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PATH 179 LO 4 Flashcards

1
Q

What is renal calculi?

A
  • underlying metalbolic abnormality such as hypercalcemia or any increased calcium excretion
  • Urinary stasis and infection
  • Most commonly form in the kidney
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2
Q

What are signs and symptoms for renal calculi?

A
  • asymptomatic until they lodge in the ureter and cause partial obstruction
  • Pain radiates from kidney to groin - FLANK PAIN
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3
Q

What are the radiographic exams for renal calculi?

A
  • x-ray

- CT is the best to demonstrate stones

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4
Q

what is the rad appearance for renal calculi? *

A
  • is a stone contains enough Ca it will be visible
  • If radiolucent then no Ca and are made up of magnesium or uric acid
  • Films miss 34% of stones because of their size, location or they are obscured by bowel or bone
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5
Q

What is the treatment of renal calculi?

A
  • lithotripsy surgery (works well for stones in the kidney or upper ureter)
  • Stones in lower ureter require basket removal or laser destruction
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6
Q

What causes uterteral calculi?*

A

from the downward movement of kideny stones.

-Lodge in the lower portion of the ureter*

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7
Q

What is bladder calculi associated with?

A

bladder-outlet obstruction, urethral strictures, neurogenic bladder, and bladder diverticula

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8
Q

What are the two types of biliary calculi (cholelithiasis)?

A

cholesterol and pigmented

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9
Q

What does the higher incidence include in biliary calculi? *

A

family history

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10
Q

What are the sign and symptoms of biliary calculi?

A

pain can be involved in the RUQ but usually asymptomatic

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11
Q

What are the radiographic exams for biliary calculi?

A
  • x-ray
  • CT
  • Ultrasound
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12
Q

What is the radiographic appearance of biliary calculi?

A
  • only pigmented stones are visible b/c of the minerals they contain
  • most are not visible on plain fil because cholesterol
  • Appear as freely moving filling defects
  • Solitary stones or multiple
  • US for diagnosis
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13
Q

What is the treatment for biliary calculi?

A
  • lithotripsy
  • Stone retrieval
  • Cholecystectomy
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14
Q

What is Acute cholecystitis?

A

inflammation of the gallbladder

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15
Q

What causes acute cholecystitis? *

A

after obstruction of the cystic duct by impacted gallstone

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16
Q

What does urinary tract obstruction include?

A

urinary calculi, pelvic tumors, urethral structures, and enlargement of the prostate

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17
Q

What causes urinary tract obstruction in children?

A

due to congential ,malformations

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18
Q

What are the normal points of narrowing for urinary tract obstruction?

A

ureteropelvic and urterovesical junctions, bladder neck and urethral meatus.

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19
Q

What are the signs and symptoms of urinary tract obstruction?

A
  • abdominal pain
  • Frequent urination
  • Dysuria
  • Painful unrination
  • Urinary tract infection
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20
Q

Rad exams for urinary tract obstruction?

A
  • x-ray
  • IVU
  • CT
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21
Q

What is the rad appearance for urinary tract obstruction?

A
  • CT is the best way to diagnosis**
  • Acute obstruction: kidney is enlarged, calyces are moderaltry dilated
  • Chronic: very dilated pelvicalyceal system with clubbing
  • Any blockage above the level of the bladder will cause dilation of an unilateral ureter and renal pelvicalyceal system
  • If blockage is below the level of the bladder bilateral involvement will occur
  • Hydronephrosis can occur during pregnancy
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22
Q

What is the treatment for urinary tract obstruction?

A

decompression of the urinary system to prevent damage

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23
Q

What is gastritis?

A

inflammation of the stomach

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24
Q

what is the cause of gastritis?

A
  • various irritants: alcohol, corrosive agents and infection

- Heliobacter pylori can cause chronic gastrisis that can lead to peptic ulcer disease

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25
Q

What is the rad exams of gastritis?

A
  • abdominal series

- Upper GI

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26
Q

What is the rad appearance of gastritis?

A
  • alcohol gastrits: thickening of gastric folds, multiple superfical erosion
  • Corrosive gastritis: heals with fibrosis and scarring, narrowing of the antrum, possible gastric outlet obstruction
  • Vhronic gastrsis: severe mucosal athrophy, absence of mucosal fold
  • Due to age, malnutrition, medication and alcoholism
  • Pernicoius anemia=can not absorb B12
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27
Q

What is the treatment for gastritis?

A
  • medication

- Avoid trigger foods

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28
Q

what is peptic ulcer disease?

A

inflammatory process involving the stomach and duodenum

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29
Q

What causes peptic ulcer disease?

A
  • the action of acid and pepsin

- Occurs most frequently on the lesser curvature

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30
Q

What are the complications of peptic ulcer disease?

A

hemorrhage, gastric outlet obstruction and perforation

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31
Q

What is the rad appearance for duodenal ulcer?

A

ulcer crater

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32
Q

Where does 95% of duodenal ulcer occur?

A

-duodenum (duodenal bulb)

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33
Q

Where does gastric ulcer occur?

A

the lesser curvature of the stomach

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34
Q

What is the radiographic appearance of gastric ulcer?

A
  • penetration, projection of the ulcer outside the normal gastric lumen
  • radiating gastric folds to the edge of the crater (smoothness indicates benign ulcer)
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35
Q

What is acute pancreatitis?

A

protein and lipid digesting enzymes become activates within pancreas and it digests itself

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36
Q

What causes acute pancreatitis?

A

alcohol is most common. Also obstruction of gallstones in ampulla of vater

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37
Q

What is chronic pancreatitis?

A

frequent intermittent injury that produces scar tissue. Loses its ability to produce digestive enzymes

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38
Q

What causes chronic pancreatitis?

A

usually from chronic alcohol abuse

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39
Q

What are the signs and symptoms of acute pancreatitis?

A

-sudden onset of severe, steady abdominal pain that radiates into the back, jaundice, nausea and vomiting

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40
Q

What are the signs and symptoms of chronic pancreatitis?

A
  • Pain
  • Malabsorption causing weight loss
  • Diabetes
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41
Q

What are the rad exams for acute and chronic pancreatitis?

A
  • x-ray

- CT

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42
Q

What is the rad appearance for acute pancreatitis?

A
  • usually no appearance, or at least not conclusive
  • US and CT to definethe degree pancreatic inflammation and if its spread
  • ERCP’s and MRCP’s are performed
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43
Q

What is the rad appearance for chronic pancreatitis?

A

-small, irregular calcifications at the head of the pancreas, can extend into body and tail or organ

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44
Q

What is the treatment for acute, chronic pancreatitis?

A

-depends on the case of pancreatitis

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45
Q

What is regional enteris (chrons)

A

chronic inflammation condition of small bowel (usually the terminal ileum) of unknown origin

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46
Q

What causes regional enteritis?

A

diet and psychological factors may play a role . Most common in young adults

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47
Q

What are the signs and symptoms for regional enteritis?

A
  • attack and remission of severe abdominal pain, and diarrhea, blood in stools, and mucous
  • Possible perianal/rectal abscesses from fistulas
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48
Q

What are the radiographic exams for regional enteritis?

A
  • plain abdominal films
  • UGI
  • SBFT
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49
Q

What is the rad appearance for regional enteritis?

A
  • irregular thickening, inflammation, edema
  • ‘cobblestone’: transverse and longitudinal ulcerations and thickened mucosa and submucosa
  • ‘skip lesions’: diseased sections followed by normal segments
  • Fistula formation: burrow through bowel wall into adjacent loops of bowel
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50
Q

What is another name for regional enteritis?

A

chrons

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51
Q

What is the treatment for regional enteritis?

A

-medications, diet, surgical resection of diseased bowel

52
Q

What is irrtable bowel syndrome?

A

any alteration in the intestinal motility

53
Q

What are the signs and symptoms of IBS?

A

-chronic abdominal pain, constipation, intermittent water diarrhea or bouts of constipation and diarrhea,

54
Q

What is ulcerative colitis?

A

affects mucosal layer of bowel

-starts in the rectum/sigmoid and works way back, but only the large bowel affected

55
Q

What causes ulcerative colitis?

A

unknown, but autoimmune and aggravated by stress

56
Q

What are the signs and symptoms of ulcerative colitis?

A
  • bloody diarrhea
  • Abdominal pain
  • Fever
  • Weight loss
57
Q

What is the rad exams of ulcerative colitis?

A
  • x-ray

- barium enema

58
Q

What is the rad appearance of ulceratice colitis?

A

-large nodular protrusion of hyperplastic
-Deep ulcers outlined by intraluminal gas
-Loss of haustral marking
-Toxic megacolon: ddistent distal colon. If it affects the entire colon.
Patient may have abd tenderness and pain, tachycardia, fever and increased WBC count

59
Q

What is the treatment for ulcerative colitis?

A
  • anti-flammatory

- Diet modification

60
Q

What is chrons colitis?

A

same as chrons disease but happens in the large bowel instead of the small

  • Proximal portion in most frequently affected
  • Affects all layers of the GI tract
61
Q

What causes diverticulosis?

A
  • usually in older people as years of stress on bowel weaken the wall
  • Though to be caused by strain on passing stool, so those with low fiber diet are at a higher
62
Q

What is diverticulitis?

A

complication of ‘osis’ in which retained fecal material in the nodule causes inflammation, infection and perforation
-These can cause perforation or abscess

63
Q

What is the signs and symptoms of diverticulosis?

A
  • usually asymptomatic
  • Chronic or intermittent lower abdominal pain, related to stress or meals
  • Diarrhea/constipation/bleeding
  • Positive occult blood test
64
Q

What is the signs and symptoms of diverticulitis?

A

same as osis but may involve symptoms of excessive bleeding, pain

65
Q

What are the radiographic exams for diverticulosis/lithus?

A
  • 3 veiws abdominal
  • BaEn
  • CT
66
Q

What is the rad appearance for diverticulosis?*

A
  • round or oval outpouchings of barium projecting beyond the lumen
  • Usually multiple and if so it produces ‘saw tooth’ configuration
67
Q

What is the rad appearance for diverticulithis?

A

-requires evidence of diverticular perforation to indicate abscess and infection OR a soft tissue mass that indicates a healed, walled of abscess of an older perforation

68
Q

What is the treatment for diverticulosis?

A
  • Dietary changes (high fiber diet)

- Exercise

69
Q

What is the treatment for diverticulitis?

A
  • antibiotics

- Dietary adjustments

70
Q

Who does cancer of the large bowel mostly affect?

A

-most occur in 50-70 year old range, men 2x as often as women

71
Q

Where does cancer of the large bowel occur?

A

half occur in rectum and sigmoid where they can be felt in rectal exam

72
Q

What causes cancer of the large bowel?

A

most come polyps, so detection of polyps is vital

73
Q

What are the signs and symptoms of cancer of the bowel?

A
  • Diarrhea
  • Constipation
  • Weight loss
  • Fatigue
  • Symptoms of obstruction
74
Q

What is the rad exams for cancer of the large bowel?

A
  • 3 views, BaEn, CT,US

- radiography in conjunction with digital exam, scope, and biopsy

75
Q

What is the rad appearance for cancer of the large bowel?*

A
  • since polyps can produce cancers identifying them is important:
    1. benign are smooth and have a stalk (pedunculated)*
    2. Malignant: irregular surface, usually without stalks (sessile)*
  • ‘Apple core’ or ‘napkin ring’ sign indicates annular carcinoma
76
Q

What is the treatment for cancer of the large bowel?

A
  • resection
  • Chemo
  • Radiation therapy
77
Q

What is cirrhosis of the liver

A

chronic destruction of the liver cells

78
Q

What causes cirrhosis of the liver ?

A

alcoholism and malnutrition that occurs during these years

  • initally the liver enlarges, over time it shrinks
  • Bumpy and nodular surface
79
Q

What are the signs and symptoms of cirrhosis of the liver?

A
  • Pt appears jaundice
  • Fatigue
  • Weakness
80
Q

What are the rad exams of cirrhosis of the liver?

A
  • x-ray
  • CT
  • MRI
81
Q

What is the rad appearance for cirrhosis of the liver?

A
  • enlargement of the spleen (splenomegaly)
  • Edema, swelling of lower extremities
  • Ascities: accumulation of fluid in peritoneal cavity
  • Increase of exposure factors, overall haziness
82
Q

What is the treatment of cirrhosis of the liver?*

A

cirrhosis is irreversible

83
Q

What is hepatic metastases?

A

most common malignant tumor involving the liver

  • After diagnosis most patients do not survive
  • CT and MRI most sensitive
84
Q

What is pneumoperiotoneum?

A

free air in the peritoneal cavity

85
Q

What causes pneumoperitoneum?

A

perforation of a gas-containing viscus (internal organ) or abdominal, hyneocologic, intrathoracic surgey or iatrogenic cause. Perforation of peptic ulcer wither gastric or duodenal

86
Q

What are the signs and symptoms of pneumoperitoneum?

A
  • pain
  • Tenderness
  • Rigid abdomen
  • Loss of bowel sounds
87
Q

What is the rad exam for pneumoperitoneum?

A
  • abdominal series

- CT

88
Q

What is the rad appearance for pneumoperitoneum?

A
  • 1cc of air can be identified
  • Upright or decub for 10 mins
  • Gas rises to the highest point
  • Sickle shaped lucency
  • Can also be detected along the flank to the pelvis
89
Q

What is the treatment for pneumoperitonuem?

A

-immediate surgery

90
Q

What are the signs and symptom of hiatal hernia?

A

reflux may produce esophagitis, esopgaeal ulcer, esophageal stenosis as a result of the hernia, but the hernia itself is basically asymptomatic

91
Q

What are the rad exams for hiatal hernia?

A
  • x-ray

- Upper GI

92
Q

What are the rad appearance for hiatal hernia?

A
  • protrusion of stomach contents into the thoracic cavity sometimes with volvulus
  • Mucosal folds are used to determine which structure has herniated: linear and paralell in esophagus, nuumerous and thick with no parallel in stomach
93
Q

what is the treatment for hiatal hernia?

A

usually condition resolves, if not surgery to hold contents in place

94
Q

Where does FB usually become lodged in?

A

cervical esophagus

95
Q

What are the signs and symptoms of FB?

A
  • patient is sometimes unable to swallow
  • Choking
  • Sometimes asymptomatic
96
Q

What are the rad exams for FB?

A
  • x-ray
  • Fluro
  • Endoscopy if not seen on x-ray
97
Q

What is the rad appearance for FB?

A
  • metallic objects are easily visualized
  • some objects may not appear on x-rays
  • 2 projections are needed
98
Q

What is the treatment for FB?

A
  • surgical retrieval
  • Endoscopy
  • Child may pass object
99
Q

what may cause perforation in the esophagus?

A
  • esophagitis, peptic ulcer, neoplasm, external trauma or instrumentation
  • severe coughing or vomiting attack
  • Mallory-Weiss syndrome: after alcoholic bout of vomiting can produce a severe hemorrhage
100
Q

What causes bowel obstruction?

A

any stenosis, lesion, volvulus, intussusception, that obstructs the bowel lumen

101
Q

What are the signs and symptoms of bowel obstruction?

A
  • pain
  • distension
  • Problem having bowel movement
102
Q

What are the rad exams for bowel obstruction?

A

3 view abdomen

103
Q

What are the rad appearance of bowel obstruction?

A
  • massive distension of lucent, air filled bowel (LBO)

- classic stepladder appearance (SBO)

104
Q

What is the treatment of bowel obstruction?

A
  • therapeutic enema

- Surgery

105
Q

What is adynamic ileus?

A

fluid and gas do not progress normally through a non-obstructed small and large bowel

106
Q

What causes adynamic ileus?

A

abdominal surgery, peritonitis, meds that decrease motility, electrolyte and metabolic disorders, trauma

107
Q

What are the signs and symptoms of adynamic ileus?

A
  • abdominal distension
  • Pain
  • Vomiting
  • Risk of perforation
108
Q

What are the rad exam for adynamic ileus?

A

x-ray

109
Q

what are the rad appearance for adynamic ileus?

A

appears as a large area of retained gas/fluid in dilated sm and lg bowel

110
Q

What is the treatment for adynamic ileus?

A
  • surgical repair

- Therapeutic Barium Enema

111
Q

What is volvulus?

A

twisting of the bowel upon itself may lead to intestinal obstruction

112
Q

What does volvulus involve?

A

mostly the cecum and sigmoid

113
Q

What causes volvulus?

A

mostly found in elderly that consume a high-residue diet causing constipation

114
Q

What is cecal?

A

can develop from a fault in embryonic development

115
Q

What are the signs and symptoms of volvulus?

A
  • Nausea
  • Vomiting
  • Lack of stool
116
Q

What is the rad exam for volvulus?

A

x-ray

117
Q

what is the radiographic appearance for volvulus?

A
  • cecal: kidney shaped mass (from the twisted bowel)
  • Sigmoid: app as inverted ‘U’ shape, devoid of haustra and inflated balloon app
  • on BaEn exams, barium will flow and stop at sight of twist
118
Q

What is the treatment for volvulus?

A

surgery, or BaEn may resolve

119
Q

What is intususception?

A

telescoping of the bowel upon itself because of peristalsis

120
Q

What are the signs and symptoms of intussusception?

A
  • severe abdominal pain ‘currant jelly’ (blood in stool)

- Often a palpable right sided mass

121
Q

What is the rad exam of intussusception?

A
  • x-ray
  • barium enema
  • CT
122
Q

What are the rad appearance for intussuscpetion?

A

-‘coiled spring’ appearance of barium filled colon

123
Q

What is the treatment for intussusception?

A
  • reduction of telescoping bowel

- Therapeutic enema

124
Q

What is esophageal atresia?

A
  • discontiuation of the esophagus because it fails to develop
  • in ability pass NG tube into stomach with terminal end shown y chest x-ray
125
Q

What causes esophageal atresia?

A

congenital

126
Q

What is the rad appearance for esophageal atresia?

A

lack of gastrointestinal air below the diaphragm

127
Q

What is the treatment for esophageal atresia?

A

immediate surgery required

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