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MRSO 2 > Rite ad 6 > Flashcards

Rite ad 6 Flashcards

1
Q

After an emergent quench has begun, how long does it take for the magnetic field to be reduced to a safe level?

Approximately 7 minutes
Approximately 1 hour
Approximately 15 minute
Approximately 30-60 seconds

A

Approximately 30-60 seconds

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2
Q

What are the reasons that we would quench an MRI unit? Select all that apply.

An uncontrollable fire occurs in the MRI room
Code blue occurs in the MRI room
A large ferrous object is pinning a patient
It is the end of your shift

A

An uncontrollable fire occurs in the MRI room

A large ferrous object is pinning a patient

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3
Q

Which of the following are considerations for a quench vent pathway?

Restrict access to quench vent area
Use signage to indicate quench vent outside
Have the quench vent inspected on a consistent basis
All of the choices

A

Restrict access to quench vent area
Use signage to indicate quench vent outside
Have the quench vent inspected on a consistent basis
All of the choices

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4
Q

Which of the following are risks associated with the cryogen substance found in a superconducting unit if it enters the MRI room? Select all that apply.

Magnetohydrodynamic effect
Asphyxia
Disorientation
Hypothermia

A

Asphyxia
Disorientation
Hypothermia

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5
Q

A quench is performed and a malfunction of the quench vent cause cryogen to leak in the room. The patient is in danger from which of the following?

All of the choices
Sedation
Heating
Damage to eardrum

A

Damage to eardrum

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6
Q

A fire breaks out in the MR room, cannot be controlled, and poses a serious threat. Which of the following would be safest to do first?

Leave the area
Wait for firefighters
None of the choices
Quench the magnet

A

Quench the magnet

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7
Q

A nurse accidentally brings an MR unsafe cart into the room and it gets stuck to the MR unit pinning a patient against the scanner. The cart is large and the nurse cannot get around it. What do you do?

Try to move the cart
Call a code blue
Call for a group of people to move the cart
Quench the magnet

A

Quench the magnet

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8
Q

A quench is performed and a malfunction of the quench vent causes cryogen to leak in the room. Pressure builds up and the door cannot be opened. What could you do to get to the patient?

Tell the patient to try to open the door
Call for help to get the door open
Wait till the pressure dissipates
Break the window to the zone IV

A

Break the window to the zone IV

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9
Q

A quench is performed and a malfunction of the quench vent causes cryogen to leak in the room. The patient is in danger from which of the following?

All of the choices
Hypothermia
Asphyxiation
Frostbite

A

All of the choices
Hypothermia
Asphyxiation
Frostbite

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10
Q

What eGFR level indicates severe kidney failure?

31-45 mL/min/1.73m2
60-89 mL/min/1.73m2
46-60 mL/min/1.73m2
0-15 mL/min/1.73m2

A

0-15 mL/min/1.73m2

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11
Q

Which of the following are considered anaphylactoid reactions? Select all that apply.

Headache
Hives
Abdomen pain
Difficulty breathing

A

Hives

Difficulty breathing

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12
Q

For all inpatients receiving group I contrast, ACR recommends an eGFR should be obtained within

An eGFR obtained within the last 7 days is sufficient and no additional eGFR is required
2 days prior to the planned administration of a group I or group III GBCA
eGFR, is not necessary in inpatients as the potential benefit of a GBCA-enhanced MRI exam are felt to outweigh the risk of NSF

A

2 days prior to the planned administration of a group I or group III GBCA

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13
Q

Which of the following patient histories may increase the chance for a gadolinium contrast reaction? Select all that apply.

Currently recovering from a cold
History of seasonal allergies
History of heart disease
History of a reaction to iodinated contrast

A

History of seasonal allergies

History of a reaction to iodinated contrast

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14
Q

How long does it take to excrete gadolinium contrast from a patient with normal kidney function?

4 hours
24 hours
48 hours
9 hours

A

24 hours

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15
Q

A conservative approach to breast-feeding after a mother receives gadolinium contrast is:

To continue breast-feeding immediately after receiving an intravenous injection of gadolinium contrast
To wait 12-24 hours to breastfeed after intravenous injection of gadolinium contrast
To pump and dump breastmilk for 168 hours after intravenous injection of gadolinium contrast
To mix formula with breastmilk for 24 hours after intravenous injection of gadolinium contrast

A

To wait 12-24 hours to breastfeed after intravenous injection of gadolinium contrast

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16
Q

What eGFR level indicates mild kidney function loss?

30-45 mL/min/1.73m2
45-60 mL/min/1.73m2
0 mL/min/1.73m2
60-89 mL/min/1.73m2

A

60-89 mL/min/1.73m2

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17
Q

Which of the following is used to determine renal function?

eGFR
Blood platelet
D-dimer
Both GFR and D-dimer

A

eGFR

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18
Q

Which of the following can be given to a patient to relieve the symptoms of a severe allergic reaction? Select all that apply.

Advil
Diphenhydramine
Epinephrine
Propofol
Corticosteroid

A

Diphenhydramine
Epinephrine

Corticosteroid

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19
Q

Which of the following are physiologic factors that occur from an anaphylactic reaction? Select all that apply.

Elevated creatinine levels
Headache
Vasodilation
Bronchiole smooth muscle contraction

A

Vasodilation
Bronchiole smooth muscle contraction

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20
Q

Which of the following is a short-term effect of gadolinium contrast?

GAP
NSF
Gadolinium retention
Nausea

A

Nausea

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21
Q

Approximately how much gadolinium is absorbed by an infant from a mother who has breastfed them and has received a dose of gadolinium contrast?

> 1%
0.0004%
0.4%
20%

A

0.0004%

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22
Q

Group I agents are associated with the greatest number of:

unconfounded cases of NSF, so the use of eGFR is not required
confounded cases of NSF, so the use of eGFR is not required
confounded cases of NSF, so the use of eGFR is required
unconfounded cases of NSF, so the use of eGFR is required

A

unconfounded cases of NSF, so the use of eGFR is required

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23
Q

Gadolinium contrast media is excreted into breastmilk in an unstable non-water-soluble form.

False
True

A

False

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24
Q

T1 shortening pre-contrast from a history of multiple doses of gadolinium contrast is commonly seen in which of the following? Select all that apply.

Heart
Achilles tendon
Globus pallidus
Dentate nucleus

A

Globus pallidus
Dentate nucleus

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25
Q

A patient is set to have an MRI knee scan with and without contrast and has labs drawn. The results show that the patient has an eGFR of 25. It is highly suggested that what occurs according to the manufacturer’s BlackBox warning?

The patient should not undergo an MRI.
A full dose of gadolinium can be given unless the patient has a history of allergies to contrast media.
A half dose of gadolinium contrast should be given.
Gadolinium contrast is not given.

A

Gadolinium contrast is not given.

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26
Q

In evaluating a patient for a potential contrast reaction, what assessments should be made if clinically feasible: (select all that apply)

What is the patient’s pulse?
Can the patient speak?
What is the patient’s blood pressure?
What is the quality of the patient’s breathing?

A

What is the patient’s pulse?
Can the patient speak?
What is the patient’s blood pressure?
What is the quality of the patient’s breathing?

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27
Q

Earplugs can reduce noise when used properly by how much?

40-50 decibels
10-30 decibels
70-90 decibels
0-10 decibels

A

10-30 decibels

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28
Q

What is the A-weighting limit for noise produced in MRI per the IEC 60601-2-33 document?

99 dBA
69 dBA
40 dBA
120 dBA

A

99 dBA

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29
Q

Using a headset and earplugs will reduce noise by how much?

By the reduction of headset + the reduction of earplug divided by two
The reduction of overall headset capacity
By the reduction of earplugs (10-30dB) and a portion of the overall headset reduction
50dB

A

By the reduction of earplugs (10-30dB) and a portion of the overall headset reduction

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30
Q

Eddy currents are produced from which of the following?

Gradient magnetic field
Walking through the static magnetic field
Moving MR table
All of the choices

A

Gradient magnetic field
Walking through the static magnetic field
Moving MR table

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31
Q

What unit is used to determine how well hearing protection works?

dt
NRR
PHR
HRR

A

NRR

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32
Q

The _________ gradients are used to express what gradient coils are activated in a pulse sequence diagram to fill our k space.

Logical
Physical

A

Logical

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33
Q

Theoretically, which of the following has the greatest chance for the time-varying gradient field to cause arrhythmogenesis in the patient? Select all that apply.

Scanning the head with abandoned leads in their chest
Using a slew rate of 200 T/m/s
Scanning at a 1 T MR unit
Scanning an MR cardiac study

A

Scanning the head with abandoned leads in their chest
Using a slew rate of 200 T/m/s

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34
Q

Which of the following will reduce noise the most?

NRR 33 dB
NRR 0 dB
NRR 10 dB
NRR 25 dB

A

NRR 33 dB

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35
Q

Which of the following will produce the lowest chance for peripheral nerve stimulation?

EPI
Conventional spin echo
Gradient echo
Fast spin echo

A

Conventional spin echo

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36
Q

The NRR is a unit of measurement used to measure what?

The function of hearing protection
Potential of heating
Peripheral nerve stimulation
Translational force

A

The function of hearing protection

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37
Q

A patient is having an MR pelvis scan and has a brain stimulator. They are advanced feet first. What risks are associated with this implant when considering the time-varying gradient magnetic field?

The only risk is associated with the static field
None
Electrical current induction
Heating of stimulator

A

Electrical current induction

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38
Q

Which of the following pulse sequences will produce the greatest chance for peripheral nerve stimulation?

Conventional spin echo
Fast spin echo
Gradient echo
Inverse recovery

A

Gradient echo

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39
Q

How can noise be reduced in MRI for a patient during an exam?

Earplugs
Headphones
Sponge
Earplugs and headset

A

Earplugs and headset

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40
Q

Which of the following is true of 3 T MRI? Select all that apply.

It has a greater chance for peripheral nerve stimulation than at 1.5 T
It will produce more stimulation at isocenter than higher field strengths
It will have a larger maximum spatial gradient than a 1.0 T unit
It will have a higher whole-body SAR limit in normal mode than the normal mode at a 1.5 T

A

It has a greater chance for peripheral nerve stimulation than at 1.5 T

It will have a larger maximum spatial gradient than a 1.0 T unit

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41
Q

Which of the following will produce the greatest chance for peripheral nerve stimulation?

Conventional spin echo
Gradient echo
DWI
Fast spin echo

A

DWI

42
Q

The noise heard in MRI is caused by which of the following?

Increased heating in a circuit
Two competing magnetic fields (gradient field and magnetic field)
Larmor force
The antenna effect

A

Two competing magnetic fields (gradient field and magnetic field)

43
Q

The gradient coils are located around the patient in the gantry and as the coils are activated there is little effect of the time-varying gradient magnetic field at___________, but extreme effects of the time-varying gradient magnetic field at

the periphery of our patient, isocenter
isocenter, the periphery of our patient

A

isocenter, the periphery of our patient

44
Q

Which of the following will reduce patient heating? Select all that apply.

Using saturation bands
Increase flip angle
Increase duration of RF exposure (soft RF pulse)
Increase TR
Decrease the bandwidth

A

Increase duration of RF exposure (soft RF pulse)
Increase TR
Decrease the bandwidth

45
Q

Which of the following can reduce the risk of patient burns caused by the antenna effect from external equipment?

Avoid scanning a patient with a transmit-receiver coil.
All of the choices
Use only spin echo sequences.
Place a barrier between tissue/skin and electrical devices touching our patient

A

Place a barrier between tissue/skin and electrical devices touching our patient

46
Q

Which of the following will increase patient heating?

Increasing the TR
Decreasing the TE
Decreasing the flip angle
Increasing the echo train length

A

Increasing the echo train length

47
Q

Which of the following pulse sequences will produce the most patient heating?

Inverse recovery sequence
Gradient echo
Conventional spin echo
Single shot fast spin echo

A

Single shot fast spin echo

48
Q

A patient has a medication patch on them with a foil backing. This patient is at risk of what?

Magnohydrodynamic effect
Missile effect
Peripheral nerve stimulation
Burning

A

Burning

49
Q

Which of the following will influence the SAR? Select all that apply.

Type of RF coil
Body shape and size
The tissue permittivity
The tissue conductivity

A

Type of RF coil
Body shape and size
The tissue permittivity
The tissue conductivity

50
Q

Which of the following pulse sequences will produce the most heating?

Conventional spin echo
DWI
Conventional gradient
Fast spin echo

A

Fast spin echo

51
Q

Which of the following are risks associated with a linearly placed pacing wire within a patient?

Resonant heating
Radiant heating
Loop induction
Near field burning

A

Resonant heating

52
Q

A patient has a removed vagus stimulator with the leads left in and is having an MR knee scan performed with a transmit-receive coil. In terms of patient burning, is the risk low?

Yes, only if that patient is less than 200lb
Yes, only with a heat sink
No
Yes

A

Yes

53
Q

Which of the following techniques can be used to reduce the heating in a fast spin echo?

Increase the echo spacing
Reduce the TR
Increase the flip angle
Tell them to hold their breath

A

Increase the echo spacing

54
Q

Which of the following will create RF energy localized to only a specific body part?

None of the choices
Receive only coil
Body RF coil
Transmit-receive coil

A

Transmit-receive coil

55
Q

A patient has a carotid stent and is having an MR knee scan performed. In terms of patient heating, can this patient be scanned with relatively low risk?

Yes, only with a heat sink
No
Yes
Yes, only if that patient is less than 200lb

A

Yes

56
Q

If you expose a patient to RF energy, which of the following items could burn a patient? Select all that apply.

Insulated wire with the ends touching the patient
Sternal wires
BB
Cardiac stent
Femur rod

A

Insulated wire with the ends touching the patient

57
Q

What is the relationship between SAR and field strength?

Inverse
Linear
Squared
Logarithmic

A

Squared

58
Q

Which of the following can be used to reduce a proximity burn?

Use ECG gating
Use a barrier between the patient and the gantry
Unwind loops in wires from the static magnetic field
Increase TR

A

Use a barrier between the patient and the gantry

59
Q

A patient is undergoing an MR brain and has pacing wires. What would lower the risk of this exam? Select all that apply.

It is never safe
Increase the flip angle
Ice pack on the patient’s chest
Using a transmit-receive brain coil
Decrease TR

A

Using a transmit-receive brain coil

60
Q

An obese patient is laying in the MR gantry and has bare skin touching the sides of the bore. What is she at risk of?

Magnetophosphenes
Missile effect
Peripheral nerve stimulation
Proximity burning

A

Proximity burning

61
Q

Which of the following will reduce the risk of patient with a pacing wire from getting burned? Select the best answer given that the patient is having an MR pelvis performed.

Advance patient into scanner head first
Place an ice pack on the patient’s chest
Don’t expose wires to the gradient field
Position patient with pacing wires as far from RF exposure field

A

Position patient with pacing wires as far from RF exposure field

62
Q

A patient is warming up during their exam. What can be done to reduce the heating? Select all that apply.

Decrease phase encoding
Use parallel imaging
Increase slices
Increase the TR
Increase the ETL

A

Decrease phase encoding
Use parallel imaging

Increase the TR

63
Q

Why does a fast spin echo produce more heat than a conventional spin echo sequence?

It doesn’t use a 180-degree RF pulse
It does not
It contains more 180-degree refocusing pulses
It has more gradient activations

A

It contains more 180-degree refocusing pulses

64
Q

Why is magnetic shielding used on an MR unit?

To reduce heating
To reduce the e-fields
To maintain field homogeneity
To limit the fringe field

A

To limit the fringe field

65
Q

When performing an MR pelvis scan, which of the following would cause the most artifact in our exam?

Titanium hip replacement
Dacron iliac graft
IUD
Ureter stent

A

Titanium hip replacement

66
Q

______ magnetic shielding uses coils of wire in the opposite direction than found with the coil of wire used to produce the static magnetic field.

Active
Passive

A

Active

67
Q

The spatial magnetic gradient has the most influence on which of the following?

Translational force
Peripheral nerve stimulation
Heating
Noise

A

Translational force

68
Q

Testing has shown that larger deflection angles in implants have been seen when objects are exposed to a _____-bore MR system when compared to a _____-bore MR system. This means that _____-bore MR unit have a steeper magnetic spatial gradient.

short, long, short
short, long, long
long, short, long
long, short, short

A

short, long, short

69
Q

Translational force is typically strongest where?

At every 10cm from isocenter
Along the table
Isocenter
By the control panel on the MR unit

A

By the control panel on the MR unit

70
Q

The differences in magnetic field strength as you approach the MRI unit are termed what?

Gauss line
Gradient coils
RF energy
Spatial magnetic gradient

A

Spatial magnetic gradient

71
Q

Which of the following will produce the largest artifact in MRI?

Super paramagnetic objects
Diamagnetic objects
Paramagnetic objects
Ferromagnetic objects

A

Ferromagnetic objects

72
Q

When performing an abdominal MRI, which of the following would pose the largest artifact issue?

Femur rodding with titanium
Sternal wires with stainless steel
Descending aortic aneurysm repair with stainless steel mesh
Lumbar 4-5 fusion with stainless steel

A

Descending aortic aneurysm repair with stainless steel mesh

73
Q

A patient coming in for an MRI of the lumbar spine for pain, what would you say the level of risk is?
Use a saturation band over the implant
Cannot scan a lumbar spine
Low
High

A

Low

74
Q

It is common to find superconductive MRI units manufactured with vertical magnetic fields.

False
True

A

False

75
Q

Rotational force is strongest where?

It is uniform everywhere
On the table
At the control panel on the MR unit
Isocenter

A

Isocenter

76
Q

How do you determine the total attractive force of a ferrous object at a given magnetic field strength?

By the speed of the gradient coils and the static magnetic field.
Using the SAR.
By the static field strength and the spatial magnetic gradients.
By the static magnetic field strength.

A

By the static field strength and the spatial magnetic gradients.

77
Q

A BB is located near a vessel. Would you consider this a high risk to the patient?

Depends on if it is stainless steel or not
Maybe
Yes
No

A

Yes

78
Q

What formula is mathematically used to describe the spatial magnetic gradient?

dB/dx
dB/dt
Gauss
W/kg

A

dB/dx

79
Q

A patient has a non-ferrous MR conditional pain pump and as you advance them in very quickly, they start to complain that the pain pump is moving. What would you do?

Tell them that the pain pump is safe and that nothing will happen to them.
Since the pain pump is non-ferrous, it is not possible for it to move.
Cancel the patient’s exam.
Advance the patient into the gantry slowly.

A

Advance the patient into the gantry slowly.

80
Q

Typically, where is the area surrounding the MR unit with the highest spatial magnetic gradient field?

Isocenter
Area peripheral to the opening of the bore
At the 5 gauss line
MR table prior to being advanced into the gantry

A

Area peripheral to the opening of the bore

81
Q

When scanning an MR pelvis on this patient for pain, what would you say the risk to the patient is?

Only with a heat sink
Not for a knee
Moderate
High

A

Moderate

82
Q

How do we calculate the maximum spatial gradient/force product?

dB/dx * B
dB/dt * W/kg
B
W/kg

A

dB/dx * B

83
Q

If a standard of care is not delivered to a patient and DID NOT result in injury, it is called what?

Tort
Negligence
Malpractice
Felony

A

Negligence

84
Q

Which of the following can be used to test if an object is ferrous? Select all that apply.

Radiograph
Ferromagnetic detection system
Metal detector
Tester magnet

A

Ferromagnetic detection system

Tester magnet

85
Q

What are the patient FDA limits for the time-varying gradient coils?

35 T/s
To the comfort of the patient
To the point a patient has a seizure
10 T/s

A

To the comfort of the patient

86
Q

An MRI technologist has heart disease and requires a pacemaker. What does this mean for this technologist?

They are unable to work in the MR environment.
They can go into the MR environment as long as they can meet their pacemakers conditions
None of the choices
They must limit their time in zone IV.

A

They can go into the MR environment as long as they can meet their pacemakers conditions

87
Q

If a standard of care is not delivered to a patient and this resulted in an injury to that patient, it is called what?

Infraction
Malpractice
Tort
Negligence

A

Malpractice

88
Q

MRI magnets can explode because ______.

Helium converts to gas in the Dewar
Helium is flammable
Magnetic can not explode
Helium is reactive with air

A

Helium converts to gas in the Dewar

Helium is reactive with air

89
Q

What is a deposition in a court case?

The opening words in a court case.
The final verdict in a case.
The reason why a defendant is on trial.
A testimony of what happened.

A

A testimony of what happened.

90
Q

A technologist is on their cellphone while a patient is being scanned. The patient is trying to get a hold of the technologist, but the technologist doesn’t notice. This is an example of what?

Tort
Felony
Malpractice
Negligence

A

Negligence

91
Q

What is defined in the captain of the ship doctrine?

It defines the fact that there is a person who is responsible for the care of another.
None of the choices
It does not apply in medicine.
It states that the technologist is responsible for the care of a patient.

A

It defines the fact that there is a person who is responsible for the care of another.

92
Q

Which of the following are true of level 1 MR personnel according to the ACR Manual on MRI Safety? Select all that apply.

Have enough MR safety training to take care of themselves in the MRI environment
Can perform an MRI scan
Can enter zone III unaccompanied
Can be responsible for non-MR personnel in zone IV

A

Have enough MR safety training to take care of themselves in the MRI environment

Can enter zone III unaccompanied

93
Q

Which of the following is an ASTM MR label used in MRI? Select all that apply.

MR compatible
MR safe
MR conditional
MR unsafe

A

MR safe
MR conditional
MR unsafe

94
Q

What is the ICNIRP occupational workers dose for magnetic flux limit to the extremities?

2 Tesla
8 Tesla
400 milliTesla
14 Tesla

A

8 Tesla

95
Q

An MR technologist is distracted by another patient and brings a non-MR compatible O2 tank into the room which severely injures a patient. This is an example of what?

Malpractice
Negligence
Tort
Infraction

A

Malpractice

96
Q

What is the ICNIRP occupational workers dose for magnetic flux limit for the head and torso?

2 Tesla
14 Tesla
400 milliTesla
8 Tesla

A

2 Tesla

97
Q

Which are true of individuals WORKING in zone 3 according to the ACR Manual on MRI Safety? Select all that apply.

Competencies must be done annually
MR screening sheet should be filled out
Must complete one live or prerecorded competency in MR safety
Maybe level 1 or 2 MR personnel.

A

Competencies must be done annually
MR screening sheet should be filled out
Must complete one live or prerecorded competency in MR safety
Maybe level 1 or 2 MR personnel.

98
Q

What organization is responsible for defining the limits of the MRI environment on occupational works?

ACR
FDA
JCAHO
ICNIRP

A

ICNIRP

99
Q

Which of the following are true of MR level 1 personnel according to the ACR Manual on MRI Safety? Select all that apply.

Can enter zone III unaccompanied
Need annual basic MR safety training
Can be responsible for non-MR personnel in zone IV
Can perform an MRI scan

A

Can enter zone III unaccompanied
Need annual basic MR safety training

100
Q

Which of the following are true when scanning unresponsive patients according to the ACR Manual on MRI Safety 2020? Select all that apply.

Patients are suggested to be monitored during procedure.
Areas of suspected implantation should be radiographed.
Must be examined by a level 2 personnel.
Areas of scars of unknown origin, and the chest and spine region must be radiographed.

A

Patients are suggested to be monitored during procedure.
Areas of suspected implantation should be radiographed.
Must be examined by a level 2 personnel.
Areas of scars of unknown origin, and the chest and spine region must be radiographed.

MRSO 2 (17 decks)

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