GIGU Imaging

Question 1

What does a KUB flat plate x-ray screen for?

Answer 1

Acute abdominal disease

Question 2

What does an Acute Abdominal Series x-ray help to identify?

Answer 2

Air under diaphragm, obstruction and fracture

Question 3

Appropriate situations to order an Acute Abdominal Series x-ray?

Answer 3

Abdominal pain, distention or absent bowel sounds

Question 4

With an x-ray, how does air appear?

Answer 4

Black

Question 5

Why are KUBs and Acute Abdominal series x-rays good?

Answer 5

Quick and readily available

Question 6

How does an ultrasound work and what appears white/black?

Answer 6

Sound waves reflected back from tissues due to density

• Solid structures appear white
• Fluid filled structures appear black

Question 7

What is ultrasound good for imaging?

Answer 7

Size
Shape
Inflammation
STONES - gallbladder

Question 8

Why is ultrasound a good imaging choice?

Answer 8

Quick, readily available and NO RADIATION

- Safe for pregnant women and children

Question 9

What limits ultrasound?

Answer 9

Bowel gas

Question 10

How will gallstones appear on an ultrasound?

Answer 10

White with an acoustic shadowing with them

Question 11

List some disease that ultrasound is good for imaging?

Answer 11

Gallstones
Pancreatitis
Appendicitis 
Ovarian/testicular masses 
Pregnancy

Question 12

What does a HIDA scan inject and what is it useful for?

Answer 12

Nuclear tagged material is taken up the liver and excreted into the bile
- Useful for patients that have persistent symptoms of gallstones with lack of evidence from an ultrasound

Question 13

What can a HIDA scan evaluate?

Answer 13

Gallbladder FUNCTION and cystic duct patency

Question 14

What are the disadvantages to a HIDA scan?

Answer 14

Takes time and cannot inject nuclear tagged material into pregnant women

Question 15

What is something you could add to a HIDA scan?

Answer 15

CCK

Question 16

What is the purpose of adding CCK to a HIDA scan?

Answer 16

Assesses gallbladder function by stimulating it to empty!

Question 17

What percentage of gallbladder emptying is abnormal?

Answer 17

< 35-40% is abnormal

Question 18

What are the disadvantages to CCK being added to a HIDA scan?

Answer 18

Takes time and causes extreme abdominal cramping

Question 19

Purpose of a Fluoroscopy - Barium swallow?

Answer 19

Assess esophageal function AND anatomy

Question 20

Disadvantages of a Fluoroscopy - Barium swallow?

Answer 20

High doses of radiation

- Multiple x-rays while swallowing a radiopaque fluid

Question 21

What is a disease example that would need a Fluoroscopy - Barium swallow to identify?

Answer 21

Zenker’s Diverticula - pouch in esophagus that causes dysphagia, halitosis, regurgitation and unintentional weight loss

Question 22

What are the 2 types of CT contrast?

Answer 22

Oral and IV

Question 23

What is oral contrast with a CT good for imaging?

Answer 23

Intraluminal assessment of intestines

- Masses, tumors, perforations, obstructions

Question 24

What is IV contrast with a CT good for imaging?

Answer 24

Vascular relationships

- Aorta and renal arteries

Question 25

What is CT WITH contrast good for imaging?

Answer 25

Pathologic conditions

Question 26

Advantages of CT WITH contrast?

Answer 26

Fast, noninvasive and does NOT require consent

Question 27

Disadvantages of CT WITH contrast?

Answer 27

High doses of radiation and contrast could cause an allergic reaction (fish)

Question 28

CT WITHOUT contrast is the test of choice for what?

Answer 28

Kidney stones!!

Question 29

What is an alternative choice for kidney stone testing for pregnant females?

Answer 29

Ultrasound of kidney and bladder

Question 30

Out of the tests discussed, which have the highest radiation?

Answer 30

CT!

Question 31

Which tests require consent?

Answer 31

Upper Endoscopy Colonoscopy Cystoscopy

Question 32

Which tests are more sensitive to smaller ulcerations, bleeds and biopsy/removal of objects

Answer 32

EGD Colonoscopy Cystoscopy

Question 33

What gives you direct visualization of the upper GI tract?

Answer 33

EGD - upper endoscopy

Question 34

Prep for EGD?

Answer 34

Nothing to eat after midnight and requires anesthesia and intubation to protect airway

Question 35

What is an upper endoscopy good for detecting?

Answer 35

Upper GI bleed, GERD, dysphagia

Question 36

What gives you direct visualization of the lower GI tract?

Answer 36

Colonoscopy

Question 37

Prep for colonoscopy?

Answer 37

Laxatives to clear out bowel and light anesthesia

Question 38

What is a colonoscopy good for detecting?

Answer 38

Cancer screening and lower GI bleed

Question 39

What gives you direct visualization of the bladder and urethra?

Answer 39

Cystoscopy

Question 40

Advantages of cystoscopy?

Answer 40

Relatively quick (20 mins) and variable anesthesia

Question 41

What symptoms would suggest a cystoscopy?

Answer 41

Painless hematuria UTIs Kidney/bladder stones

Question 42

Do you need consent for x-ray, ultrasound or CT?

Answer 42

NO