Practice 2 Flashcards
- Clinical breast examination (CBE) and breast self examination (BSE) are similar in that both
(A) involve looking and feeling for changes in the breast
(B) are performed by a trained medical professional
(C) are performed montly
(D) are performed yearly
A - involve looking and feeling for changes in the breast
Both clinical breast examination and breast self examination are examinations in which changes in the shape, contour, and texture of the breast are assessed and the breast is checked for lumps. CBE is performed by a heatlh care profession, whereas BSE is performed by the woman herself.
- The most common cause of under compression is
(A) a faulty compression paddle
(B) inadequate compression by technologist
(C) the patients pain tolerance level
(D) a broken autmatic compression device
(B) inadequate compression by technologist
Studies have shown that although there are many reasons for undercompression, the main reason is lack of communication between the technologist and the patient. The technologist undercompresses the breast either because the patient refuses further compression or is unable to tolerate more compression or the technologist wants to protect the patient from further pain.
- The Health Insurance Portabilit and Acountability Act (HIPAA) of 1996 has an influence on the radiology department and other hospital departmenents because of its focus on
(A) patient record confidentiality
(B) facility reimbursement
(C) quality management
(D) risk management
(A) patient record confidentiality
HIPPA (Health Insurance Portability and Accountability Act of 1996 comprises privacy rules that provide all patients with federal protections of their health information. it gives patients an array of rights with respect to their health records and monitors the disclosure of health information needed for patient care.
- Ductal papilloma is
(A) a benign proliferation of tissue in the male breast
(B) a malignant tumor involving ducts
(C) a collection of blood in the breast occurring after surger
(D) benign growths involving the milk ducts
(D) benign growths involving the milk ducts
An intraductal papilloma generally occurs near the nipple within the larger ducts but can also occur deep within the breast. The papilloma may produce spontaneous discharge from the nipple or if located deep within the breast, may appear radiographically as a mass. Ductal papillomas are benign and can be vizualized with ductography or galactography. However, ultrasonography is becoming the modality of choice when evaluation ducts.
- The right craniocaudal (CC) projection in a routine imaging series showed a small irregular shaped lesion at the posterior margin of the image plus scattered calcifications, including calcification clusters. Typically the radiologist will recommened ___ as the immediate next step
(A) ultrasonography to assess the content of the lesion and provide an analysis of the calcifications
(B) spot compression, including magnification, to assess calcifications and the margins of the lesion
(C) magnetic resonance imaging to assess for malignancy and to assess any calcifications
(D) a breast biopsy to check for malignancy
(B) spot compression, includign magnification, to assess calcifications and the margins of the lesion
Further imaging depends on the preference of the radiologist. However, when possible, imaging should show a lesion in its entirety. Before moving to another modality, such as MRI or ultrasonagraphy, the radiologist is likely to recommend further mammographic examinations, such as spot compression to delineate the margins of the lesion and/or magnification to asses the calcifications. MRI and ultrasonagraphy do not image calcifications well.
- A bunch of eight bits equals one
(A) pixel
(B) byte
(C) matrix
(D) bit depth
(B) byte
A digital image consists of a box of cells or picture elements (pixels) corresponding to numeric values arranged in rows and columns. Each pixel contains bits of information. The rows and columns form a matrix and each cell corresponds to a specific location in the image. The matrix size is determined by the number of pixels in the rows and columns. The bit depth is the number of gray shades that a pixel produce. A bunch of eight bits is a byte.
- Which of the following could be used when imaging extremely small breasts in the CC position
(A) spatula
(B) mediolateral (ML) projection
(C) cleavage view (CV) projection
(D) exaggerated craniocaudal (XCCL) projection
(A) spatula
The spatula can be used instead of the technologist’s fingers to pull extremely small breasts into position for compression. The Mediolateral (ML) projection is a lateral projection. Cleavage view (CV) images the extreme medial breast from the craniocaudal (CC) position and the exaggerated craniocaudal (XCCL) projection images the extreme lateral breast from the CC position.
- In the tangential (TAN) projection, any tube angulation will depend on
(A) the size of the patients breast
(B) the location of the abnormality
(C) the position of the mid axillary line in relation to the detector
(D) whether the abnomality is palpable or non palpable
(B) the location of the abnormality
In the Tangential (TAN) projection, the technique is to take a skimming projection of the area of interest. Because TAN can be taken in any porojection, the degree of obliquity and the projection depends on the location ofht abnormality a BB (lead) marker can be used to establish the area of interest.
- A small but growing cancer may not be obvious to the individual because it often presents as
(A) skin irritation
(B) inverted nipples
(C) a painless mass
(D) a painful mass
(C) a painless mass
Although pain can be associated with breast cancer, a painless mass is the more common symptom of breast cancer. Painful masses are associated with cysts. Less common symptoms of advanced breast cancer include skin thickening, skin irritation or distortion, and sudden nipple inversion, discharge, erosion, or tenderness.
- Mammography is more accurate in
(A) premenopausal women
(B) postmenopausal women
(C) women with fibrocystic breast
(D) women with dense breast tissue
(B) postmenopausal women
On average, mammography can detect up to 90% of breast cancers in women without symptoms and is more accurate in postmenopausal women compared with premonopausal women. Some cancers are not visualized mammographically. The reasons are varied. The patient may have extremely dense breasts, or ammography may not be the best method of detection for a particular type of cancer. Poor imaging techniques applied by the technologist and the interpretation skills of the radiologist can also be contributing factors.
- In taking medical history, hormone use (both natural and artificial) is taken into account because
(A) hormones cause breast cancer
(B) early menarche can increase breast cancer risks
(C) late menarche can increase breast cancer risks
(D) contraceptive use lowers the risk for breast cancer
(B) early menarche can increase breast cancer risks
Hormone use influences breast cancer risk but does not actually cause breast cancer. All factors that increase the number of menstrual cycles in a woman’s lifetime can increase breast cancer.
- One major difference between collimation in mammography and collimation in general radiography is that
(A) in mammography, the entire detector area is exposed
(B) decreasing collimation increases exposure in mammography
(C) mammography uses a variety of beam limiting device
(D) in radiogrpahy, the entire detector area is always exposed
(A) in mammography, the entire detector area is exposed
In general, the use of any beam-limiting device in radiography or mammography requires increased exposure. Both imaging methods use various sized beam limiting devices. However, unlike general radiography, where the beam should be limited to the size of the part, in mammography, the entire field is exposed. This is ncecessary to reduce extraneous light when viewing the analog image on the view box and, although postprocess masking is possible with digital imaging, the technique has not been altered.
- Line pair per millimeter is the unit of
(A) matrix size
(B) spatial resolution
(C) field of view (FOV)
(D) bit depth
(B) spatial resolution
The spatial resolution of a digital system is the minimum separation betwen two objects at which they can be distinguished as two separate objects in the image. In digital imaging, spatial resolution is determined by the pixel size. Smaller pixels have better sptial resolution. Spatial resolution is measured as line pairs per millimeter (lp/mm). The matrix size is determined by the number of pixels in the row and columns. The bit depth is the number of gray shades that a pixel can produce. The Field of view (FOV) sets the collimation for breast size and describes how much of the breast is imaged in the matrix.
- Image brightness is adjusted by changing the
(A) milliampere second (mAs)
(B) peak kilovoltage (kVp)
(C) window level
(D) window width
(C) window level
In digital imaging, the term brightness replaces density (optical density). Brightness can be altered after the exposure. The controlling factors are milliampere second (mAs), processing software, and predetermined digital algorithms. Increasing window level will increase brightness. Window width controls the black and white display and therefore, the contrast. The peak kilovoltage (kvp) plus processing software and digital algorithms will also be factors in controlling contrast.
- The retromammary space is filled with
(A) supportive and connecting tissues
(B) adipose tissue
(C) fibroglandular tissue
(D) blood vessels
(B) adipose tissue
The retromammary space separates the breast from the pectoral muscle. It is filled with a layer of adipose, or fatty, tissue as opposed to the supporting and connective tissue (stroma), blood vessels, and various ductal structures that make up the glandular and fibrous tissues of the breast.
- The fatty versus fibroglandular nature of the breast itssue is affected by which of the following
(A) age
(B) hormone use
(C) number of pregnancies
(D) all of the above
(D) all of the above
Generally, glandular tissues predominate in younger women and adipose, or fatty, tissues in older patients. This ratio is not fixed and depends on the woman’s age and genetic predisposition. It fluctuates with hormone levels, whether the hormonal changes are caused by medication use, pregnancy, lactation, or menopause.
- In positioning for the exaggerated craniocaudal (XCCL) projection, if the shoulder of the affected side is in the way of the compression device
(A) push the shoulder down
(B) use 5-degree lateral tube angulation
(C) use 5-degree medial tube angulation to avoid superposing the shoudler on breast tissue
(D) reduce the patients lateral rotation
(B) use 5-degree lateral tube angulation
The purpose of the XCCL projection is to image the lateral aspect of the breast. AFter positioning the patient for the craniocaudal (CC) projection, the patient is rotated to bring the outer lateral aspect of the breast on the detector. If the ipsilateral shoulder is in the way, a 5 degree lateral tube angulation ca be used to avoid superimposition of the humeral head on the breast. The ipsilateral arm should hang down and both shoulders should be at the same level. The patient can hold the support bars with the contralateral hand. Pushing the shoulders down will distort the lateral aspect of the breast.
- In the CC position, the pectoral muscle is seen
(A) all the time
(B) rarely if ever
(C) about 30 to 40% of the time
(D) about 50% of the time
(C) about 30 to 40% of the time
Depending on the patient’s body habitus, the pectoral muscle is imaged on the posterior aspect of the breast on about 30% to 40% of all CC projections. It may be visualized unilaterally or bilaterally. Routine CC imaging that includes the pectoral muscle all the time can indicate faulty positioning with loss of visualization of medial or lateral breast tissue.
- Between ages 20 and 39 years, the American Cancer Society (ACS) recommends CBE every
(A) year
(B) 2 years
(C) 3 years
(D) 4 years
(C) 3 years
The ACS guidelines for early detection of breast cancer include CBE every 3 years between the ages of 20 and 39 years and every year after age 40.
- Regardless of the reason, if the proper amount of compression cannot be applied, which of the followign must apply
(A) the patient must be infomred
(B) the patients doctor must be informed
(C) the radiologist must be informed
(D) it must be noted on the patients history form
(D) it must be noted on the patients history form
Although the technologist should inform the radiologist as well as the patient, anything unusual must be documented in the patient’s medical records or on the patients medical history form. The patients records are a means of communication between the technologist and the radiologist and can be important legal documents used to define what was or was not done to a patient. Records can also be used as evidence in court cases.
- On the CC image, the posterior nipple line (PNL) should extend to the
(A) level of the nipple
(B) posterior breast or edge of the image
(C) level of the inframammary fole (IMF)
(D) most anterior breast
(B) posterior breast or edge of the image
On the CC projection, the PNL measures the distance from the nipple to the edge of the image. On MLO, the PNL is drawn from the nipple, extending posteriorly to meet the pectoral muscle at a right angle (perpendicularly). The length of the PNL on the CC view should be within 1 cm of its length on the MLO when MLO is properly positioned. This means that the PNL is usually longer on MLO compared with CC. However, in approximately 10% of the cases, the PNL is greater on the CC>
- The interspace material of the mammography linear grid is generally made of
(A) carbon or wood
(B) aluminum
(C) any highly radiopaque material
(D) lead
(A) carbon or wood
Grids absorb scatter and increase visibility of image details. Mammography grids usually use carbon or wood as the interspace material. Some mammography units have a high transmission cellular (HTC) grid, which uses air as the interspace materail and copper instead of lead as strips.
- Which section of the breast is poorly visualized on the CC projection
(A) medial
(B) axial
(C) lateral
(D) superior
(C) lateral
All efforts should be made to image the medial breast tissue on the CC projection; eliminating the medial breast tissue could eliminate it from the examination. CC best demonstrates the anterior, central, medial, and posteriomedial portions of the breast but is poor at visualizing the lateral breast tissue. IN the CC projection, if the breast is too wide to fit on the detector, additional images must be taken to ensure coverage of the medial breast. Although the medial breast is imaged on the MLO, superimposition of glandular structures and increased object to image receptor distance (OID) and the oblique nature of the projection often cause distortion of that area.
