Question 1

Which of the following statements is NOT true in regard to a pediatric small bowel series?

Accepted Answer

The transit time for barium through the small intestine is actually shorter in a pediatric patient compared to an adult due to their faster metabolic rate.

Question 2

A patient comes to radiology with possible diverticulosis.Which of the following studies is most diagnostic for detecting this condition?

Accepted Answer

Double-contrast barium enema is the most diagnostic study for detecting diverticulosis as it provides better visualization of the colonic wall and mucosa. A single-contrast barium enema may miss smaller diverticula, while a small bowel series and evacuative proctogram are not useful in diagnosing diverticulosis.

Question 3

Which of the following positions best demonstrates the left colic flexure?

Accepted Answer

The answer of Which of the following positions best demonstrates...

Question 4

During a double-contrast barium enema (BE)procedure,the radiologist suspects a polyp in the descending colon.Which position would best demonstrate this?

Accepted Answer

The right lateral decubitus position is best for demonstrating suspected lesions in the descending colon during a double-contrast barium enema procedure because it allows the air (used as a contrast medium along with barium) to rise and contrast the medial aspect of the descending colon, where polyps would be more visible against the radiolucent air background.

Question 5

The height of the enema bag should not exceed 36 inches (92 cm)above the radiographic table at the beginning of the study.

Accepted Answer

The answer of The height of the enema bag should...

Question 6

The opening leading into the intestine for the patient with a colostomy is termed the stoma.

Accepted Answer

True, the stoma is the opening created from the colon through the abdominal wall for the purpose of diverting stool into a colostomy bag.

Question 7

Which of the following pathologic conditions is best demonstrated with evacuative proctography?

Accepted Answer

Evacuative proctography, also known as defecography, is the best imaging modality for demonstrating rectal prolapse. It allows the radiologist to evaluate the anorectal angle, sphincter function, and pelvic floor descent during defecation. Intussusception, volvulus, and diverticulosis are better evaluated with other imaging modalities such as ultrasound, CT, or barium studies.

Question 8

Central ray and image receptor centering for a 1-hour small bowel radiograph should be:

Accepted Answer

The answer of Central ray and image receptor centering for...

Question 9

Which imaging modality can demonstrate abscesses in the retroperitoneum?

Accepted Answer

MRI is the best imaging modality to demonstrate abscesses in the retroperitoneum because it has high soft tissue contrast resolution and can clearly differentiate between fluid-filled abscesses and surrounding tissues.

Question 10

During the initial enema tip insertion,the tip is aimed:

Accepted Answer

During the initial enema tip insertion, the tip is aimed towards the umbilicus. This helps ensure that the tip is inserted into the rectum and not the vagina (in females) or the prostate (in males).

Question 11

Which one of the following imaging modalities and/or procedures is very effective in detecting the Meckel diverticulum?

Accepted Answer

Nuclear medicine, specifically a technetium-99m pertechnetate scan, is very effective in detecting the Meckel diverticulum. This is because the Meckel diverticulum contains ectopic gastric mucosa that takes up the radioactive tracer, making it easily visible on the scan. CT, double-contrast barium enema, and sonography may also be useful in certain cases, but are generally less effective than nuclear medicine.

Question 12

The ideal kV range for a double-contrast barium enema is:

Accepted Answer

The ideal kV range for a double-contrast barium enema is 90 to 100, as this range provides optimal contrast between the barium and the surrounding tissues.

Question 13

A patient comes to radiology for a barium enema (BE).He has a possible fistula extending from the rectum to the urinary bladder.Which one of the following projections and/or positions would best demonstrate the fistula?

Accepted Answer

The lateral rectum position is best for demonstrating a fistula extending from the rectum to the urinary bladder because it provides a clear profile view of the rectal area, allowing for optimal visualization of any abnormal connections or pathways between the rectum and adjacent structures like the urinary bladder.

Question 14

Which specific aspect of the large intestine must be demonstrated during evacuative proctography?

Accepted Answer

Evacuative proctography is used to assess the anorectal angle, which is the angle between the anal canal and the rectum.

Question 15

Evacuative proctography is most commonly performed on geriatric patients.

Accepted Answer

Evacuative proctography is performed on patients of all ages who have symptoms such as constipation, fecal incontinence, or pelvic floor dysfunction. It is not exclusively performed on geriatric patients.

Question 16

A radiograph of an AP barium enema (BE)projection reveals poor visualization of the sigmoid due to excessive superimposition of the sigmoid colon and rectum.How can this area be better visualized on the repeat exposure?

Accepted Answer

CAngling the central ray (CR) 30° to 40° cephalad with an AP projection helps separate the sigmoid colon from the rectum, improving visualization. Taking a PA projection with the patient in the left lateral decubitus position also helps in better visualizing the sigmoid by using gravity to separate the intestinal loops.

Question 17

Why is the posteroanterior (PA)rather than the AP projection recommended for a small bowel series?

Accepted Answer

The PA projection for small bowel series produces better separation of loops of small intestine, allowing for better visualization of the entire small intestine. It also reduces radiation dose to radiosensitive organs (such as the reproductive organs) and places the small intestine closer to the image receptor for improved image quality. While patient comfort is indeed important, it is not the primary reason for choosing the PA projection over the AP projection.

Question 18

What type of enema tip is recommended for a barium enema on an infant?

Accepted Answer

A 10 Fr, flexible silicone catheter is the recommended choice for a barium enema on an infant. It is gentle and flexible, which minimizes discomfort and the risk of injury.

Question 19

Which projection and/or position is most commonly performed during an evacuative proctogram?

Accepted Answer

The most commonly performed projection during an evacuative proctogram (also known as a defecography or defecogram) is the lateral projection. This allows for visualization of the rectum and anal canal during the act of defecation. Other projections or positions may be used to supplement the lateral view, but the lateral is the most essential.

Question 20

During a colostomy barium enema,a double-contrast retention enema tip is used.

Accepted Answer

During a colostomy barium enema, a cone tip or a specifically designed colostomy tip is used to fit into the stoma, not a double-contrast retention enema tip, which is used for standard barium enema procedures through the rectum.

Quiz 13: Lower Gastrointestinal System