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Ct Review Class > Ch5 Iv And Contrast > Flashcards

Ch5 Iv And Contrast Flashcards

1
Q

Contrast agent p 4

A

Compound usually pharmaceutical in nature, which when administered to a patient , may improve the sensitivity and specify clinical diagnoses

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2
Q

Most contrast agents used do what? P 4

A

Caused perfumed tissues to enhance

Appear brighter on images because attenuated xray beam

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3
Q

Negative contrast agents p 4

A

Air

Water

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4
Q

Two things negative contrast agents do? P 4

A

Distend structure

Improve visualization of internal structures

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5
Q

Five contrast media categories p 4

A 
Intravenous
Oral
Rectal
Intrathecal
Intraarticulate
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6
Q

Increases the attenuation of X-ray beam and causes enhancement? P 6

A

Iodine

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7
Q

Intravenous contrast p 6

A

Injected into bloodstream

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8
Q

Iodine causes what on ct film? P 6

A

Brighter image

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9
Q

Enhancement p 6

A

Increased brightness by contrast on ct image

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10
Q

Ionic agents p 6

A

Break into charged particles in the bloodstream

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11
Q

Non-ionic contrast p 7

A

Do not divide into charged particles rather entire until excreted by kidneys

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12
Q

Effects how well contrast tolerated p 7

A

Less an agent breaks down into greater number charged particles , the better tolerated

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13
Q

Osmolality p 7

A

Concentration of molecular particles in contrast agent

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14
Q

Two iv contrast osmality groups

A

Low osmolar

High osmolar

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15
Q

Non ionic contrast and osmaliity p 7

A

Low osmolar category due to lower concentration of particles

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16
Q

Lower the osmolity effects on the patient p 7

A

Better tolerated by patient

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17
Q

Why need drink lots water both before and after contrast exam? P 7

A

Hypertonic solutions compared to blood plasma cause movement of water within tissues into vascular space, causing dehydration

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18
Q

Viscosity p 8

A

Measure of thickness of liquid related to frictional force of molecules of substance as they pass one another

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19
Q

______the contrast the more force required to administer the solution . Therefore , _____ viscosity is better

A

Thicker

Lower

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20
Q

Kidneys have hard time clearing ____ molecules out blood p8

A

Large

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21
Q

Minor reactions

A 
Nausea
Chills
Vomiting
Feeling warm
Minor hives
Metallic taste 
Itching
Shaking 
Headache 
Dizziness 
Sweating
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22
Q

Moderate reactions

A 
Moderate hives
Change pulse rate
Hypotension/ hypertension
Wheezing
Bronchospasm/ larygynospasm 
Facial edema
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23
Q

Two mechanisms of reactions p 8

A

Chemotoxic reaction

Idiosyncratic

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24
Q

Chemotoxic reaction p 9

A

Effected by total volume of the agent and rate of injection

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25
Q

Idiosyncratic reaction p9

A

Reactions not caused by injection rate and type

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26
Q

Ionic, high osmolar contrast has more molecular particles than low osmolar contrast resulting in ? P 10

A

Osmotic process- draw water from body tissues and cells

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27
Q

____ reduces viscosity of contrast prior to injection

A

Warming

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28
Q

_____ the viscosity the more force to inject causing injection site pain

A

Thicker

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29
Q

______injection rates and _____ concentration of contrast have increased reactions

A

Higher

Higher

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30
Q

Pre medicating patient with before injection? P 12

A

Antihistamine

Steroid

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31
Q

Minimizing adverse reactions p 13

A

Read al labels

Know non ionic contrast for diabetics and diseases of liver or kidneys

Low osmolity and low viscosity the better

Warm contrast to body temperature to reduce viscosity

Pre medicate with antihistamine and steroid to recuse idiosyncratic reactions

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32
Q

Precaution p 13

A

Condition that would warrant medical decision as to whether the benefits of the exam outweigh the risks posed to the patient

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33
Q

Contraindication p 13

A

Condition that would preclude a patient from having a study performed in a given manner

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34
Q

Extra action contrast agents with these diseases : p 14

A 
Liver 
Kidney 
Thyrotoxicosis
Myelomatosis
Diabetes
Multiple myeloma 
Sickle cell
Pheochrmocytoma
Hyperthyroidism 
History of reaction 
Asthma
Hay fever
Food allergies
Congestive heart disease
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35
Q

Iv contrast to pregnant lady when ? P 14

A

No other modality can obtain diagnostic info

If the ct would affect the fetus

If ct. can’t wait until after pr egnancy

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36
Q

When to breast feed after ct injection p 14

A

Safe right after or if mom wants wait 24 hrs

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37
Q

Bun

A

5-25 mg/dl

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38
Q

Creatinine

A

0.6-1.7 mg/dl

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39
Q

Gfr

A

95-120 ml/min/1.73 m2

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40
Q

eGFR

A

> 60

41
Q

In healthy adult, How long for 50% of all contrast out blood stream? P 15

A

2hrs

42
Q

Normal pt

A

10-14 sec

43
Q

Normal ptt

A

20-40 sec

44
Q

Normal inr

A
  1. 9-1.3
  2. 0-3.9 for patient on anticoagulant
  3. 5-3.5 patients with high risk clot formation
45
Q

Platelet count

A

150,000/mm3- 400,000/mm3

46
Q

Why fasting important for injection ? P 16

A

Perstslsis creates motion

Vomiting

47
Q

Diabetic or renal insufficiency patients and injection p 17

A

Low,osmolar

Non ionic

48
Q

Metformin ( glucophage, glucovance ) acr 3 caogries

A

No metformin 48hrs after exam

Metformin resumed after Blooodwork is done to confirm kidney function

Patients with renal insufficiency should stop metformin before injection and should be monitored after

49
Q

Technique used prior intravenous injection p 18

A

Aseptic technique

50
Q

Optimum injection enhancement is achieved at higher injection rates of ___-____

A

5-6 ml/sec

51
Q

Power piccs are used at injection rates of ________

A

Up to 5ml/sec

52
Q

Regular picc lines and injection p 18

A

Can’t be used for injection

53
Q

Type gauge needle p19

A

18-22 gauge

54
Q

22 gauge needle allows rates up to ?

A

3 ml /sec

55
Q

Required for 5/ml

A

18 gauge needle injection rate

56
Q

If site hand

A

Slow injection rates

57
Q

Most common site for injection p20

A

Basilic vein in cubital fossa

58
Q

How distend vein for injection p 20

A

Apply tourniquet
Have patient pump hand
Slap vein
Apply heat

59
Q

Signs of extravastion what must be done? P 22

A

Stop injection

60
Q

Venous air emboli p 22

A

Air introduced into vein during injection

61
Q

Three tissue enhancement phases p 23

A

Bolus phase

Non equilibrium phase

Equilibrium phase

62
Q

Bolus phase p 23

A

Enhanced begins when contrast injected

Significant density difference between abdominal aorta and inferior vena cava

Bolus moves away from heart

Optimal quality cta imaging

63
Q

Non equilibrium phase p 23

A

10-30 HU density difference between abdominal aorta and inferior vena cava

Bolus disperses into capillaries then into the veins

Best differentiation in soft structures

64
Q

Since _______has dual supply , timing of scan is crucial p 24

A

Liver

65
Q

Equilibrium phase p 24

A

Density difference of less than 10 hu between abdominal aorta and inferior vena cava

Concentration in veins becomes similar to concentration in arteries

66
Q

Hepatic arterial phase p 24

A

20-40 sec into injection

67
Q

Portal venous phase p 24

A

60-90 s into injection

68
Q

Liver injection phases p 24

A

Hepatic arterial phase

Portal venous phase

69
Q

Opacification by oral contrast agents used? P 27

A

Reduce risk of misdiagnosing fluid filled bowel as abscess or tumor and helps visualize lesion is exterior to the bowel or if it infiltrates the bowel

70
Q

Oral contrast media p 27

A

Barium sulfate

Iodinated

71
Q

Barium used in ct vs conventional radiography ? P 29

A

Conventional barium too high density causing sever streak artifacts

72
Q

Barium passes through gi tract without _____? P 29

A

Being absorbed or metabolized

73
Q

Adverse reactions barium p 29

A 
Diarrhea 
Abdominal cramping
Barium granuloma
Barium appendicitis
Intestinal perforation
Peritonitis
74
Q

Contraindications of barium p 30

A

Colon obstruction

Tracheosopageal fistula

Obstructing lesions of small intestine

Pyloric stenosis

Hypersensitivity to barium sulfate

75
Q

Barium passes gi tract? P 30

A

Less than 2 hours

76
Q

Iodinated oral contrast are more ____ than iv agent

A

Diluted

77
Q

When to use iodinated oral agents vs barium? P 30

A

When contraindicated

78
Q

How long Iodinated oral contrast passes through gi ? P 31

A

2 hrs

79
Q

Post myelographic ct p 34

A

Elevate head

Confirm density of contrast media

Ensure contrast media does not separate from csf

80
Q

Intraarticuar exam p 35

A

Injected into patient joint under fluro

81
Q

Contrast for head exams p 36

Amount?

Delay?

No?

A

Dose 100 ml

Scan delay up to 5 mins after injection

No oral contrast

82
Q

Normally enhanced during contrast ct of the head ? P 36

A

Blood vessels
Choroid plexus
Dura

83
Q

Non contrast studies of head show ? P 37

A

Sininutis, trauma bleed, Graves’ disease, early cerebrovascular events, early subdural hematoma, hydrocephalus, dementia, mastoiditis, labyrinthisis, facial or seventh nerve palsy, hearing loss, perteous and temporal bone

84
Q

Contrast for neck ct pg 37

Amount

Injection rate

Delay

No?

A

Dose 100 ml

Injection rate 3 ml / sec

Scan delay 35 sec

No oral contrast

85
Q

Ct neck with contrast allows differentiation of ? P 37

A

Blood vessels from lymph nodes and outline epidural venous plexus

86
Q

Studies used for ct neck with contrast p 38

A 
Neck mass
Lymph nodes
Parathyroid adenoma
Paratoid gland mass
Oral pharynx
Larynx
Brachial plexus
87
Q

Contrast for chest exam p 38
Dose

Rate

Delay

A

Dose 100 ml

Injection rate 3 ml/sec

Scan delay 30 sec

No oral contrast

88
Q

Studies of abdomen require both ____ ? P 39

A

Oral and iv contrast

89
Q

Oral contrast abdomen ct helps ? P 39

A

Opacity gi tract helps decrease risk of mistaking fluid filled bowel for tumor or abscess

90
Q

Ct abdomen with contrastrSt shows? P 39

A

Mass
Lesions
Vascular abnormalities
Trauma

91
Q

Contrast for abdominal exams p 40

A

Dose 75-150 ml

Injection rate 2-4 ml/s

Scan delay
Liver: 70-80 sec

Pancreas: 50-60 sec

Kidneys: 80-90 sec

Oral contrast used

92
Q

Biphasic liver study p 41

A

Used to perform differentiate liver lesions with arterial blood supply And those with venous blood supply

93
Q

Cta study used for ? P 43

A

Evaluation of arteries and vessels

94
Q

Why a cta exam? P 43

A

Narrowing by atherosclerosis

Anuerysms

Dissections

Traumatic injury

Congenital vascular anomolies

Effects of vascular treatment

95
Q

Cta injection rate ? P 44

A

3-5 ml/sec

96
Q

For cta exam, thin slices collected _______ direction of blood flow ? P 44

A

Same direction

97
Q

Cta exams increasing the _____ scans vessels faster p 45

A

Pitch

98
Q

Reconstruction of slices in cta p 45

A

With overlap which increases resolution

Ct Review Class (7 decks)

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