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Gastroesophageal Reflux

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Guillermo J. Villalonga NMT 2534 Group # 4 Objectives To learn the symptoms of gastroesophageal reflux To learn about the test and procedure used for this diseases ... – PowerPoint PPT presentation

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Title: Gastroesophageal Reflux


1
Gastroesophageal Reflux
  • Guillermo J. Villalonga
  • NMT 2534
  • Group 4

2
Objectives
  • To learn the symptoms of gastroesophageal reflux
  • To learn about the test and procedure used for
    this diseases, including
  • Patient preparation
  • Patient history
  • Methods of administration
  • Acquisition parameters for the study
  • Procedure

3
What is GERD?
  • Gastroesophageal reflux disease, or GERD, occurs
    when the lower esophageal sphincter (LES) does
    not close properly and stomach contents leak
    back, or reflux, into the esophagus. The LES is a
    ring of muscle at the bottom of the esophagus
    that acts like a valve between the esophagus and
    stomach

4
What are the symptoms of GERD?
  • The main symptoms are
  • Heartburn
  • Acid regurgitation
  • Chest pain
  • Hoarseness in the morning
  • Trouble swallowing
  • Dry cough
  • Bad breath

5
Nuclear Imaging Test
  • Gastroesophageal Reflux

6
Patient Preparation
  • Identify the patient
  • Verify doctors order
  • Explain the procedure
  • Ensure patient has fasted for 4 hours or overnight

7
Patient History
  • Patient should answer the following questions
  • Do you have a history or family history of
    cancer?
  • If so, what type and for how long?
  • Do you have a history of esophageal motility
    dysfunction?
  • Do you feel burning or have pain in upper abdomen
    or lower chest after eating?
  • Do you have any lever diseases?
  • Do you have any stomach diseases or problems?
  • After a meal, does it taste like gastric juices
    when you belch (as in a mini-vomit)?

8
Method of Administration
  • PO in water, orange juice, milk, oatmeal or
    saline
  • PO with acidified orange juice (150ml of 0.1
    normal HCl) to delay gastric emptying time and
    predispose the patient to reflux
  • Ingested through a nasogastric tube if patient
    has a history of esophageal motility dysfunction

9
Acquisition Parameters
Acquisition Parameters Acquisition Parameters
Patient full name Collimator LEAP, LEHR
Patient ID Image isotope 99mTc
Date of birth Radiopharmaceutical 99mTc-SC (sulfur colloid)
Patient sex Dose 300 µCi - 2 mCi
Patient height Energy 140 KeV
Patient weight Patient rotation Supine
Referring physician Number of counts 300k - 500k
Study date Start angle
Acquisition type Static Rotation direction
Data type Tomo Number of projections 64
Image format 64 x 64 Acquisition mode Step-and-shoot
Pixel depth 16 Orbit Non circular
Number of frames 64 Patient orientation head in
Time per frame 30 sec/image Study duration 30 min
10
Procedure
  • At 15 minutes after ingestion, position patient
    sitting or standing in front of camera, anterior
    projection
  • Acquire 30-seconds image
  • Place patient in supine position on table
  • Place the abdominal binder around lower abdomen
    below the rib cage

11
  • Attach a sphygmomanometer anterior, under the
    binder. This can also be accomplished by using a
    plastic block used for IV pyelograms
  • Acquire 30-seconds images with pressures in the
    abdominal binder at 0, 20, 40, 60, 80, and 100
    mmHg

12
  • Processing to obtain percent gastroesophageal
    reflux
  • To be extremely accurate, correct the prebinder
    counts (esophageal and gastric counts) for each
    image by a decay factor

13
Artifacts
  • Inability to swallow or aspiration of dose
  • Esophageal retention
  • Regurgitation with or without aspiration
  • Attenuation articles or clothing
  • Patient with known esophageal varices perhaps
    not enough for a contraindication, but
    consideration may be given to this condition

14
Results
  • Normal
  • Dose should present brightly in stomach with very
    little or no residual activity in esophagus
  • The activity should remain in the stomach with no
    reflux at any pressure
  • Abnormal
  • Activity will appear to be refluxing up the
    esophagus toward the mouth

15
Effects of GERD on Quality of Life Compared to
other Conditions
16
Conclusion
  • Various methods to effectively treat GERD range
    from lifestyle measures to the use of medication
    or surgical procedures. It is essential for
    individuals who suffer persistent heartburn or
    other chronic and recurrent symptoms of GERD to
    seek an accurate diagnosis, to work with their
    physician, and to receive the most effective
    treatment available

17
References
  • www.medicinenet.com/gastroesophageal_reflux_diseas
    e_gerd/article.htm
  • www.aboutgerd.org/
  • Nuclear Medicine Technology. Procedures and Quick
    References. Pete Shackett

18
Questions
  • 1. One of the methods of administration for the
    gastroesophageal reflux test is/are
  • a) Coke
  • b) Beer
  • c) Orange juice
  • d) Oat meal

c or d Orange juice or Oatmeal
19
  • 2. All of the following steps are true regarding
    patient preparation, except
  • a) Identify the patient
  • b) Verify doctors order
  • c) Marital status
  • d) Explain the procedure

c) Marital status
20
  • 3. What type of collimator is used for this test?
  • a) Low energy
  • b) Medium energy
  • c) High energy

a) Low energy
21
  • 4. Which of the following radiopharmaceutical is
    used for the gastroesophageal reflux test?
  • a) 123I
  • b) 133Xe
  • c) 99mTc-SC
  • d) 87Ga

c) 99mTc-SC
22
  • 5. What type of acquisition is used for
    gastroesophageal reflux test?
  • a) SPECT
  • b) Static
  • c) Dynamic
  • d) MUGA

b) Static
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