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GI > Imaging > Flashcards

Imaging Flashcards

1
Q

Types of GI/Abdominal Imaging

A 
X-rays
CT
Ultrasound
Direct visualization
ERCP
HIDA Scan
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2
Q

What can Abdominal X-rays show?

A

Gas in abnormal places or amounts
Stones
Metallic FB

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3
Q

Indications for an Abdominal X-Ray

A 
Suspected bowel obstruction/perforation
Suspected intussusception
FB
Suspected abdominal mass
Blunt abdominal trauma (seatbelt from MVA)
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4
Q

When are Abdominal X-rays not Indicated

A

Vague central abdominal pain
Gastroenteritis
Haematemesis

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5
Q

Gas within the Small Bowel on Abdominal Xray

A

Intraluminal gas minimal
Centrally located
Tight loops of sm. diameter
Valvulae conniventes

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6
Q

Gas within the Large Bowel on Abdominal X-ray

A

Mixture of gas & feces
Loops larger in diameter
Haustra

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7
Q

Abnormal Findings on an Abdominal X-ray

A 
Dilated loops
Air-fluid levels on erect film
Intramural gas
Intraperitoneal gas
Extraperitoneal gas
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8
Q

Liver on Abdominal X-ray

A

Large are in RUQ

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9
Q

Spleen on Abdominal X-ray

A

Soft tissue LUQ
Size of a fist
Can be seen, obscured, or not at all

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10
Q

Kidneys on Abdominal X-ray

A

Bean shaped
Left higher than right
About 3 vertebrae in size

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11
Q

Psoas Muscles on Abdominal X-ray

A

Straight lines extending inferolaterally from lumbar spine to lesser trochanter of femur

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12
Q

Bladder on Abdominal X-ray

A

Only if full

Soft tissue density in pelvis

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13
Q

Define Ileus

A

Hypo mobility of the GI system in the absence of mechanical bowel obstruction

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14
Q

What is another name for an upper GI series?

A

Barium swallow

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15
Q

What does an Upper GI Series use for diagnostics?

A

Plain film x-ray

Fluoroscopy

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16
Q

What are the two types of upper GI series?

A

Standard barium upper GI series

Double-contrast upper GI series

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17
Q

What does an upper GI series look at?

A

Esophagus
Stomach
Duodenum

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18
Q

Indications for an Upper GI Series

A 
Dysphagia
GERD
Assessment of hiatal hernia
Strictures
Tumors
Ulcers
Fistulas
varices
Diverticulum
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19
Q

Contraindications for an Upper GI Series

A

Intestinal obstruction
Esophageal perforation or rupture is suspected
Pregnant women
Individuals with poor swallowing reflex

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20
Q

Risk of an Upper GI Series

A

Constipation

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21
Q

Indications for a Small Bowel Follow Through

A 
Crohn's 
Tumors
Unexplained abdominal pain
Malabsorption symptoms
Small bowel fistulas
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22
Q

What is another name for a lower GI study

A

Barium Enema

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23
Q

What does a lower GI study evaluate?

A

The colon

24
Q

Indications for a Lower GI Study

A 
Colon cancer
Diagnose/monitor UC or Crohn's disease
Diverticultitis
Fistulas
Megacolon
25
Q

Risk of a Lower GI Study

A

Pregnant women

Colon perforation

26
Q

What is a sensitive method to diagnose abdominal diseases?

A

Abdominal CT

27
Q

What are Abdominal CT Frequently Used for?

A

Stage

Follow CA

28
Q

Indications for an Abdominal CT

A

Patients with jaundice
Pancreatic disease
Hepatic matastases

29
Q

Contraindications for an Abdominal CT

A

Expensive

High doses of radiation

30
Q

Hepatobiliary Scintigraphy (HIDA Scan)

A

Used in Diagnosis of problems with the liver, gallbladder, or bile ducts
Nuclear-medicine scan

31
Q

Indications for a Hepatobiliary Scintigraphy (HIDA Scan)

A 
Cholecystitis
Bile duct obstruction
Assessment for liver transplant
Biliary atresia
Bile leaks
32
Q

Abdominal Ultrasonography

A 
Transabdominal ultrasound
Can combine with endoscopy
Performed quickly at bedside
No radiation
Inexpensive
33
Q

What is an abdominal ultrasound hampered by?

A

Fat
Air
Operator dependent
Limited sensitivity

34
Q

What is the preferred imaging in RUQ pain?

A

Abdominal Ultrasound

35
Q

What is useful in evaluating the unstable trauma patient?

A

Abdominal Ultrasound

FAST- Focused Assessment with Sonography for Trauma

36
Q

Types of Endoscopy

A 
EGD- esophagogastroduodenoscopy
Colonoscopy
ERCP- endoscopic retrograde cholangiopancreatograph
Capsule endoscopy
Flexible sigmoidoscopy
37
Q

EGD- esophagogastroduodenoscopy

A

Visualize esophagus to duodenum

Minimally invasive

38
Q

Indications of an EGD

A

Signs/symptoms of upper GI disease
Surveillance for upper GI cancer in high-risk patients
Biopsy
Recurrent emesis
Dysphagia
Dyspepsia
Therapeutic intervention: strictures, placement of G-tub

39
Q

Contraindications for an EGD

A 
Possible perforation
Medically unstable/unwilling patients
Anicoagulation (relative)
Pharyngeal diverticulum (relative)
H&N surgery (relative)
40
Q

Indications for a Capsule Endoscopy

A

Obscure GI bleeding
IBD: Crohn’s, UC
Small bowel polyps & tumors
Celiac disease

41
Q

Contraindications for a Capsule Endoscopy

A

Swallowing disorder

Small bowel obstruction/stenosis

42
Q

How does capsule endoscopy work?

A

Patient swallows camera pill

Takes 60,000 pictures of the bowel

43
Q

Cons of a Capsule Endoscopy

A

Short battery life

Can miss part of the bowel

44
Q

Pros of a Flexible Sigmoidoscopy

A 
May be done in office
Inexpensive
Reduces deaths from rectal cancer
Easier bowel prep
Rarely needs sedation
45
Q

Cons of a Flexible Sigmoidoscopy

A

Detects only 1/2 of polyps
Misses 40-50% of CA beyond view of sigmoidoscope
Limited by discomfort, poor bowel prep

46
Q

Indications for a Flexible Sigmoidoscopy

A 
Screening test
Blood in stool
Evaluation of colon
Medical management of colitis
Removal of FB
Pre-op eval prior to rectal surgery
47
Q

Contraindications for a Flexible Sigmoidoscopy

A

Bowel perforation
Acute diverticulitis
Active peritonitis

48
Q

What is a colonoscopy for?

A

Visualization of rectum, colon, and distal ileum

49
Q

Possible Complicaiton

A

Bleeding, perforation with polypectomy

50
Q

Indications for a Colonoscopy

A 
Screening
Evaluation
Follow up colorectal CA
Polyps
Management of IBD, IBS
51
Q

Contraindications for a Colonoscopy

A

Pregnancy
Colonic perforation (relative)
Toxic megacolon (relative)
IBD with ulceration (relative)

52
Q

What is an Endoscopic Retrograde Cholangiopancreatography (ERCP)?

A

Technique that uses combination of luminal endoscopy and fluoroscopic imaging to diagnose and treat conditions associated with the pancreatobiliary system

53
Q

Indications for an ERCP

A

Biliary disease

Pancreatic disease

54
Q

Why an ERCP in Biliary Disease?

A

Assessment & treatment of biliary obstruction due to stones
Treatment of gallstones during a cholecystectomy
Assessment and treatment of bile duct strictures

55
Q

Why an ERCP in Pancreatic Disease?

A

Assess & treat acute pancreatitis, strictures, or pancreatic duct stones
Treatment of pseudocyst & malignancies

56
Q

Contraindications for an ERCP

A

Refusal
Unstable cardiopulmonary, neurologic, or cardiovascular status
Existing bowel perforation

GI (20 decks)

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