Contrast media, ivp, and cystogram Flashcards
(169 cards)
1
Q
how is contrast introduced for a cystogram
A
retrograde through catheter
2
Q
Anything in the abdominal cavity must be
A
removed
3
Q
do you have to remove a bra?
A
yes
4
Q
contrast starts from:
A
kidneys to bladder
5
Q
Do a scout……… injecting contrast
A
before
6
Q
Currently we use ionic or nonionic contrast?
A
non-ionic contrast
7
Q
Non ionic was first introduced in:
A
1984 (cost more)
8
Q
What are the two methods to administer contrast? and which is more common?
A
1)Bolus and 2)Drip infusion. The most common one is Bolus
9
Q
2 most common types of needles used for bolus injection of contrast media
A
- Butterfly
2. Over the needle catheter
10
Q
The structure that considered to be most posterior
A
Kidneys
11
Q
TRUE or FALSE: The patient must sign an informed consent form before a venipuncture procedure is performed on a pediatric patient
A
True
12
Q
For most IVUs, veins in the ___ are recommended for venipuncture
A
Antecubital Fossa
13
Q
The most common size of needle used for bolus injections on adults
A
18 to 22 gauge
14
Q
TRUE or FALSE: The bevel of the needle needs to be facing downward during the actual puncture into a vein
A
FALSE, upward
15
Q
TRUE or FALSE: If extravasation occurs during the puncture, the tech should slightly retract the needle & then push it forward again
A
FALSE, needle should be withdrawn and pressure applied
16
Q
TRUE or FALSE: If unsuccessful during the intial puncture, a new needle should be used during the second attempt
A
TRUE
17
Q
TRUE or FALSE: The radiologist is responsible for documenting all aspects of the venipuncture procedure in the patient’s chart
A
FALSE, the person who performs it is responsible
18
Q
Name the iodinated contrast media from the charactertistics listed: Uses a parent compound of a benzoic acid; creates a hypertonic condition in the blood plasma; Poses a greater risk for disruptiing homeostasis, may increase the severity of side effects
A
Ionic
19
Q
Name the iodinated contrast media from the characteristics listed: Doesn’t significantly increas osmolality in blood plasma; is more expensive; is near a isotonic solution; uses a parent compound of an amide or glucose group
A
Nonionic
20
Q
Name the first 3 steps of a venipuncture procedure in order
A
- Wash hands and put on gloves
- Select site, apply tourniquet & cleanse the site
- Initiate puncture
21
Q
Name the last 3 steps of a venipuncture procedure in order
A
- Confirm entry and secure needle
- Prepare and proceed with injection
- needle or catheter removal
22
Q
The compound is a common anion in ionic contrast media
A
Diatrizoate or iothalamate
23
Q
Leakage of contrast from the vein to the surrounding soft tissue
A
IV contrast extravasation
24
Q
Confirm correct content and expiration date before:
A
Injecting
25
Document expiration date, lot number, amount of contrast injected and Radiologist name on request
True
26
Contrast agents have been around since the
1950s
27
Organic iodinated contrast media (ICM) have been amongst the most ..........used prescribed drugs in the history of modern medicine.
Commonly
28
ICM have a good
Safety track record
29
Adverse effects from intravascular administration are generally
mild and self limiting.
30
The kidneys & ureters are located in the ___ space
Retroperitoneal
31
The ___ glands are located directly superior to the kidneys
Suprarenal (Adrenal) glands
32
The structures that create a 20 angle between the upper pole & lower pole of kidney
Psoas Major muscles
33
The specific namefor the mass of fat that surrounds each kidney
Perirenal fat or adipose capsule
34
The degree of rotation from supine that is required to place the kidneys parallel to the IR
30
35
2 Landmarks that can be palpated to locate the kidneys
xiphoid process and iliac crest
36
The term that describes an abnormal drop of the kidneys when the patient is placed erect
nephroptosis
37
3 functions of the urinary system
1. remove nitrogenous waste
2. regulate water levels
3. Regulate acid base balance
38
A buildup of nitrogenous waste in blood
Uremia
39
The longitundinal fissure found along the central medial border of the kidney
Hilum
40
The peripheral or outer portion of the kidney
Cortex
41
The term that describes the total functioning portion of the kidney
Renal parenchyma
42
The microscopic functional & structural unit of the kidney
Nephron
43
The structure of the medulla that is made up of a collection of tubules that drain into the minor calyx
Renal pyramids
44
Another name for the glomerular capsule
Bowmans capsule
45
TRUE or FALSE: The glomerular capsule & proximal & distal convoluted tubules are located in the medulla of the kidney
False, cortex
46
TRUE or FALSE: The efferent aterioles cary blood to the glomeruli
FALSE, afferent
47
Name structures located in the cortex of the kidney
Distal & proximal convoluted tubule, Glomerular capsule, Afferent & Efferent arterioles
48
Name structures located in the medulla of the kidney
Loop of henle, Descending & Ascending limb, Collecting tubule
49
2 processes that move urine through the ureters to the bladder
Perisalsis and Gravity
50
The structure that is located more anterior as compared with the others
Urinary bladder
51
The name of the junction found between the distal ureters & urinary bladder
ureterovesical junction
52
The name of the inner, posterior region of the bladder formed by the 2 ureters entering & the urethra exiting
Trigone
53
The name of the small gland found just inferior to the male bladder
Prostate Gland
54
The total capacity for the average adult bladder
350 to 500 ml
55
The structure that considered to be most posterior
Kidneys
56
2 ways intravenous contrast media is administered
1. Bolus injection
| 2. Drip infusion
57
Any disruption in the physiological functions of the body that may lead to a contrast media reaction is the basis for this theory
Chemotoxic theory
58
The normal creatinine level of an adult
0.6 to 1.5 mg/dl
59
Normal BUN levels for an adult
8 to 25 mg/100 ml
60
Metformin hydrochloride is taken for this condition
Diabetes mellitus
61
Metformin should be withheld for ___ hours following a conttrast media procedure
48 hours
62
4 general categories of contrast media reactions
1. mild
2. moderate
3. severe
4. organ specific
63
This type of reaction is a true allergic response to iodinated contrast media
Anaphylactic reaction
64
This type of reaction is due to the stimulation of the vagus nerve by introduction of contrast media, which causes heart rate & bp to fall
Vasovagal reaction
65
TRUE or FALSE: Vasovagal reactions are not considered to be life threatening
false
66
TRUE or FALSE: Acute renal failure may occur 48 hours following an iodinated contrast media procedure
true
67
Hypersensitivity to iodinated contrast media, Anuria, multiple myeloma, diabetes mellitus, sever hepatic renal disease, congestive hear failure, pheochromocytoma, patient taking metformin, renal failure, acute or chronic are contraindications of what?
Contraindications that may prevent from having a contrast media procedure performed
68
List symptoms for a mild reaction to contrast media
Lightheadedness, mild hives
69
List symptoms for a moderate reaction to contrast media
Tachycardia, angioedema
70
List symptoms for a severe reaction to contrast media
Brachycardia, hypotension, Laryngeal swelling, cardiac arrest
71
List symptoms for a Organ specific reaction
Anuria
72
TRUE or FALSE: Mild level contrast media reactions do not usually require medication or medical assistance
true
73
TRUE or FALSE: Urticaria is the formal term for excessive vomiting
FALSE, hives
74
The leakage of contrast media from a vessel into the surrounding tissues
Extravasation
75
provides a better assessment of bladder pathology and residual urine
Post Void
76
Nephrogram visualizes the renal parenchyma
1 minute
77
Early visualization of the upper collecting system (calyces, renal pelvis, and upper ureters)
5 minute
78
Late visualization should include the lower ureters and bladder.
15-20 minutes
79
Before the contrast is injected, to evaluate renal calcifications.
Plain Tomograms
80
After injection, assess renal outline and fine calcifications
Tomograms
81
NPO ......hours after injection
4
82
*** Glomerular filtration rate (GFR) is considered by medical professionals to be the best measure of
Kidney function
83
Symptoms /Reactions from contrast
Mild – inconvenience (itching/hives)
Moderate- requires treatment for the symptoms & patient comfort
Severe - Life threatening
Emergency-(cardiac arrest)
84
AP scout KUB
Cr angle= none
Cassette= 14 x 17 LW
Pnt. Position= supine
Center= at the iliac crest
85
AP bladder shot cystogram
Cr angle= 10-15 caudad
Cassette= 10 x 12 CW
Pnt. Position= supine
Center= 2" superior to pubis symphysis
86
Oblique bladder RPO and LPO for cystogram
Cr angle= none
Cassette= 10 x 12 CW
Pnt. Position= supine
Center= 2" below the pubis symphysis and 2" medial to the ASIS
(45-60 rotation)
87
Lateral (optional) for cystogram
Cr angle= none
Cassette= 10 x 12 CW
Pnt. Position= true lateral
Center= 2" superior and posterior to the pubis symphysis
**place lead apron behind patients sacrum to reduce scatter
88
Voiding cystogram
Cr angle: none
Cassette: 10 x 12 CW
Pnt. Position:
* *AP for Females & 30 degrees RPO for Males
* * Foley catheter is removed before patient can VOID and the exposure is made while patient is voiding.
Center: perpendicular to the symphysis pubis.
89
Which of the following refers to the gauge of a needle?
Diameter size of needle
90
When selecting a vein puncture site it is preferable to select the most ...... Site in which the desired size needle can be accommodated
Distal
91
When performing an intravenous injection you should first?
Check the patients identification
92
When performing an intravenous injection when should the tourniquet be removed?
After the insertion of the needle before injection
93
Large amount at one time
Bolus
94
A typical flow rate for drip infusion is
10-20 drops per minute
95
How does negative contrast appear on a radiograph?
Less dense than surrounding tissue
96
When you may be exposed to patients blood you should
Act as if the patient may have a blood borne disease
97
What does the prefix "contra" mean?
Against
98
Non ionic water soluble iodinated contrast media
Does not dissolve into charged particles
99
A water soluble iodinated contrast media whose osmolality is high:
Has more particles in solution and increased adverse reactions
100
Allergic reactions to water soluble iodinated contrast media is thought to be due to the release of ....by cells in the body
Histamine
101
.....is the number of particles in a solution per kilogram of water
Osmolality
102
When charting drug information, which of the following is not necessary ?
Gauge of needle used
103
Medication that is administered sublingually is put
Under the tongue
104
Which of the following reactions to contrast media does not usually require treatment?
Nausea and vomiting
105
Which of the following may help make veins more prominent on patients whose veins are difficult to locate?
1. Pat or rub area
2. Apply hot packs
3. Allow arm to hang
All of the above
106
Which of the following patient factors is not a consideration for the administration of contrast media?
Gender
107
The primary disadvantage of oil based iodinated contrast media is :
It isn't absorbed in the body
108
Oil based iodinated contrast media is commonly used during a
Sialogram
109
A very high creatine level is
A contraindications for an IVU
110
The preferable water soluble iodinated contrast media would be:
Noionic with low osmolality
111
In what order should the following be done to discontinue a contrast media administration?
3. Place sterile gauze over puncture site
2. Quickly smoothly and gently remove cannula from the vein
1. Elevate extremity and apply pressure until all bleeding stops
3,2,&1
112
After the administration of contrast media which is true?
1. Do not recap the needle
| 3. Do not remove a needle from a disposable syringe
113
What does the root word "nephr" mean?
Kidney
114
What is the condition called when a patients kidney cannot excrete any urine?
Anuria
115
Root words for "renal pelvis"
Pyel
116
Another name for kidney stone
Renal calculus
117
What is hematuria?
Blood in urine
118
Condition in which, an obstructed ureter will cause the renal pelvis to dilate with urine.
Hydronephrosis
119
Wilms tumor involves which of the following ?
Kidney
120
Which of the following defines dysuria?
Painful urination
121
What is an inflammation of the kidney and renal pelvis called?
Pyelonephritis
122
Which of the following relates to the outer layer of the kidney?
Cortex
123
Cystitis would be an inflammation of which of the following organs?
Urinary bladder
124
Subject contrast relates to
The patient
125
Ureters
Lie on psoas muscles ,
28-34 cm long
1mm to 1cm in diameter
126
Ureters enter ....,bladder
Posterolateral
127
Points of constriction
1. Ureteropelvic junction
2. Pelvic brim
3. Ureterovesical junction
128
Minor calyces are ..... To major calyces
Superior
129
Major calyces are superior to
Renal pyramids
130
Cone down of kidneys
14 x 17 CW bottom of IR is at top of iliac crest
131
Nephogram
14 x17 CW
Supine
Is a blush or outline of the kidneys, it must be taken as soon as they have injected the contrast 45 sec-1 minute
132
Ivp RPO---Obliques 30 degrees
14 x 17
Cr is perp. To iliac crest
RPO- shows RIGHT kidney and ureter but LEFT kidney in profile
133
Ivp LPO--Obliques 30 degrees
14 x 17
Cr is perp. To iliac crest
LPO- shows LEFT kidney and ureter but RIGHT kidney in profile
134
Ap cone down bladder
10 x 12 supine
| Cr is perp. To a point 1& 1/2 above the pubic bone
135
Ap or pa KUB post void
14 x 17 LW
Supine/erect
Cr is Perp to iliac crest
136
Avg adult bladder holds .....ml of liquid
500
137
For cystogram a Foley catheter
Must be inserted and clamped
138
Tomography .... The area above and below the plane of interest
Blurs
139
2 types of tomography
Linear and pluridirectional
140
Linear tomography
Blurs the structures above and below the fulcrum
141
The greater the tube angle
The thinner the tomo cut
142
The smaller the tube angle
The thicker the tomo cut
143
3 elements of a tomographic system
The X-ray tube
The object
And the image receptor
144
Fulcrum
The pivot point, grossman principle
145
Exposure amplitude, angle or ARC
The total distance the tube travels
146
Thicker cut
Less than 10 degrees
147
Thinner cut
Bout 50 degrees
148
Post void must include entire bladder to evaluate...?
Enlarged prostate or prolapse
149
For Ivp you must clamp
The Foley catheter
150
Which kidney is more inferior?
The right kidney
151
two common side effects
Metallic taste and warm, flush sensation
152
what to do to the patient for a mild reaction
reassure and observe them
153
a "true allergic reaction" catagory
moderate section
154
What is moderate reaction; moderate to severe hives ex:
urticaria
155
What is age -related enlargement of the prostate gland
Benign Prostatic Hyperplasia(BPH)
156
We do expiration to get the diaphragms
Up and out if the way
157
Which slices are better for tomography?
Thinner slices
158
The more you oblique the patient
The more you get the ureter on top of the spine
159
Retrograde urography is usually done in OR and is injected
From the bottom , up
160
When there is contrast filled what structures do u see?
Renal pelvis, calyces, and ureters
161
Common reasons to do an IVP?
Kidney stones ,
Hematuria
Renal problems
162
Cystogram is only in the
Bladder
163
Why do you do the lateral cystogram?
To see Extravasation ESP for someone with a ruptured bladder
164
For a voiding cysto the patient must void on the
Table
165
For males in a voiding cysto
Must see entire right urethra, recumbent or 30 degrees RPO
166
For females voiding cysto
There AP and must extend and slightly separate legs
167
Prolapse bladder us typically for
Older people
168
For a voiding cysto the Cather must
Come out
169
For a cystogram we use .... Contrast
Ionic, because is just reaches the bladder not the bloodstream
