GI Part 1

Question 1

A congenital anomaly of the stomach in which the pyloric canal is greatly narrowed because of abnormal enlargement of the pyloric sphincter.

tracheoesophageal fistula
hypoplasia
hypertrophic pyloric stenosis
pylorospasm

Answer 1

hypertrophic pyloric stenosis

Hypoplasia- Less than normal development

Pylorospasm -is an incomplete obstruction of fluid flow into the duodenal bulb resulting from spasmodic changes in pyloric muscle tone.

Tracheoesophageal fistula- abnormal passage between the trachea and esophagus, associated with esophageal atresia.

Question 2

Malignant strictures of the GI tract often have:

dilated bowel loops.
a small pouch or sac that forms in the intestinal wall.
smooth with tapered or obtuse margins.
unsmooth mucosa and irregular contours with acute or “shouldered” margins.

Answer 2

unsmooth mucosa and irregular contours with acute or “shouldered” margins.

Benign strictures are often smooth with tapered or obtuse margins. The mucosa of a benign stricture may be normal or abnormal.

A “shoulder” sign is when a tumor margin abruptly transitions from the intraluminal component to the adjacent normal mucosa, forming a shouldered edge. For example, shouldered margins on an esophagus in a radiograph can be a sign of a malignant tumor, such as esophageal cancer.

Question 3

A pouch formed at a weakened area of wall in a hollow organ structure.

diverticulum
intussusception
volvulus
herniation

Answer 3

diverticulum

Intussusception: The prolapse of a segment of bowel into a distal segment.

Volvulus: An intestinal obstruction caused by a twisting of the bowel about its mesenteric base

Hernia: The protrusion of a part of an organ (e.g., bowel loop) through a small opening in the wall of a cavity

Question 4

In abdominal radiography, free air within the peritoneum can be best seen in which positions:

1. erect
2. prone
3. right lateral decubitus
4. left lateral decubitus

2 and 4
3 and 4
2 and 3
1 and 4

Answer 4

1 and 4
Erect and Left lateral decubitus

Question 5

Which of these organs are located in the retroperitoneum of the abdominal cavity?

stomach, ileum, appendix

ascending colon, kidneys, adrenals

urniary bladder, first part of the duodenum, spleen

tail of the pancreas, transverse colon, liver

Answer 5

ascending colon, kidneys, adrenals

Question 6

Match the medical term with its definition: achalasia

loss of speech

difficulty in swallowing

neuromuscular abnormality of the esophagus results in failure of the lower esophageal sphincter to relax

congenital absence or abnormal closure of a normal anatomic opening

Answer 6

neuromuscular abnormality of the esophagus results in failure of the lower esophageal sphincter to relax

aphasia- loss of speech

dysphagia- difficulty in swallowing

atresia- congenital absence or abnormal closure of a normal anatomic opening

Question 7

Match the medical term with its definition: aphasia

loss of speech

difficulty in swallowing

neuromuscular abnormality of the esophagus results in failure of the lower esophageal sphincter to relax

congenital absence or abnormal closure of a normal anatomic opening

Answer 7

loss of speech

dysphagia- difficulty in swallowing

achalasia- neuromuscular abnormality of the esophagus results in failure of the lower esophageal sphincter to relax

atresia- congenital absence or abnormal closure of a normal anatomic opening

Question 8

Match the medical term with its definition: dysphagia

loss of speech

difficulty in swallowing

neuromuscular abnormality of the esophagus results in failure of the lower esophageal sphincter to relax

congenital absence or abnormal closure of a normal anatomic opening

Answer 8

difficulty in swallowing

aphasia- loss of speech

achalasia- neuromuscular abnormality of the esophagus results in failure of the lower esophageal sphincter to relax

atresia- congenital absence or abnormal closure of a normal anatomic opening

Question 9

Match the medical term with its definition: atresia

loss of speech

difficulty in swallowing

neuromuscular abnormality of the esophagus results in failure of the lower esophageal sphincter to relax

congenital absence or abnormal closure of a normal anatomic opening

Answer 9

congenital absence or abnormal closure of a normal anatomic opening

aphasia- loss of speech

dysphagia- difficulty in swallowing

achalasia- neuromuscular abnormality of the esophagus results in failure of the lower esophageal sphincter to relax

Question 10

Small bowel gas in an adult may therefore indicate a pathologic process.

True or False

Answer 10

True

Question 11

A series of muscular contractions, initiates to propel food and liquids through the gastrointestinal system:

valvulae conniventes
rugal folds
chyme
peristalsis

Answer 11

peristalsis

Question 12

A small-caliber tube used to deliver a liquid diet directly to the duodenum or jejunum:

PEG
Levin
Dobhoff
Cantor

Answer 12

Dobhoff

A gastrostomy tube (G-tube), is a tube surgically placed through the wall of the stomach, whereas a duodenostomy or a jejunostomy tube (J-tube) is specific to that portion of the small intestine.

A percutaneous endoscopic gastrostomy (PEG) tube is a G-tube that is placed endoscopically.

A G/J-tube is one tube placed into the stomach with continuation through the duodenum into the jejunum.

Millier-Abbott, Harris and Cantor tubes are types of nasoenteric decompression tubes.

Question 13

A modified barium swallow study is:

a fluoroscopic examination that assesses swallowing safety.
conventional imaging that focuses on the motility of the esophagus.
a fluoroscopy examination of the thyroid.
a CT study that assesses dysplasia

Answer 13

a fluoroscopic examination that assesses swallowing safety.

Question 14

CT is the most accurate imaging modality for evaluating persons who do not have a clear clinical diagnosis of acute appendicitis.

True or False

Answer 14

True

Question 15

A biphasic fluoroscopy study of the GI tract:

uses both positive and negative contrast agents.

uses double and single contrast methods during the same examination.

uses only negative contrast agents.

is the same as a vitrual colonoscopy.

Answer 15

uses double and single contrast methods during the same examination.

Question 16

Which of the following protocols are more likely to visualize esophageal varices during an esophagram:

1. administer thick barium
2. administer thin barium
3. erect positioning
4. recumbent positioning

1 and 4
2 and 3
2 and 4
1 and 3

Answer 16

2 and 4

administer thin barium
recumbent positioning

Varicose veins are abnormally lengthened, dilated, and superficial veins; those in the esophagus are referred to as esophageal varices.

Esophageal varices : Varicose veins of the esophagus that occur in patients with portal hypertension.

Esophageal varices are more likely to be demonstrated during barium studies in a recumbent position because gravity causes poor visualization in the erect position. A thin barium mixture shows the varices as smooth worm-like and serpiginous (wavy margins) filling defects within the column of barium. Use of thick barium may be counterproductive because the increased density can obscure the varices.

Question 17

A frequent and persistent retrograde flow of gastric acid and stomach contents into the esophagus, often associated with heartburn and/or dysphagia.

dilation disease
gastroesophageal reflux disease
hiatal hernia
duodenal ulcers

Answer 17

gastroesophageal reflux disease

Question 18

This condition is a malabsorption disorder causing inability to digest lactose. It can be demonstrated by mixing lactose with barium during a SBFT exam which shows the barium moving quickly through the bowel and becoming diluted in the distal ileum and colon with mild bowel dilation.

celiac disease
carbohydrate intolerance
dairy product disease
mad cow disease

Answer 18

carbohydrate intolerance

celiac disease- autoimmune hereditary disorder involving increased sensitivity to the gliadin fraction of gluten.

Question 19

A type of chronic inflammatory bowel disease, that causes swelling of the tissues in the digestive tract , affecting all layers of the bowel wall. It usually begins in the terminal ileum and cecum and descends through the bowel, often with skip areas. It rarely produces megacolon or bowel perforations.

ulcerative colitis
regional enteritis
enteroclysis
appendicitis

Answer 19

regional enteritis

Question 20

Gluten-Sensitive Enteropathy is an autoimmune inherited disorder, where radiographic changes can be demonstrated on a SBFT exam. This condition is also know as ______.

esophageal strictures.
gastroesophageal reflux.
Meckel diverticulum.
celiac sprue or celiac disease.

Answer 20

celiac sprue or celiac disease.

Question 21

A congenital pouch in the distal ileum. It may cause painless rectal bleeding and bowel obstruction.

Carbohydrate Intolerance
Gluten-Sensitive Enteropathy
Meckel diverticulum
Hirschsprung Disease

Answer 21

Meckel diverticulum

Question 22

A chronic inflammatory bowel disease of the mucosa of the colon, that typically begins at the rectum and ascends though the large intestine, resulting in megacolon and bowel perforations and frequently progressing to cancer.

appendicitis
Crohn disease
ulcerative colitis
ileitis

Answer 22

ulcerative colitis

Question 23

When interpreting abdominal radiographs, radiologists often employ some version of this mnemonic:

So Long To Pinky, Here Comes The Thumb
Right, Left, Up and Down
Bones, Stones, Gasses, and Masses
Some Lovers Try Positions That They Can’t Handle

Answer 23

Bones, Stones, Gasses, and Masses

Question 24

This bacteria is responsible for about 80% of cases of gastritis, gastric ulcers, and duodenal ulcers.

helicobacter pylori
gluten
salmonella
streptococcus pneumoniae

Answer 24

helicobacter pylori

Question 25

A radiographic indication of this congenital disease is the “double bubble sign.” Gaseous distention of the stomach creates one bubble, and gas in the proximal duodenum creates a second bubble.

hypertrophic pyloric stenosis
Hirschsprung disease
duodenal atresia
malrotation

Answer 25

duodenal atresia

duodenal atresia- congenital anomaly in which the lumen of the duodenum does not exist, resulting in complete obstruction of the GI tract at the duodenum.

hypertrophic pyloric stenosis- congenital anomaly of the stomach in which the pyloric canal is greatly narrowed because of abnormal enlargement of the pyloric sphincter.

Hirschsprung disease- the absence of neurons in the distal large bowel wall, typically in the distal colon, impairing peristalsis.

malrotation- unnatural position of intestines caused by failure of normal rotation during embryo development

Question 26

A congenital condition that occurs due to absence of neurons in the distal colon that may result in toxic megacolon, a contraindication for barium enema examinations.

Meckel diverticulum
esophageal strictures
Crohn disease
Hirschsprung disease

Answer 26

Hirschsprung disease