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Questions and Answers

List five causes of blood in the stool.

Hemorrhoids, diverticulitis, polyps, colitis, upper gastrointestinal ulcers, colorectal cancer.

Define the term melena, and explain what causes it.

Melena is black and tarlike stool caused by oxidation of the iron in blood present in the stool by intestinal and bacterial enzymes.

What is the primary reason for screening patients for the presence of fecal occult blood?

Early diagnosis and treatment of colorectal cancer, which increases a patient's survival.

What are the symptoms of colorectal cancer?

Bleeding from the rectum, blood in the stool, a change in the shape of the stool, a change in bowel habits, general abdominal discomfort, unexplained weight loss, constant fatigue. Signup and view all the answers

Why must three stool specimens be obtained for the fecal occult guaiac slide test?

Allows the detection of blood from gastrointestinal lesions that do not bleed every day. Signup and view all the answers

List two reasons for placing a patient on a high-fiber diet when testing for fecal occult blood.

To encourage bleeding from lesions that bleed only occasionally and to add bulk to promote bowel elimination to ensure adequate specimen collection. Signup and view all the answers

What medications and vitamin supplements must be discontinued before guaiac slide testing?

Ibuprofen, naproxen, more than one adult aspirin per day, iron supplements, vitamin C supplements of more than 250 mg per day. Signup and view all the answers

List two factors that could cause false-positive test results on a guaiac slide test.

Taking an iron supplement, eating foods containing peroxidase, eating red or rare meat, performing the test during a menstrual period, taking medications that irritate the gastrointestinal tract. Signup and view all the answers

List three examples of diagnostic tests that may be performed if the guaiac slide test result is positive.

Colonoscopy, sigmoidoscopy, a double-contrast barium enema radiographic study, CT colonoscopy. Signup and view all the answers

Why is it important to perform quality control methods when developing the guaiac slide test?

To ensure reliable and valid results. Signup and view all the answers

How should the guaiac slide test be stored?

At room temperature; protected from heat, sunlight, and strong fluorescent light. Signup and view all the answers

What factors can cause a failure of the expected control results to occur on a guaiac slide test?

Use of outdated slides or developing solution, an error in technique, subjection of the slides to heat, sunlight, strong fluorescent light, or volatile chemicals. Signup and view all the answers

List the advantages of the fecal immunochemical test (FIT) compared with the guaiac slide test.

FIT is more sensitive to the presence of lower gastrointestinal bleeding; FIT is not affected by drugs or food and therefore does not require medication and dietary restrictions; FIT leads to fewer false-positive test results. Signup and view all the answers

How does a fecal DNA test function to detect colorectal cancer?

Uses DNA technology to detect abnormal cells that are shed into the stool from cancerous growths or colorectal polyps. Signup and view all the answers

What is the purpose of performing a sigmoidoscopy?

To determine the source and cause of bleeding after a positive result on a fecal occult blood test. Signup and view all the answers

Describe the following patient preparation required for a sigmoidoscopy.

The day before the procedure: Do not consume any solid food; drink only clear liquids. The evening before: Drink magnesium citrate laxative; continue with clear liquids. The day of: Continue clear liquids until 4 hours before, then use Fleet enemas. Signup and view all the answers

What is the purpose of performing a digital rectal examination (DRE) before a sigmoidoscopy?

To palpate the rectum for the presence of tenderness, hemorrhoids, polyps, or tumors. Signup and view all the answers

What is the purpose of insufflating air into the colon during a sigmoidoscopy?

To distend the lumen of the colon for better visualization. Signup and view all the answers

What is the purpose of suctioning during sigmoidoscopy?

To remove secretions such as mucus, blood, and liquid feces that interfere with proper visualization of the intestinal mucosa. Signup and view all the answers

What is the recommended position of the patient during flexible fiberoptic sigmoidoscopy?

Sims' position. Signup and view all the answers

What parts of the colon are viewed during a colonoscopy?

Sigmoid colon, descending colon, transverse colon, ascending colon. Signup and view all the answers

What is the purpose of a full bowel preparation before a colonoscopy?

To empty the colon of fecal material that can interfere with good visualization. Signup and view all the answers

How should a patient consume the liquid laxative solution when preparing the bowel for a colonoscopy?

One 8-ounce glass of the liquid laxative solution should be drunk every 10 to 15 minutes until 2 quarts have been consumed. Signup and view all the answers

Where is the prostate gland located?

The prostate gland surrounds the urethra and is located just below the bladder and in front of the rectum. Signup and view all the answers

What are the symptoms of prostate cancer?

Difficulty in urinating; weak or interrupted urinary flow; pain or burning during urination; frequent urination; blood in the urine; pain in the lower back, pelvis, or upper thighs. Signup and view all the answers

How is the digital rectal examination used for the early detection of prostate cancer?

Normally, the prostate gland should feel soft, whereas malignant tissue is firm and hard. Signup and view all the answers

What conditions can cause an elevated PSA level?

Prostate cancer, benign prostatic hyperplasia, prostatitis. Signup and view all the answers

What is the PSA level for each of the following: normal range, slightly elevated range, moderately elevated range, highly elevated?

Normal range: 0 to 4 ng/mL. Slightly elevated range: 4 to 10 ng/mL. Moderately elevated range: 10 to 20 ng/mL. Highly elevated: Higher than 20 ng/mL. Signup and view all the answers

What patient preparation is required for a PSA test?

Patient can engage in normal activity for 2 days before the test; vigorous exercise should be avoided; patient should not have sexual intercourse for 2 days before the test. Signup and view all the answers

What tests may be ordered by the physician if the patient has positive prostate screening results?

Transrectal ultrasonography, biopsy of the prostate gland, bone scan, CT scan. Signup and view all the answers

What is the definition of the term screening?

Process of testing an individual to detect disease when the individual is not yet experiencing symptoms of that disease. Signup and view all the answers

What is the American Cancer Society's recommendation for the PSA test and the DRE?

Health care providers should discuss the potential benefits and limitations of prostate screening with men older than 50 years; after this discussion, the PSA test and the DRE should be offered annually. Signup and view all the answers

When does testicular cancer most commonly occur?

Between the ages of 15 and 34. Signup and view all the answers

When is the best time for a male to perform a testicular self-examination (TSE) and why?

After taking a warm bath or shower. Signup and view all the answers

What are the risk factors for testicular cancer?

History of undescended testicles, family history of testicular cancer, cancer of the other testicle, Caucasian race. Signup and view all the answers

What is the most common sign of testicular cancer?

Small, hard, painless lump located on the front or side of the testicle. Signup and view all the answers

Who discovered x-rays?

Wilhelm Konrad Roentgen. Signup and view all the answers

What is the function of x-rays?

To diagnose and treat disease. Signup and view all the answers

What are the two ways in which radiographs can be taken?

Conventional film method or digitally with the use of a computer. Signup and view all the answers

Why is it important for a patient to prepare properly for a radiographic examination?

If the patient fails to prepare properly, a radiograph of poor quality may result. Signup and view all the answers

What is the function of a radiopaque contrast medium?

To provide a contrast in density between the tissue or organ and the surrounding area. Signup and view all the answers

What are the various ways in which contrast medium can be administered to a patient?

Orally, injected into a vein, delivered through an intravenous line, in an enema. Signup and view all the answers

What is the purpose of mammography?

To detect many forms of breast disease, such as benign breast masses, breast calcification, fibrocystic breast disease, and breast cancer. Signup and view all the answers

Why should the patient be instructed not to apply lotions, powders, or deodorants when having a mammogram?

These substances may contain small amounts of metal that can interfere with interpretation. Signup and view all the answers

Why must the breasts be compressed during mammography?

To obtain a clear radiograph and to reduce the radiation dose as much as possible. Signup and view all the answers

What is the purpose of a bone density scan?

To measure the bone mineral density of the human skeleton to detect bone loss. Signup and view all the answers

What is osteoporosis?

Condition in which there is a gradual loss of calcium that causes the bones to become thinner and more fragile. Signup and view all the answers

Who is at particular risk for osteoporosis?

Postmenopausal women. Signup and view all the answers

What patient preparation is required for a bone density scan?

Patient should abstain from taking a calcium supplement or osteoporosis medication. Signup and view all the answers

What information is provided by DEXA bone density measurements?

They indicate if the patient has lost bone density; assist in detecting osteoporosis. Signup and view all the answers

What is the purpose of the upper GI radiographic examination?

To examine the upper digestive tract to help diagnose disorders of the esophagus, stomach, duodenum, and small intestine. Signup and view all the answers

Why must the GI tract be free of food and fluid before an upper GI radiographic examination is performed?

Food and fluid have a degree of density and could cause confusing shadows on the radiograph. Signup and view all the answers

How can the patient prevent constipation after an upper GI examination?

By increasing fiber and fluid intake for several days following the procedure. Signup and view all the answers

A lower GI radiographic examination assists in the diagnosis of what conditions?

Polyps, cancerous tumors, diverticulosis, and the extent of inflammatory bowel disease. Signup and view all the answers

Why is it important to remove gas and fecal material from the colon before a lower GI radiographic examination is performed?

Gas shows up on the radiograph as confusing shadows; fecal material obscures the image of the colon. Signup and view all the answers

What is the advantage of the air used with a double-contrast barium enema?

The air distends the wall of the colon and allows the colon to be viewed in greater detail. Signup and view all the answers

What is an intravenous pyelogram (IVP)?

Radiograph of the kidneys, ureters, and bladder. Signup and view all the answers

An IVP assists in the diagnosis of what conditions?

Kidney stones, blockage or narrowing of the urinary tract, growths within or near the urinary system. Signup and view all the answers

What may the patient experience during an IVP when the iodine enters the bloodstream?

Patient may feel warm and flushed and have a metallic or salty taste in the mouth. Signup and view all the answers

Define the following angiographic terms: angiocardiogram, bronchogram, cerebral angiogram, coronary angiogram, cystogram.

Angiocardiogram: Radiograph of the heart. Bronchogram: Radiograph of the lungs. Cerebral angiogram: Radiograph of major arteries of the brain. Coronary angiogram: Radiograph of the coronary arteries. Cystogram: Radiograph of the urinary bladder. Signup and view all the answers

What are the primary uses of ultrasonography?

To diagnose conditions of the abdominal and pelvic organs. Signup and view all the answers

What are the advantages of ultrasonography?

It shows movement, allows for continuous viewing, and uses sound waves rather than radiation. Signup and view all the answers

What can be determined during an echocardiogram?

Size, shape, and position of the heart; movement of the heart valves and chambers. Signup and view all the answers

What is the purpose of the gel used with ultrasonography?

To increase the conductivity of the sound waves between the skin and the transducer. Signup and view all the answers

What is the purpose of performing an obstetric ultrasound?

To determine gestational age of a fetus and confirm the due date, to detect congenital abnormalities and multiple pregnancies. Signup and view all the answers

Doppler ultrasound assists in the diagnosis of what conditions?

Blood flow blockages, narrowing of blood vessels due to atherosclerosis. Signup and view all the answers

What type of image is produced by computed tomography?

A series of cross-sectional images of a body part. Signup and view all the answers

What are the primary uses of computed tomography?

To detect and evaluate tumors and other abnormalities. Signup and view all the answers

What type of patient preparation is required for computed tomography?

Patient must remove all radiopaque objects, and if a contrast agent is used, fast for several hours. Signup and view all the answers

What are the primary uses of magnetic resonance imaging?

To assist in the diagnosis of intracranial and spinal lesions and soft tissue abnormalities. Signup and view all the answers

What items must the patient remove before having an MRI scan?

Hairpins, eyeglasses, hearing aids, watches, rings, credit cards. Signup and view all the answers

What material is used with a nuclear medicine diagnostic imaging procedure?

Radioactive material known as a radiopharmaceutical. Signup and view all the answers

What is the function of a gamma camera used in nuclear medicine?

To detect the radiation being given off by the body part that has been targeted by the radiation. Signup and view all the answers

What is the purpose of a bone scan?

To assess the health and integrity of the bones over a wide area. Signup and view all the answers

Study Notes

Blood in Stool Causes

Common causes include hemorrhoids, diverticulitis, polyps, colitis, upper gastrointestinal ulcers, and colorectal cancer.

Melena

Defined as black, tarlike stool resulting from blood oxidizing due to intestinal and bacterial enzymes.

Fecal Occult Blood Screening

Primary purpose is early detection of colorectal cancer, enhancing patient survival rates.

Symptoms of Colorectal Cancer

Symptoms include rectal bleeding, blood in stool, altered stool shape, changes in bowel habits, abdominal discomfort, unexplained weight loss, and fatigue.

Fecal Occult Guaiac Slide Test

Requires three stool specimens to detect intermittent gastrointestinal bleeding.

High-Fiber Diet Prior to Testing

Increases likelihood of detecting occasional bleeding lesions and ensures adequate specimen collection by promoting bowel elimination.

Medications to Discontinue

Advise discontinuation of ibuprofen, naproxen, multiple daily aspirin, iron, and high doses of vitamin C prior to testing.

False-Positive Results Factors

Possible causes include iron supplements, peroxidase-rich foods (like red meat), menstruation, and medications irritating the gastrointestinal tract.

Diagnostic Tests After Positive Guaiac Test

Follow-up tests may include colonoscopy, sigmoidoscopy, CT colonoscopy, and double-contrast barium enema.

Quality Control in Testing

Important to ensure valid and reliable test results.

Guaiac Slide Storage

Should be kept at room temperature, shielded from heat, light, and chemicals for accurate results.

Control Result Failures

Possible due to outdated materials, errors in technique, or exposure to inappropriate environmental conditions.

Fecal Immunochemical Test (FIT) Advantages

More sensitive to lower gastrointestinal bleeding and does not require dietary restrictions.

Fecal DNA Test

Detects colorectal cancer by identifying abnormal cells shed into stool from tumors or polyps.

Purpose of Sigmoidoscopy

Determines the source of bleeding, evaluates symptoms related to the colon, and identifies lesions and infections.

Sigmoidoscopy Patient Preparation

Includes clear liquid diet, laxatives, and specific timing for enemas to ensure colon cleanliness.

Digital Rectal Examination (DRE)

Performed to assess for abnormalities and prepare the patient for sigmoidoscopy.

Air Insufflation During Sigmoidoscopy

Used to expand the colon for enhanced visibility.

Suctioning During Sigmoidoscopy

Cleanses the area of secretions to improve visualization of the intestinal mucosa.

Patient Positioning for Sigmoidoscopy

Patients are typically placed in the Sims' position.

Colonoscopy Visualization

Examines major sections of the colon: sigmoid, descending, transverse, and ascending.

Bowel Preparation for Colonoscopy

Aims to clear the colon for optimal visualization of abnormalities.

Liquid Laxative Consumption

Patients should consume specific amounts of laxative solution at intervals for bowel cleansing.

Prostate Gland Location

Found below the bladder and encircling the urethra, positioned in front of the rectum.

Symptoms of Prostate Cancer

Include urination difficulties, blood in urine, pelvic pain, and frequent urination.

DRE in Prostate Cancer Detection

Detects hard areas in the prostate that may indicate malignancy.

Elevated PSA Level Causes

Causes include prostate cancer, benign prostatic hyperplasia, and prostatitis.

PSA Level Ranges

Normal: 0-4 ng/mL
Slightly elevated: 4-10 ng/mL
Moderately elevated: 10-20 ng/mL
Highly elevated: >20 ng/mL

PSA Test Preparation

Normal activities are permitted, but vigorous exercise and sexual activity should be avoided two days before testing.

Tests for Positive Prostate Results

Possible additional tests include transrectal ultrasonography, prostate biopsy, bone scan, and CT scan.

Screening Definition

Testing to identify disease in asymptomatic individuals.

American Cancer Society PSA and DRE Guidelines

Annual discussions on screening for men over 50, particularly those at average risk.

Testicular Cancer Incidence

Most commonly diagnosed in males aged 15 to 34.

Testicular Self-Examination (TSE) Timing

Best performed after a warm bath/shower to soften scrotal skin for easier palpation.

Testicular Cancer Risk Factors

History of undescended testicles, family history, and being Caucasian.

Common Sign of Testicular Cancer

Presence of small, hard, painless lumps in the testicles.

Wilhelm Roentgen

Discovered x-rays.

X-ray Function

Utilized for diagnosing and treating diseases.

Radiograph Capture Methods

Can be taken using conventional film or digital techniques.

Importance of Patient Preparation for Radiographic Exams

Proper preparation ensures high-quality radiographs and minimizes rescheduling.

Radiopaque Contrast Medium

Enhances visibility of organs/tissues on radiographs.

Contrast Medium Administration

Can be given orally, intravenously, or rectally.

Mammography Purpose

Detects various breast diseases, including benign conditions and cancer.

Avoidance of Lotions Before Mammogram

Metal content in products can show up on radiographs and disrupt interpretations.

Breast Compression in Mammography

Ensures clearer images while reducing radiation exposure.

Bone Density Scan Purpose

Measures bone mineral density to assess for loss and osteoporosis.

Osteoporosis

Condition marked by gradual calcium depletion leading to fragile bones.

Osteoporosis Risk Group

Postmenopausal women are particularly at risk.

Bone Density Scan Preparation

Patients should avoid calcium supplements before the test.

DEXA Bone Density Measurements

Indicate bone density loss, presence of osteoporosis, fracture risk, and treatment response.

Upper GI Examination Purpose

Diagnoses disorders in the upper digestive tract.

Fasting Before Upper GI Exam

Necessary to avoid confusing shadows on radiographs.

Preventing Constipation After GI Exam

Increase fiber and fluid intake post-procedure.

Lower GI Exam Diagnostic Capabilities

Assists in identifying polyps, tumors, and inflammatory bowel disease.

Importance of Clearing Gas and Fecal Matter

These can obscure colon images on radiographs.

Double-Contrast Barium Enema Advantage

Air assists in better visualization of the colon's inner walls.

Intravenous Pyelogram (IVP) Definition

A radiographic study of the kidneys, ureters, and bladder.

IVP Diagnostic Uses

Identifies kidney stones, urinary tract issues, and abnormal growths.

Patient Experience During IVP

May feel warmth or a metallic taste when iodine is injected.

Various Radiographic Procedures Explained

Angiocardiogram, Bronchogram, Cerebral Angiogram, Coronary Angiogram, Cystogram are radiographs using contrast mediums to visualize specific systems.

Ultrasonography Applications

Examines abdominal and pelvic organ conditions.

Ultrasonography Advantages

Provides real-time imaging without using radiation.

Echocardiogram Functionality

Evaluates heart size, shape, and valve movement.

Ultrasound Gel Purpose

Enhances sound wave conductivity between skin and transducer.

Obstetric Ultrasound Purpose

Determines fetal age, health, position, and gender.

Doppler Ultrasound Applications

Detects vascular issues and blockages.

Computed Tomography Imaging

Produces cross-sectional images for detailed body part assessment.

CT Uses

Diagnoses tumors and monitors treatment effects.

Patient Preparation for CT

Radiopaque objects must be removed, and fasting may be required if using contrast.

Magnetic Resonance Imaging (MRI) Uses

Assists in diagnosing brain and spinal lesions as well as soft tissue conditions.

MRI Preparation Checklist

Patients need to remove metal items such as jewelry and hairpins.

Nuclear Medicine Material

Uses radiopharmaceuticals for diagnostic imaging.

Gamma Camera Function

Detects radiation emitted from targeted body parts.

Bone Scan Purpose

Identifies undetectable fractures and lesions.

Nuclear Cardiac Stress Test

Evaluates coronary artery disease.

PET Scan Applications

Assists in diagnosing brain cancer and heart disease.

Digital Imaging Technology Advantages

Provides instant image accessibility and electronic sharing capabilities.

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