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Networking Systems Flashcards

Medical IT (94 cards)

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1
Q

What are some common clinical ICT systems?

A
  1. EHR/EPR
  2. MPI
  3. PAS
  4. RIS
  5. PACS
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2
Q

What is EHR/EPR?

A

Electronic Health/Patient Record:
Comprehensive electronic record of a patient’s entire health record, available anywhere in an organisation
However, the reality is a limited subset of the patient’s record, locally accessible

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3
Q

What is MPI?

A

Master Patient Index:
List of all patient’s known to an organisation, along with their demographics and ID numbers

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4
Q

What is PAS?

A

Patient Administration System:
Central administration system covering patient appointments, note tracking etc. often containing test results and acts as a portal to other systems

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5
Q

What is RIS?

A

Radiology Information System:
- Scheduling of imaging
- Resource management
- Inventory tracking
- Reporting of images
- Presentation of reports
- Report sign-off
- Billing

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6
Q

What is PACS?

A

Picture Archive and Communications Systems
- Storage of images
- Storage of other data
- Visualisation of images
- Data transfer between systems

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7
Q

What is a R&V System?

A

Verify:
Prevents linac from delivering a treatment which is out of specification, unless deviation has been authorised

Record:
Records the treatment actually delivered, including unexpected deviations and who authorised intended deviations

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8
Q

What is OMS?

A

Oncology Management System:
Incorporates
- R&V
- TPS
- General patient information
- Prescriptions
- Imaging
- Scheduling
- Documents

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9
Q

What does networking allow?

A
  • A complex system to be made up of individual, connected components
  • One clinical system to communicates with another
  • Multiple systems to be used in the care of a patient
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10
Q

What is a logical diagram?

A

Diagramatically represents a network showing how different systems link to each other with a focus on the flow of data without technical detail

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11
Q

What is a physical diagram?

A

Diagramatically represents a network showing the network topology, representing physical connections between components with technical information, often maintained by IT departments

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12
Q

What are 4 types of network architecture?

A
  1. Client/Server
  2. Standalone
  3. Hybrid
  4. Peer to peer
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13
Q

What is a client/server network architecture?

A

Client server communicates with server, with some or all of the processing performed on the server

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14
Q

What is a standalone network architecture?

A

System is not networked and contains all of its own data and performs all of its own processing

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15
Q

What is a hybrid network architecture?

A

Has elements of both client/server and standalone architectures which may acquire data from the server and then perform processing locally

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16
Q

What is a peer to peer network architecture?

A

Discrete systems communicate with each other and may be client/server and/or standalone

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17
Q

What is an application server?

A

Extreme case of client/server architecture, the application is presented via a web browser and all processing is performed on the sever. This makes it easy to distribute and upgrade applications

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18
Q

What is TCP/IP?

A

Transmission Control Protocol/Internet Protocol

More flexible and less prescriptive than ISO OSI with only 5 layers (not 7)

Bidirectional (sends data, sends back acknowledgement)

Application
Transport (TCP operates here)
Internet (IP operates here)
Data Link
Physical

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19
Q

What is the ISO OSI Model of Networking?

A

International Standards Organisation
Open Systems Interconnection

Application
Presentation
Session
Transport
Network
Data Link
Physical

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20
Q

What is IP?

A

Internet Protocol

Way to uniquely identify a device’s interface on a network to facilitate data transfer to that interface

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21
Q

An IP address is represented by how many bits, and in what format?

A

32 bits represented by 4 bytes

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22
Q

How many possible IPv4 addresses are there?

A

2^32

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23
Q

What is the form of an IP address?

A

aaa.bbb.ccc.ddd

10.1.19.246

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24
Q

What is a hub?

A

Passes data to all devices that are connected to it

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25
What is a switch?
Passes data only to the intended device, rejecting traffic if the intended device is not connected to it
26
What is a gateway?
Connects two or more subnets and can be a switch or a router
27
What is a router?
Directs network traffic between physical segments of the network
28
What is a subnet?
Defined by - the subnet address, can be any address in the range but it is usually the first - a prefix or 'netmask'
29
What is a private subnet?
A range of private IP address which can be allocated at will, but must not appear on the Internet because it is not unique (not routable over the public internet).
30
When is a private subnet used?
Within private networks within organisations or at home
31
Why is a private subnet used?
Convenience - can allocate at will Security - does not appear on the internet (isolates systems) Helps with compliance with GDPR but keeping data secure
32
What is NAT?
Network Address Translation: Mechanism by which traffic from a host on a private subnet can be directed to the Internet. The apparent (translated) address will be that of internet access point. laptop->wifi (phone)->service provider (EE)->Internet Only EE is connected directly to the internet - from the Internets perspective, it looks as if the request has come from EE Each step keeps a record of which address requested it so it knows where to send it back
33
What is a loopback address?
Special, reserved address which directs traffic back to the local computer without it reaching any 'real' network interface 127.0.0.1 It is used for testing and troubleshooting Tests whether data can sent and received Sends traffic to own computer without needing a network, to test whether data can be sent and received without needing a network interface (troubleshooting purposes)
34
What are the three private subnets (and their subnet masks)?
10.0.0.0/8 (255.0.0.0) 172.16.0.0/12 (255.240.0.0) 192.168.0.0/16 (255.255.0.0)
35
What are some radiotherapy systems?
- TPS - Dose checking - RV - OMS
36
Why was IPv6 introduced?
Running out of IPv4 addresses
37
How long is an IPv6 address and how is it represented?
128 bits long (16 bytes) represented by 8 sections of 2 bytes each using hexadecimal
38
How many IPv6 addresses are there?
2^128
39
What is an advantage and a disadvantage of IPv6?
More combinations = more possible devices/addresses May be compatibility issues, especially in healthcare
40
What is TCP?
Transmission Control Protocol: It manages data transfer as a series of bundles of information (packets). Each packet is a series of bytes sent in sequential order. Each packet has a built-in error detection/correction. Every packet is acknowledged that it has been received and if it is lost/corrupt, the packet is sent again. The data is then assembled by ordering the packets at the destination.
41
What is the structure of a TCP packet?
TCP Header Length Source port Destination port Sequence number Checksum Other Information Data
42
What is the purpose of the TCP header?
Identifies the packet as TCP
43
What is the purpose of the sequence number in a TCP packet?
Allows the data to be assembled in the right order at the destination
44
What is the purpose of the checksum in the TCP packet?
Error checking
45
What is a port?
'Internet socket' Identifies the application to communicate to on the device
46
How many port numbers are there?
2^16
47
What port is DICOM?
104
48
How many port numbers are reserved for specific applications?
1024
49
What is UDP?
Universal Datagram Protocol Simpler packets (than TCP) which are not acknowledged before the next packet is sent, without any information about the order.
50
What is an advantage of UDP?
Fast
51
What are two disadvantages of UDP?
1. More prone to errors 2. Missing packets are not resent 3. No error checking
52
When is UDP used?
Anything that needs near real-time and small errors are not significant e.g. video, voice
53
What is the structure of a UDP packet?
UDP header Source port Destination port Length Checksum Data
54
What is a MAC address?
Media Access Control Physical address of the device, 'burnt in' to the hardware. Every network device has its own unique address.
55
What layer of the TCP/IP model does the MAC address operate at?
Data link layer
56
How is a MAC address represented?
6 bytes e.g. 00-1E-64-5C-5B-24
57
What could the first part of a MAC address signify?
Prefix specific to a manufacturer
58
What are the 3 network scales?
LAN WAN MAN
59
How are network scales described?
By their operational purpose
60
What is LAN?
Local Area Network - restricted to a small geographical area
61
What are two examples of a LAN?
A single hospital or an office building
62
What is WAN?
Wide Area Network - Distributed over a large geographical area
63
What are some examples of a WAN?
The Internet, two LANs connected, two hospitals in the same trust
64
What is MAN?
Metropolitan Area Network - Special case of a WAN, distributed over a city
65
What is HSCN?
Health and Social Care Network - A private network linking NHS and social care organisations where third parties may connect via an authorised "Connectivity Supplier"
66
What is an example of when the HSCN may be used?
To provide remote support for medical equipment or providing an off-site archive at a data centre
67
What is DNS?
Domain Name Service - Links hostnames to IP address
68
What is DHCP?
Dynamic Host Configuration Protocol - Allocates IP address automatically to a network device, based on its MAC address
69
What is AD?
Active Directory - Superset of DNS which provides information about additional resources such as user rights or printers etc.
70
What is a VPN?
Virtual Private Network - Allows secure connections to networks, usually LANs, from external locations through an encrypted "tunnel". The external resource appears on the restricted (private) network with a local IP address
71
What is the physical layer?
Describes the low level details of the physical connection
72
What cable is used at the physical layer?
A network cable consisting of a twisted pair of cables
73
How many bits are in a byte?
8 bits in a byte
74
How do you convert from a byte to a kbyte to Mbyte etc?
2^10 1kB=2^10B
75
What is network bandwidth?
'Maximum throughput' Rate at which data can be transferred in one direction
76
What unit is bandwidth measured in?
BITS per second
77
What is half duplex?
One direction of communication at a time (send, wait for acknowledgement, send another, wait)
78
What is full duplex?
Both directions of communication at a time (send and acknowledge simultaneously)
79
What is network latency?
The time taken for a packet to travel from sender to receiver (ms)
80
What does ipconfig show?
- Interfaces - Status of interfaces - IP addresses - MAC addresses - DHCP information - DNS information
81
What is ipconfig used for?
Verifies information about the local network interface
82
What is ping used for?
Verifies a route between source and destination exists, measures latency, resolves IP addresses from hostname (using DNS) and vice versa
83
What are some troubleshooting tools?
- ipconfig - ping - Trace Route - nslookup - Sysinternals Tools - procmon, tcpview - Wireshark
84
What is Trace Route?
tracert Records routers through which packets travel on the way to destination, displaying information at each 'hop'
85
What is nslookup?
Name Server lookup Interrogates DNS server for a given hostname
86
What is netstat?
Reports the status and statistics of network services, used to determine whether a service is 'listening' for connections or whether a connection is in progress e.g. DICOM storage service listening on port 104
87
What is a wireshark?
Monitors and reports on network traffic
88
What is TCPView?
GUI for netstat showing the processes starting and stopping listening
89
What is ProcMon?
GUI allowing monitoring of the disk, registry and network activity of running processes
90
What are sysinternal tools?
GUIs for network monitoring, where results can be stored for later review
91
Give examples of when TCP would be used
When accuracy is important for example bank transfers and software downloads
92
Give two examples of where a private subnet is used in a hospital environment.
1. Medical Device Networks Use: Connecting imaging devices (e.g., MRI, CT, X-ray), infusion pumps, and patient monitors to local servers. Why Private? Ensures secure and isolated communication between devices, with no exposure to the internet. Example: A private subnet like 192.168.10.0/24 used for all radiology equipment. 2. Electronic Health Record (EHR) System Access Use: Staff access to patient records through terminals within the hospital. Why Private? Protects sensitive patient data from external threats while allowing internal data flow. Example: EHR servers and workstations communicating over 10.0.0.0/16.
93
How might a scientist troubleshoot and resolve connectivity issues between devices which are supposedly standards compliant? Refer to real-world systems in your answer.
Diagnose layer by layer: 1. Confirm Physical and Network Connectivity (Layers 1–3) Steps: Check cabling, power, and network interfaces (Ethernet, Wi-Fi, fibre, etc.) Use tools like ping, traceroute, or network analyzers (e.g., Wireshark) to test basic connectivity and routing. Confirm that devices are on the same subnet or that proper routing exists between them. Real-world example: A DICOM-compliant MRI scanner cannot send images to a PACS server. Check whether both devices are on the same network or VLAN. Use ping to confirm IP-level connectivity. Check firewall rules or port blocks (e.g., port 104 for DICOM). 2. Validate Configuration and Protocol Settings (Layer 4–7) Steps: Verify that port numbers, protocol versions, and authentication settings match. Ensure mutual support for specific standards features or optional extensions. Real-world example: A HL7 interface engine (like Mirth Connect) is failing to receive messages from an EMR system. Confirm that message formats (e.g., HL7 v2.5 vs. v2.3) are compatible. Check MLLP (Minimal Lower Layer Protocol) framing and character encoding. Validate IP address, port, and TLS settings for secure connections. 3. Review Logs and Audit Trails Steps: Enable and examine logs on both devices. Look for errors related to handshakes, dropped connections, or data formatting issues. Real-world example: A laboratory information system (LIS) fails to send results to an EHR. LIS logs may show a timeout or message rejection. EHR logs might show an invalid message header or missing field.
94
What is the range of IP addresses which redirect to 127.0.0.1?
127.0.0.0/8

Medical IT (13 decks)

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