GI - 1 Imaging Techniques

Question 1

• Best method for examining UGI: Mouth -> esophagus ->stomach->duodenum

Answer 1

EGD

Question 2

Flexible endoscope

Answer 2

EGD

Question 3

Directed biopsy & therapeutic

Answer 3

EGD

Question 4

• Gold Standard for diagnosing colonic mucosal disease

Answer 4

Colonoscopy

Question 5

Flexible colonoscope

Answer 5

Colonoscopy

Question 6

Anal canal ->rectum -> colon 95% reach cecum

Answer 6

Colonoscopy

Question 7

Terminal ileum can be examined

Answer 7

Colonoscopy

Question 8

• Sensitivity > barium enema or CT for colitis, polyps, cancer

Answer 8

Colonoscopy

Question 9

Anus -> sigmoid colon

Answer 9

Flexible Sigmoidoscopy

Question 10

Name 3 things Flexible Sigmoidoscopy is used to evaluate?

Answer 10

o Diarrhea
o Rectal bleeding
o Colon cancer screening with other modalities

Question 11

swallow disposable capsule with camera

Answer 11

Capsule endoscopy (Small Bowel Endoscopy)

Question 12

Visualization of jejunal & ileal mucosa: beyond conventional endoscope

Answer 12

Small Bowel Endoscopy

Question 13

o	Implanted electromagnetic devices
o	Intestinal motility disorders
o	Zenker’s diverticulum
o	Swallowing disorders
o	Small bowel diverticulosis 
o	Pregnancy
o	Severe Crohn’s enteritis
o	Small intestinal strictures
o	Obstruction 
All of these are contraindications for:

Answer 13

Small Bowel Endoscopy

Question 14

Push down small bowl: Down mouth -> mid jejunum

Answer 14

Push enteroscopy

Question 15

Biopsies or endoscopic therapy

Answer 15

Push enteroscopy

Question 16

Used for bleeding

Answer 16

Push enteroscopy

Question 17

Diagnosing a perforated ulcer

Free air: at little as 1-2 mL of air seen

Answer 17

Plain film

Question 18

mall bowel obstruction

Answer 18

Plain film

Question 19

Moderate-Severe abdominal tenderness

Answer 19

Plain film

Question 20

Suspicion of bowl ischemia

Answer 20

Plain film

Question 21

Ingestion of FB or penetrating FB

Answer 21

Plain film

Question 22

• Drinks/swallows barium & x-ray or video taken

Answer 22

Barium Esophagram

Question 23

• Evaluates: Swallowing, Peristalsis, Lesions, HH, Rings, Strictures, Cancer, , Ulcers, Reflex

Answer 23

Barium Esophagram

Question 24

• Swallow barium, x-ray => visualize esophagus, stomach & duodenum

Answer 24

Upper GI series w/ Small Bowel Follow Through

Question 25

``` • Evaluates o Abdominal pain o Weight loss o Heme in stool o Diarrhea ```

Answer 25

Upper GI series w/ Small Bowel Follow Through

Question 26

evaluates entire SI w/ barium

Answer 26

Small Bowel Series

Question 27

LARGE bowel: rectum -> cecum

Answer 27

Barium Enema

Question 28

Can reflux into terminal ileum

Answer 28

Barium Enema

Question 29

``` X-rays taken after barium inserted. • Evaluates o Cancer o Polyps o Inflammation o Structural abnormalities ```

Answer 29

Barium Enema

Question 30

• Sound waves create image • Differentiation of  Cystic VS. Solid lesions of the liver and kidneys

Answer 30

Abdominal Ultra Sound

Question 31

• Images of gut wall * adjacent organs vessel, & lymph nodes

Answer 31

Endoscopic Ultra Sound

Question 32

``` • Most accurate preoperative local staging of esophageal, pancreatic & rectal malignancies • Highly sensitive for diagnosing o Bile duct stones o Gall bladder disease o Submucosal gastrointestinal lesions o Chronic pancreatitis ```

Answer 32

Endoscopic Ultra Sound

Question 33

* Gold standard for diagnosis of GERD * Measures reflux of acid from the stomach to esophagus * Catheter places 5cm above lower esophageal sphincter & kept in place for 24hr

Answer 33

Ambulatory 24hr pH monitoring

Question 34

Endoscope mouth -> duodenum

Answer 34

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Question 35

• Ampulla of Vater identified & cannulated w/ plastic catheter

Answer 35

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Question 36

• Radiographic material injected into bile duct & pancreatic duct under fluoroscopic guidance

Answer 36

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Question 37

• Endoscopic sphincterotomy opens sphincter of Oddi to do one of the following o Stones retrieved from ducts o Biopsies can be obtained o Strictures can be dilated & stented o Therapeutic & diagnostic procedures esp for ductal strictures & CBD stones

Answer 37

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Question 38

* Checks function of gallbladder & bile ducts * Given W/ CCK to check gallbladder emptying * Used when presenting with RUQ pain, nausea, vomiting

Answer 38

Hepatobiliary Iminodiacetic Acid (HIDA) Scan

Question 39

• Can be done with or without contrasting agent • Most helpful in evaluating o Retroperitoneum ( pancreas, kidney, nodes, aorta) o Liver o Appendicitis o Diverticular disease

Answer 39

CT Scan

Question 40

Better soft-tissue contrast than CT

Answer 40

MRI

Question 41

``` • Evaluation of intra-and extra-hepatic biliary & pancreatic duct dilatation & cause of obstruction • Evaluates o Choledocholithiasis o Retained gallstones o Pancreatobiliary neoplasms o Strictures o Primary sclerosing cholangitis o Chronic pancreatitis • No contrast agents needed • If stones - > ERCP ```

Answer 41

Magnetic Resonance Cholangiopancreatography (MRCP)