GI radiology

Question 1

2. Recognize free intra-abdominal free air on abdominal radiographs and computed tomography (CT) and describe how patient positioning affects sensitivity for its detection.

Answer 1

Upright chest is best for finding free intra-abd free air. The air will collect under the diaphragm

Question 2

benefit of fluoroscopy

Answer 2

it is seen in real time with x ray images, mobile tabel and video monitor.

Question 3

fluoroscopy negatives

Answer 3

significant radiation dose

Question 4

contrast agents

Answer 4

air, barium (avoid upstream of mechanical colon obstruction), iodinated water soluble (use in gut perforations, avoid high osmolarity)

Question 5

what do we look for in barium swallow

Answer 5

aspiration into pharynx

Question 6

biphasic esophagram

Answer 6

using air and contrast- for dysphagia and heartburn to detect reflux, hiatal hernia, aspiration, neoplasm, esophagitis

Question 7

when fundus has air and body of stomach has contrast, are they supine or prone

Answer 7

prone- fundus is posterior

Question 8

small bowel follow through indications

Answer 8

indications: IBD, malabsorption, diarrhea, partial SBO, unexplained GI bleed

Question 9

What does small bowel follow through evaluate

Answer 9

distal duodenum, duodenojejunal junction to ileocecal valve

Question 10

small bowel pathology diseases identified

Answer 10

crohns, lymphoma tuberculosis, sprue, adhesions, obstruction

Question 11

enteroclysis

Answer 11

provides more detail than SBFT- tube goes through jejunum and ileum. Methylcellulose instilled into jejunum after barium and can be used with CT

Question 12

Enteroclysis uses

Answer 12

same as SBFT

Question 13

barium enema indications

Answer 13

double contrast: rectal bleeding, polyps, cancer, IBD. Single contrast: fistula or sinus tract, if unable to tolerate double.

Question 14

Contraindications for barium enema

Answer 14

acute perforation, colitis (toxic megacolon), immediately after biopsy

Question 15

barium enema contrast benefits/disadvantages

Answer 15

water soluble, risk for intestinal perforation, therapeutic for disimpaction

Question 16

Ultrasound advantages

Answer 16

no radiation, safe in pediatric and pregnant pts, real time, portable.

Question 17

ultrasouund disadvantages

Answer 17

body habitus, operator dependent, intestinal gas can affect quality

Question 18

ultrasound indications

Answer 18

gallbladder, solid organ lesions (solid vs cystic), appendicitis, vascular flow (doppler), image guidance procedures

Question 19

CT types

Answer 19

without IV contrast: renal stone or hemorrhage. With IV contrast: ischemic, infectious, tumor, arterial. Enteric contrast: oral or rectal. CT cholangiopancreatography

Question 20

IV contrast risks

Answer 20

nephrotoxicity, allergic rxn

Question 21

CT and pregnancy

Answer 21

contraindicated unless life threatening

Question 22

nuclear medicine benefits

Answer 22

functional information

Question 23

nuclear medicine uses

Answer 23

bile leak, cholecystitis, gastric motility, source of GI bleed