: EGD or UGI?

A

EGD (+ able to biopsy)

53
Q

How can EGD be used therapeutically?

A

Band esophageal varices

Dilate esophagus

Control bleeding

54
Q

Contraindications to EGD?

A

Uncooperative patient

Severe bleeding

esophageal diverticula

suspected perforation

recent upper GI tract surg

55
Q

comps of EGD?

A

perforation

bleeding (2ndary to bx)

aspiration of gastric contents

over-sedation

56
Q

What is ERCP?

A

involves use of fiberoptic endoscope to obtain radiographic visualization of bile & pancreatic ducts

-scope passed into duodenum & small cath inserted into biliary duct > dye inserted & xray taken >

performed with conscious sedation/anesthesia

57
Q

Indications for ERCP?

A

pts with obstructive jaundice

investigation/tx of obstruction of bile/pancreatic ducts

58
Q

What can be ordered before ERCP?

A

MRCP

may be less invasive

59
Q

therapeutic uses for ERCP?

A

Incision in ampulla of Vater – widens common bile duct & gallstones can be removed

Placement of stents through strictured bile ducts

60
Q

Contraindications for ERCP?

A

uncooperative pt

previous GI surg w/ inaccessible ampulla of Vater

hx of pancreatitis

61
Q

comps of ERCP?

A 
Pancreatitis 
Perforation
Gram-negative sepsis
Introduction of bacteria into biliary & blood system
Aspiration of gastric contents
Oversedation
62
Q

What is a colonoscopy?

A

involves direct visualization of the rectum, colon & terminal ileum via a long, flexible, fiberoptic-lighted scope
-can do flexible sigmoidoscopy to visualization limited to rectum/sigmoid

63
Q

Indications for colonoscopy?

A

colon cancer screen
-sxs of colon CA, IBD

abnormal test (BE, CT)

64
Q

What can a colonoscopy detect?

A 
tumors 
polyps 
inflammation
infection 
arteriovenous malformation

results dependent on endoscopist

65
Q

Contraindications for colonoscopy?

A 
uncooperative pt 
severe rectal bleeding 
suspected perforation
toxic megacolon 
active diverticulitis

Foundations III-GI (8 decks)

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