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Applied CP 2 > Meckel's > Flashcards

Meckel's Flashcards

1
Q

purpose of Meckel’s scan

A

detect and localize meckel’s diverticulum or ectopic/heterotopic gastric mucosa

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2
Q

difference between ectopic and heterotopic gastric mucosa

A

ectopic: organ migrated
heterotopic: tissue at site of origin

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3
Q

symptoms of Meckel’s

A
  • painless hematochezia
  • presentation of GI bleed in child
  • maybe tenderness at umbilicus
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4
Q

what are other causes of heterotopic gastric mucosa

A
  • gastrointestinal duplications
  • post-operative retained gastric antrum
  • Barrett’s esophagus
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5
Q

where are meckel’s usually found?

A

LRQ in distal ileum

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6
Q

meckel’s diverticulum is usually caused by…

A

remnant of fetal omphalomesenteric duct causing outpouching

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7
Q

what are the 4 rules of 2?

A
  1. present in 2% of population
  2. 2cm outpouching
  3. 2 feet from ileocecal value
  4. usually diagnosed by 2 yo
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8
Q

if obstruction is present, what are the symptoms?

A

abdominal pain, bloating and nausea

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9
Q

treatment for Meckel’s

A

bowel/diverticulum resection

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10
Q

RP and dose

A

pert at 296-444 MBq (adults)
or 1.85 MBq/kg for peds

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11
Q

patient prep

A
  • npo for 2-4 hours
  • good hydration
  • pharm pre-treatment
  • d/c thyroid blocking meds for 48 hrs
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12
Q

what does cimetidine do?

A

inhibits gastric secretions and enhances pert accumulation

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13
Q

how does cimetidine do that?

A

it is antagonist to histamine H2 receptors

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14
Q

dose of cimetidine for adults

A

300 mg, po
given 2 days prior

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15
Q

dose of cimetidine for kids

A

10-20 mg/kg/day for two days prior

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16
Q

what is the other pharm that does the same thing as cimetidine?

A

ranitidine

17
Q

dose of zantac for kids

A

1 mg/kg up to 50 mg max
slow IV infusion over 20 mins

18
Q

dose of zantac for adults

A

150-300 mg po
2-3 hours prior

19
Q

what does glucagon do?

A

decreases peristalsis in bowel = stasis of secreted pert

20
Q

what is glucagon usually coupled with?

A

pentagastrin

21
Q

dose of glucagon

A

50 ug/kg to 1 mg/kg IV

22
Q

imaging time when using glucagon

A

10 mins prior or 10 mins post pert admin

23
Q

what does pentegastrin do?

A

stimulates gastric secretions = increase rate of TcO4- uptake from blood

24
Q

another name for pentegastrin

A

peptavalon

25
Q

another name for Ranitidine

A

zantac

26
Q

dose of pentegastrin

A

6 ug/kg SQ

27
Q

imaging time with pentegastrin

A

5-20 mins prior to pert admin

28
Q

fov for meckel’s study

A

abdomen and pelvis (including stomach and bladder)

29
Q

pos for meckel’s

A
  • focal area of increased uptake in abdomen (ant LRQ)
  • uptake increases over time
  • same timing and intensity as stomach
  • appears prior to bladder activity
30
Q

normal appearance for meckel’s

A

cardiac blood pool, large vessels that decrease over time, hepatic and splenic pool, stomach (increase over 10-20 mins then decreases over time), early renal activity, collecting system, scrotal/testicle activity

31
Q

false positives

A
  • *urinary tract activity
  • aneurysms, AVM, hemangioma
  • bowel inflammation
  • neoplasms
  • ulcers, Crohns disease, colitis, peptic ulcer
  • intussusception
  • barium enema
32
Q

false negatives

A
  • minimal gastric mucosa, small diverticula
  • rapid washout
  • competing meds
33
Q

what other pathologies can be identified with NMT pert scintigraphy?

A
  • gastrointestinal duplications
  • retained gastric antrum
  • Barrett’s esophagus imaging
34
Q

method of localization

A

active transport

35
Q

critical organ

A

large bowel

36
Q

what are pharm pre-treatments used for?

A

to improve the sensitivity of the study

37
Q

false positives

A
  • inflammatory or obstructive lesion in GI
  • vascular lesions
  • normal excretion in GI or urinary tract
  • ectopic gastric mucosa
  • recent colonoscopy or laxatives
38
Q

false negs

A
  • small, no gastric mucosa
  • necrotic mucosa
  • rapid peristalsis
  • recent barium or perchlorate

Applied CP 2 (12 decks)

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