GI Exam 2 (Imaging)

Question 1

Antibiotic Associated Colitis

Answer 1

Contract enhanced CT (Abdomen and pelvis)

Question 2

Diverticulitis

Answer 2

Abd CT — w/ fever, figuring out if there is a complication

NOW always necessary w/ MILD (NO fever + mild TTP)

NO ENDOSCOPY (Flex sig or C-scope)

Question 3

Acute Colonic Pseudo-obstruction

Answer 3

Plain films —> Colonic dilation

CT —> R/O mechanical obstruction

Question 4

Sigmoid Volvulus

Answer 4

Flex sig —> detorsion

Question 5

Colorectal Cancer

Answer 5

Colonoscopy

Question 6

Crohn

Answer 6

Crohn

Endoscopy —> Diagnosis

Colonoscopy (First) —> Evaluate colon and terminal ileum (Cobblestoning)

Barium Upper GI series —> Ulcerations. Strictures or fistulas

Capsule endoscopy —> small bowel involvement

Question 7

UC

Answer 7

Flex Sig —> Acute disease

AVOID Full Colonoscopy —> Fulminant disease

After pts have demonstrated improvement on therapy, colonoscopy is performed to determine the extent of disease

Plain films or CT —> Colonic Dilation or toxic megacolon

Question 8

Microscopic Colitis

Answer 8

Colonoscopy w/ Biopsy — Clinical Suspicion

Question 9

Jaundice

Answer 9

Hepatic US

ERCP — evaluate bile ducts if obstruction is suspected

Question 10

NAFLD (NAFL, NASH)

Answer 10

Hepatic Ultrasonography & biopsy —> Evidence of steatosis

Question 11

Alcoholic Steatosis

Answer 11

Referral for US & Biopsy if suspected

Question 12

Cirrhosis

Answer 12

Hepatic Ultrasonography

Liver biopsy —> to establish specific histopathology

EGD — Observe esophageal varices and Gastropathy

Question 13

Ascites

Answer 13

Abd US — Detect presence of fluid and guides Paracentesis

Abd CT

Question 14

Spontaneous Bacterial Peritonitis

Answer 14

Ascetic Fluid via Paracentesis

Sec BAC infx suspected? —> CT to find source

Question 15

Budd-Chiari Syndrome

Hepatic Venous Outflow Tract Obstruction —> Post-hepatic portal HTN

Answer 15

Color Doppler US !!!

Question 16

Pyogenic Hepatic Abscess

Answer 16

CT or US — Diagnose

CT guided Percutaneous drainage w/ culture of aspirate

Question 17

Hepatocellular Carcinoma

Answer 17

CT or MRI

Biopsy

Question 18

Acute Cholecystitis

Answer 18

RUQ US

HIDA scan — Check the function

Question 19

Choledocholithiasis

Answer 19

RUQ US — FIRST

ERCP — Confirmatory test and treatment

Question 20

Acute Cholangitis

Answer 20

ERCP — Biliary drainage and removal of obstruction

Question 21

Acute Pancreatitis

Answer 21

CT — Choice for diagnosis

Question 22

Pancreatic Cancer

Answer 22

US — evaluate Jaundice
Abd CT scan — Evaluate pain/wt. loss
ERCP — Evaluate ducts