GI Tract Imaging

Question 1

There are three types of endoscopy, what are they?

Answer 1

Upper GI
ERCP
Colonoscopy

Question 2

What precautions must be used for an endoscopy?

Answer 2

Sedation

Laxative (for lower GI tract)

Question 3

What are the possible problems with an endoscopy?

Answer 3

Small risk of perforation

Can be poorly tolerated by some people

Question 4

What must be done in order to perform a fluoroscopy?

Answer 4

It required contrast (barium or gastromiro)

Requires distension of the tube with gas or air

Question 5

What is a fluoroscopy?

Answer 5

A study of moving body structures

- a continuous X-Ray beam is passed though the body part being examined

Question 6

What are the benefits of using ultrasound?

Answer 6

It uses sonar - not radiation
Fast
Cheap
Safe

Question 7

List some of the ways in which the GI tract is imaged?

Answer 7

Endoscopy
Plain X-Ray
Fluoroscopic studies
Cross sectional studies
CT
Ultrasound
MRI

Question 8

What are the limitations of ultrasound?

Answer 8

Habitus - the position of the body

Gas inside the tube - you can’t see inside it

Question 9

What are the negatives of CT scanning?

Answer 9

Uses a lot of radiation
Doesn’t have very good tissue differentiation
Used an intravenous and oral dye, or water

Question 10

What is a CT scan mainly used for?

Answer 10

Diagnosis of disease
Staging of malignagcy
Assessing response to treatment
Percutaneous biopsy

Question 11

Describe a PET-CT

Answer 11

It’s a combined imaging modality

- a functional imaging of radioactive tracer uptake fused with anatomical information from CT

Question 12

What’s the most commonly used tracer in a PET-CT and what is it for?

Answer 12

FDG - flurodeoxyglucose (a glucose analogue)

It accumulates in metabolically active cells, making them easier to see

Question 13

What are the benefits of an MRI machine?

Answer 13

It uses no radiation

Has excellent soft tissue differentiation

Question 14

What are the limitation of using an MRI machine?

Answer 14

Can’t be used on people who have pacemakers or cerebral aneurysm clips
It’s a very slow procedure

Question 15

What is the specific GI roles of using an MRI?

Answer 15

Non invasive imaging of biliary tree and small bowel
Can stage rectal cancer
Can diagnose liver lesions

Question 16

What is an MRCP (magnetic resonance cholangiopanceatography) scan?

Answer 16

It’s a scan that uses magnetic resonance imaging to

produce pictures of the liver, bile ducts, gall bladder and pancreas.

Question 17

What are the pros and cons of a rigid sigmoidoscopy?

Answer 17

Pros - immediate, unprepared

Cons - very limited

Question 18

What are the pros and cons of a flexible sigmoidoscopy And radiology?

Answer 18

Pros - 2 unseated examinations

Cons - 2 preparations

Question 19

What are the pros and cons of a CT pneumocolon?

Answer 19

Pros - gives you information on outside the colon as well

Cons - doesn’t allow biopsies

Question 20

What are the pros and cons of a colonoscopy?

Answer 20

Pros - can take a biopsy

Cons - needs preparation, small risk, sedated

Question 21

What are the pros and cons of a minimal preparation stool CT?

Answer 21

Pros - easy for the frail elderly

Cons - quite crude

Question 22

What are the pros and cons of a back to back colonoscopy?

Answer 22

Pros - quality assurance

Cons - cant be done simply for quality assurance because it’s very stressful

Question 23

What are two of the structures colonic polyps can take?

Answer 23

Tubular adenoma

Villous adenoma

Question 24

Name some of the types of cancer that can be found in the GI system.

Answer 24

Rectal cancer
Polaroid carcinoma
Colonic adenocarcinoma

Question 25

What is a mesorectal excision?

Answer 25

A transverse slice through rectal cancer in the large intestine

Question 26

What things are risk factor for the development of a stress ulcer?

Answer 26

Shock
Sepsis
Hypotension
Trauma (e.g. Sever head injury, burns)

Question 27

What is the most common cause of gastric ulceration?

Answer 27

Drugs - e.g. Iron medication, gold, caffeine, cocaine

Ulcer erodes blood vessels

Question 28

Who qualifies for the bowel screening programme in Scotland?

Answer 28

Men and women between the ages of 50 and 74

- once every two years