Contrast Media - Review 2

Question 1

Ingested by mouth

Answer 1

Route: Oral; Example: Upper GI, Esophagram,

Rehab swallow study

Question 2

Administered rectally

Answer 2

Rectal; Barium enema (BE)

Question 3

Administered by injection

using a needle

Answer 3

Parenteral

Question 4

Administered directly into

a vein

Answer 4

Parenteral-Intravenous; IVU

Question 5

Administered directly into

an artery

Answer 5

Parenteral-Intra-arterial; Arteriogram

Question 6

Administered directly into

a sheath

Answer 6

Parenteral-Intrathecal; Myelogram

Question 7

Administered against the

normal flow

Answer 7

Retrograde; Cystogram, VCUG, BE

Question 8

Anatomic areas filled with negative contrast media will

appear ________________ on radiographs.

Answer 8

dark

Question 9

List examples of positive contrast media.

Answer 9

barium sulfate & iodinated contrast media

Question 10

What is the atomic number of barium?

Answer 10

56

This makes it radiopaque

Question 11

What is the chemical formula of barium sulfate?

Answer 11

BaSO4

1 atom of barium + 1 atom of sulfur + 4 atoms of oxygen

Question 12

Describe a colloidal suspension.

Answer 12

Particles are suspended in the water
and will settle out when allowed to
sit for too long

Question 13

What type of barium is best suited to coat the

mucosal lining of the esophagus?

Answer 13

Thick barium

Question 14

What are barium pills used for?

Answer 14

to evaluate for strictures in the

esophagus

Question 15

List contraindications for the administration of

barium.

Answer 15

 Suspected colon obstruction
 Gastrointestinal perforation
 Transesophageal fistula
 Obstructing lesions of the small intestine
 Inflammation or neoplastic lesions of the rectum
 Pyloric stenosis
 Paralytic ileus
 Gastrointestinal hemorrhage
 Toxic megacolon
 Recent gastrointestinal biopsy or surgery (within 3-5
days)
 Pre-op or pre-endoscopy

Question 16

A patient must undergo a small bowel series today and is
scheduled for abdominal surgery tomorrow. What type of oral
contrast should be used?

Answer 16

Oral iodinated contrast media

Gastrografin or Gastroview

Question 17

What is the most common complication of

barium administration?

Answer 17

Constipation

Question 18

List other complications of barium

administration.

Answer 18

 Perforation (extravasation into the abdominal cavity)
 Vaginal rupture caused by incorrect placement of the
catheter for lower GI exams (very rare)
 Fluid overload resulting from water absorption from
the colon
 Aspiration into the lungs (can result in barium
pneumonia)
 Allergic reactions (rare)

Question 19

What is the atomic number of iodine?

Answer 19

53

Question 20

A double contrast study involves the

administration of what types of contrast media?

Answer 20

radiopaque (positive) and radiolucent

(negative) contrast media

Question 21

Define osmolality.

Answer 21

A measure of the total number of
particles in a solution per kilogram of
water

Question 22

Define viscosity [tính nhớt
•tính dẻo, tính dính
cua chat long]

Answer 22

Resistance of fluid to movement; measured by the
amount of force required to move liquid under
specific conditions
Commonly referred to as the “thickness” of a fluid

Question 23

What is the difference between ionic contrast

media and non-ionic contrast media?

Answer 23

Ionic contrast – iodine molecules dissociate in a
solution; greater chance of adverse reaction
Non-ionic contrast – iodine molecules do NOT
dissociate in a solution; less chance of adverse reaction

Question 24

What type of contrast media contains the

same number of particles as blood plasma?

Answer 24

Isomolal

Visipaque is an example

Question 25

List some common side effects of injectable | iodinated contrast media.

Answer 25

Temporary hot flash | Metallic taste in the mouth

Question 26

What is extravasation? How is it treated?

Answer 26

Extravasation is the discharge or escape of fluid from a vessel into the surrounding tissue resulting in acute, local inflammation. Treat with a cold compress followed by a warm compress to relieve pain and promote reabsorption of extravasated contrast media

Question 27

Question: 27 to 36: For each reaction to injectable iodinated contrast media, indicate whether the reaction is Mild, Moderate, or Severe. Vomiting:

Answer 27

Mild [nhe]

Question 28

Arrhythmia

Answer 28

SEVERE [thiet nang]

Question 29

Tachycardia

Answer 29

MODERATE [trung binh]

Question 30

Urticaria

Answer 30

MODERATE

Question 31

Nausea [chong mat]

Answer 31

MILD

Question 32

Anaphylactic Shock

Answer 32

SEVERE

Question 33

Dyspnea

Answer 33

MODERATE

Question 34

Dysphagia

Answer 34

MODERATE

Question 35

Laryngeal swelling

Answer 35

SEVERE

Question 36

Anxiety

Answer 36

MILD

Question 37

List some contraindications [su cho ngai] of injectable | iodinated contrast media.

Answer 37

 Hypersensitivity to iodinated contrast media  Anuria (a.k.a. anuresis) - absence of urine excretion  Multiple myeloma  Diabetes, especially diabetes mellitus  Severe hepatic or renal disease  Congestive heart failure  Pheochromocytoma  Sickle cell anemia  Patient on certain diabetic medications (i.e. Metformin, Glucophage, Avandament, etc.)  Medication should be withheld for 48 hours after the completion of the iodinated contrast media study  Renal failure (acute or chronic)

Question 38

What is the kVp range used for the following | contrast studies?

Answer 38

 Single-contrast barium studies – 110-120 kVp  Double-contrast barium studies – 90 kVp  Injected iodinated contrast studies – 80-85 kVp

Question 39

Questions 39 - 41: Measures of Kidney Function: -BUN (blood urea nitrogen)

Answer 39

Normal Range*: 8 – 24 mg/dL for adult men 6 – 21 mg/dL for adult women

Question 40

Creatinine Level

Answer 40

Normal Range: 0.6 – 1.2 mg/dL (many facilities will not inject patients with a level above 1.5)

Question 41

GFR (glomerular filtration rate)

Answer 41

``` Normal range: Normal kidney function = 90-130 Mild kidney damage = 60-90 Moderate kidney damage = 30-60 Severe kidney damage = 15-30 Kidney failure = 0-15 ```

Question 42

Describe the valsalva maneuver that can be | used during an esophagram.

Answer 42

Patient takes in deep breath and holds breath in while bearing down as if trying to move the bowels

Question 43

What kind of patient preparation is needed | for an UGI?

Answer 43

Food and water withheld after midnight for 8 to 9 hours before examination (NPO) Stomach should be empty

Question 44

Which view in the UGI series is best for | evaluation of a hiatal hernia?

Answer 44

PA

Question 45

A small bowel series is considered complete | when the contrast is seen in the ________

Answer 45

Cecum | must pass the ileocecal valve

Question 46

When the balloon of the retention tip used for a barium enema is inflated with one squeeze, how much air will fill the balloon?

Answer 46

90 mL of air

Question 47

Most barium enema bags have a capacity of | mL and the tubing is approximately feet long.

Answer 47

``` 3000 mL (3 quarts) 6 feet ```

Question 48

What temperature should the barium be for a | barium enema?

Answer 48

85 - 90 F  Barium that is too warm can injure the intestinal tissues and be hard for the patient to retain  Barium that is too cold can cause cramping

Question 49

Describe the Sims position

Answer 49

Patient is instructed to roll onto the left side, then roll forward about 35-40 degrees, and rest the flexed right knee on the table above and in front of the slightly flexed knee

Question 50

What should the height of the barium bag be | for a barium enema?

Answer 50

Height of bag should be 19-24 inches above | the level of the anus

Question 51

Why is it important to void the bladder prior | to an intravenous urogram (IVU)?

Answer 51

A bladder that is too full could rupture, especially if compression is used. Urine already present in the bladder dilutes the contrast media that accumulates there.

Question 52

When using compression for an IVU, at what | level is the compression placed on the patient?

Answer 52

Compression is centered over level of anterior | superior iliac spine (ASIS)

Question 53

What are some contraindications to using | compression for an IVU?

Answer 53

```  Urinary stones  Abdominal mass  Aortic aneurysm  Colostomy  Suprapubic catheter  Traumatic injury  Recent abdominal surgery  Severe abdominal pain ```

Question 54

A nephoromogram is done to visualize the :

Answer 54

``` renal parenchyma (nephrons and collecting tubes) ```

Question 55

When performing the RPO view for an IVU, | which kidney is best seen?

Answer 55

Right | side closest to IR