1When is an upright abdomen indicated?
suspicion "free air" or bowel perf
bowel gas pattern
2In addition to an abdominal radiograph what else would you order if concerned about a bowel perforation?
chest xray
3How long do you have to wait in order for air to rise in non-dependent regions?
positioned for 5 minutes
4Cupolas sign is an indication of?
pneumoperitoneum
5What can pneumatosis intestinalis occur with?
necrotizing enterocoloitis
bowel ichemia/infarction
COPD
bowel infection
immunosuppressive therapy
6What are the common areas that foreign bodies get lodged?
cricopharyngeal area
middle one third esophagus
lower esophageal sphincter
pylorus
ileocecal valve
7What are the intrabdominal causes of adynamic ileus?
post op or post traumatic
post inflammatory: pancreatitis, enteritis, colitis
pain related: renal colic, epidural disease
8What are the extra-abdominal cuases of adynamic ileus?
septicemia
metabolic dz
medications
prolonged bed rest
9What is sigmoid vovlulus often associated with ?
chronic constipation
sigmoid twists on self d/t redundant sigmoid mesentary
dramatically dilated sigmoid
10What is the first line imaging for acute abdominal pain?
flat and upright abdomen with PA CXR
11What appears black on ultrasound?
no reflection of sound waves- water
12What appears shades gray/white on US?
some reflection of sound wave- organs
13What appears white on US?
total reflection of sound wave- air in gut, bone, calcifications/stones
14When can you visualize a beating heart on US?
6 weeks
15Best US view for viewing female anatomy and pathology?
transabdominal and transvaginal
16What can obstetrics US show?
pregnancy location
pregnancy age
pregnancy complication
17What are some pregnancy complications?
developmental abnormalities
placenta previa
placenta abruption
placental insufficiency
18What can you see on US in the 1st trimester?
yolk sac
embryo/fetus
presence of cadiac activity
19When is the yolk sac seen? How long does it persist?
5 weeks GA and persists to 11-12 weeks
20Where should the placenta be?
high up in the uterus
21What is the disease in which the placenta has moved to an abnormal position?
placenta previa
22What other things can be viewed on US?
ovarian cyst
ovarian abscess
ovarian torsion
uterine fibroids
endometriosis
molar pregnancy
23What is shows on US when a molar pregnancy is present?
cluster grapes/snow storm
24What is the standard of care for urinary tract examination?
CT-urography
25Which imaging is when contrasted injected into bladder with force reflux into ureters and pelvialyceal system; often with endoscopic procedure?
retrograde pyelogram
26Which imaging is used to detect ureterovesicular reflux by using dye through a catheter into the bladder fluoroscopic images during voiding?
voiding cystourethrogram
27Which imaging is used in trauma cases to detect urinary extravasation?
cystography
retrograde urography
28For an intravenous pyelography which conditions will be relatively contraindicated for IV contrast?
DM
serum creatinine > 2 mg/dl
chronic kidney disease
29What is the study of choice for renal colic?
non contrast spiral CT
30You dont need contrast in evaluating what with CT?
renal parenchymal hemorrhage
nephrolithiasis
31Which study is poor in renal evaluation?
MRI
32When is gadolinium contrast contraindicated?
nephrogenuc systemic fibrosis
stage 4 or 5 CKD
kidney transplant patient
33If you were to use MRI to evaluated the kidney what would you use it for?
diagnosing renal artery stenosis
distinguishing between the renal cortex from medulla
staging renal cancer
evaluation of renal cysts or solid lesions
34Are radionuclide studies functional or diagnostic? What are they used for?
functional
measure GFR/kidney function
35Ultrasound for male GU imaging is good for?
scrotal imaging
differentiating between testis and epididymis
identifying testicular torsion
hydrocele vs varicocele
hernia
36US for male GU can also be used to do what for prostate ?
localize areas for biopsy
37What is a transrectal US (TRUS) used for?
identify and stage prostate cancer
directing biopsy
38What is minimal imaging done for trauma?
flat and upright abd w/ PA CXR
39What is the new standard of care for evaluating abdominal trauma?
CT
40What is the test of choice for upper GIB?
endoscopy
41What is the first line imaging for lower GI bleed?
proctosigmoidoscopy
42What can be used for smaller GI bleeds or difficulty localizing?
tagged RBC study
43What is concerning/abnormal with the abdomen in neonates?
gasless abdomen
44What is another sign of pathology in pediatric abdomens?
thick walls/dispaced loops
45What is missing in pediatric in abdominal imaging until they are about 6 months old?
haustra
46What age group is pyloric stenosis most common and what causes it?
4-6 weeks old
hypertrophy of pyloric muscle resultant from inherited disorder of metabolism
47What is a common sign of pyloric stenosis?
projectile vomiting
48What is the imaging of choice for pyloric stenosis?
abdominal US
49US is the primary imaging study for?
OB/GYN
GB
Liver
renal
aorta
50What are some common signs of small bowel obstruction?
dilate loops of small bowel
air fluid levels
no gas in colon
51What will you see with colonic obstruction?
marked dilation of entire colon
52Air under the diaphragm could indicate?
perforated duodenal or gastric ulcer
colonic perforation
following laparotomy or laparoscopy
recent percutaneous gastostomy tube placement
53For intussusception which study is used and often diagnostic and therapeutic?
barium or air contrast enema
54When should you avoid a barium or air contrast enema when treating intussusception?
if patient has possible peritonitis
55What is bedside US used for?
identify free peritoneal fluid
measurement of cross sectional abdominal aortic diameter
intrauterine/ectopic pregnancy
gynecological pathologies
cholelithiasis
dilated common bile duct
pericholecystic fluid
hydronephrosis
evaluation of IVC collapse
56When is a FAST examination done?
to evaluate for major intraperitoneal bleeding
pericardial tamponade
pneumothorax/hemothorax
57What are the major types of abdominal trauma?
MVA
falls
assault
58What is a common finding/problem in children or mentally handicapped adults?
foreign body ingestion
59What is the most sensitive and specific imaging for appendicitis?
CT scan
60Which imaging is better to view perianal fistulous tracts?
MRI
61What imaging is better to view abscesses?
CT
62What imaging is done for diverticulitis?
contrast-enhanced abdominal and pelvic ct scan
63When would you do an endoscopy with diverticulitis?
when you want to evaluate for associate colorectal cancer
64CT is favored due to?
speed
availability
cheaper
65When is abdominal angiography used?
used to assess:
trauma
GI hemorrhage
vasculitis
ASCVD
66What does abdominal angiography require to be done?
IV contrast dye injected directly into vessel(s) being studied
67Which study enters the duodenum, allows for visualization and injection of contrast into the common bile duct and pancreatic ducts?
ERCP
68What is the study of choice for gallbladder and biliary tract?
US
69What are some limitations with viewing the gallbladder with ultrasound?
skill and experience of operator
patient is obese
ascites
distended bowel
70What study is done for acute cholecystitis?
HIDA scan
71When is a endoscopic retrograde choloangiopancreatography indicated?
removal or common bile duct stones
diagnostic brushings if biliary stricture noted
72What happens during an ERCP?
endoscopy with common bile duct cannulated via ampulla of vater and cholangiogram performed with fluoroscopy
73What is the inital test done when malignancy is suspected in the galllblader, extrahepatic biliary system or head of the pancreas?
CT
74CT can also be used for evaluation of?
obstructive jaundice
75Mangetic resonancy cholangiopancreatography are used for which 2 diseases?
biliary tract disease
pancreatic disease
76PET scanning is used for what in GI cancer?
initial staging
restaging after therapy
77Which GI diseases would you want to use barium studies for?
hiatal hernia
gastroesophageal reflux
reflux esophagitis
ulcerations
barrett's esophagus
strictures
metaplasia
neoplasms
78What are the intraluminal lesions?
polyp
FB
exophytic tumor
79Mucosal diseases include?
ulcerative disease
gastroenteritis
80Which GI lesions appear as extraluminal projections?
ulcerations
diverticula
81How are disorders of the esophagus imaged?
contrast administration then fluoroscopy
82Which contrast is typically used for upper GI series?
barium or air
83If perforation is suspected what should be given instead of barium for upper GI series?
water soluble contrast
84What is the prep for upper GI series?
NPO 8-12 hours prior to study
85A double contrast study for a GI series involves?
gas producing crystals and barium
86What is an antegrade small bowel series?
given after standard upper GI series
patient given second dose of contrast
serial abdominal fils at 15-30 minute intervals to eval small bowel
87Which study is performed by introducing barium and air directly into the small intestine just past the duodenal jejunal junction via naso-intestinal tube?
enteroclysis
88What is a benefit of enteroclysis?
allows direct visualization w/o causing stomach or duodenal distention
89Which study is the introduction of barium and/or air into the colon via rectal tube with subsequent visualization via films/fluoroscopy?
barium enema
90When is double contrast indicated in a barium enema?
intraluminal and mucosal disease (polyps, ulcers)
91When is a barium enema indicated?
colon inflammatory diseases
neoplasm
ulcerative colitis
granulomatous colitis
92What are some alternatives to barium enema?
colonoscopy
virtual colonscopy
93benefit of colonscopy vs barium enema?
allows direct visualization
94Colonoscopy disadvantages?
more expensive
more uncomfortable
95What conditions cause too little bowel gas?
enlarged abdominal organs
intra-abdominal tumor
fluid filled intestines
gastroenteritis
neurological defect