practice exam Flashcards
(451 cards)
1
Q
patient with prostate cancer recently fell and fractured his left distal femur. he is an inpatient receiving chemotherapy. his leg is in traction. mobile images of the fractured femur are requested. what is the most likely acquired pathology associated with the patients clinical information?
A
metastatic disease because prostate cancer commonly metastases to the bones
2
Q
patient with prostate cancer recently fell and fractured his left distal femur. he is an inpatient receiving chemotherapy. his leg is in traction. mobile images of the fractured femur are requested. what steps are required of the technologist before entering the patients room of isolation?
A
both technologists are required to wear gown, cap, gloves, mask because the patient is immunocomprimised strict/reverse isolation is required
3
Q
patient with prostate cancer recently fell and fractured his left distal femur. he is an inpatient receiving chemotherapy. his leg is in traction. mobile images of the fractured femur are requested. only an 80cm SID can be obtained for an AP projection because of the metal traction device. the exposure factors are 100cm SID would have been at 2mAs @ 65kv. what is the new mAs?
A
1.3mas
direct square law
4
Q
patient with prostate cancer recently fell and fractured his left distal femur. he is an inpatient receiving chemotherapy. his leg is in traction. mobile images of the fractured femur are requested. for the lateral view using 100cm SID the cassette is positioned to include the knee joint and as much of the distal femur as possible. where would the technologist place the lower margin end of the cassette?
A
5cm distal to the knee joint because the diverging beam will project the knee distally, 5cm will ensure the inclusion of the joint on the image
5
Q
mrs barton, 33 years old slipped and fell onto an outstretched hand. images of the wrist and scaphoid have been requested. what should be clearly seen on the images of the scaphoid views of the wrist?
A
soft tissue and bony trabeculae to visualize small fine fractures
6
Q
mrs barton, 33 years old slipped and fell onto an outstretched hand. images of the wrist and scaphoid have been requested. the technologist uses separate 18 x 24cm CR imaging plates to record each of mrs bartons wrist images. what does this ensure for all the images that will be acquired?
A
they are displayed with comparable spatial resolution. using separate IRs will ensure that different and appropriate algorithms are applied to each individual image
7
Q
mrs barton, 33 years old slipped and fell onto an outstretched hand. images of the wrist and scaphoid have been requested. department used a previous screen speed of 100 combination for extremity imaging. why is it necessary for the technologist to decrease technical factors for the use with CR?
A
CR is equivalent to 200-300 speed film screen imaging system.sensitivity of it is equal to that
8
Q
mrs barton, 33 years old slipped and fell onto an outstretched hand. images of the wrist and scaphoid have been requested. when displayed on the CR monitor mrs bartons images appeared mottled, undiagnostic and need to be repeated. what should the tech do to improve the images?
A
increase mAs to increase the number of photons going to the IR
9
Q
27 year old patient involved in a MVC arrives for xrays of skull, cspine, chest and pelvis. department uses film screen and the patient is on a spine board wearing a c collar and is conscious and alert. the horizontal beam lateral c spine image is to light across the entire image. what grid error caused the loss of density?
A
tilted grid because an off level grid misaligned results in an image with decrease in exposure across the entire image
10
Q
27 year old patient involved in a MVC arrives for xrays of skull, cspine, chest and pelvis. department uses film screen and the patient is on a spine board wearing a c collar and is conscious and alert. exposure factors for a lateral cspine using a 8:1 grid was 85kv and 12mAs. the tech decides to use a non grid technique to repeat what should the new mas be?
A
3 going from grid to non grid the technical factors must decrease.
and you must figure out the math
11
Q
27 year old patient involved in a MVC arrives for xrays of skull, cspine, chest and pelvis. department uses film screen and the patient is on a spine board wearing a c collar and is conscious and alert. AP chest is underexposed but has sufficient contrast. how should the tech alter the the Mas or kv to produce a minimal change in optical density
A
30% CHANGE IN mAs to show a visible change in optical density
12
Q
27 year old patient involved in a MVC arrives for xrays of skull, cspine, chest and pelvis. department uses film screen and the patient is on a spine board wearing a c collar and is conscious and alert. the patients OML is extended 10 degrees from the perpendicular. what is the degree of angulation and direction of CR in order to obtain a 30 degree frontooccipital towne projection?
A
40 degrees caudad because a frontooccipital towne projection requires a 30 degree caudad angulation to the perpendicular OML so with a 10 degree extension of the OML a 40 degree caudad angle is needed.
13
Q
27 year old patient involved in a MVC arrives for xrays of skull, cspine, chest and pelvis. department uses film screen and the patient is on a spine board wearing a c collar and is conscious and alert. what action by the technologist would be considered a breech of the patients right to confidentiality?
A
discussing the exam findings with the patients spouse
14
Q
600mA, 100cmSID, 1.5mm focal spot
0.05sec, 5.0 OID, 35 x 43cm field size
70kv, 8:1 grid, CR system
what new set of technical factors will achieve the same exposure rate of intensity rate?
A
60kv, 300mas, 0.2sec
because of 15% decrease in kvp the mas will be doubled in order to maintain intensity
15
Q
600mA, 100cmSID, 1.5mm focal spot
0.05sec, 5.0 OID, 35 x 43cm field size
70kv, 8:1 grid, CR system
what will be the affect of the field size adjusted to 10 x 10 cm
A
intensity is maintained and scatter production is decreased. intensity of the primary beam is controlled by mAs and kvp selected and scatter is reduced by reducing the field size
16
Q
600mA, 100cmSID, 1.5mm focal spot
0.05sec, 5.0 OID, 35 x 43cm field size
70kv, 8:1 grid, CR system
what new parameters will minimize the affect of patient motion
A
900ma and 0.33sec
mAs is maintained while length of exposure is reduced which is necessary to reduce the affects of motion on the image
17
Q
600mA, 100cmSID, 1.5mm focal spot
0.05sec, 5.0 OID, 35 x 43cm field size
70kv, 8:1 grid, CR system
what adjustment minimizes patient dose?
A
decreasing mA
18
Q
hyperstenic patient is admitted for investigation of the GI tract. his doctor ordered a GI examination of, BE, and abdominal ultrasound. what is the proper sequence of exams for this patient
A
abdominal ultrasound, BE, upper GI
19
Q
hyperstenic patient is admitted for investigation of the GI tract. his doctor ordered a GI examination of, BE, and abdominal ultrasound. following the BEwhat instructions should the technologist give the patient to prevent constipation
A
increase fluid intake
20
Q
hyperstenic patient is admitted for investigation of the GI tract. his doctor ordered a GI examination of, BE, and abdominal ultrasound. the radiology resident seeks the technologists option because he is having trouble demonstrating the barium filled duodenal bulb free of superimposition so which view should be done
A
right lateral because shows the best view of the pyloric canal and duodenal bulb in patients with hyperstenic habitus
21
Q
hyperstenic patient is admitted for investigation of the GI tract. his doctor ordered a GI examination of, BE, and abdominal ultrasound. the patients stomach is slow to empty during the upper GI exam. what recumbent position could stimulate gastric peristalsis?
A
RAO
22
Q
technologist is preparing for a enhanced CT of the chest. the patient has a history of allergic response to IV contrast. what medication should be given prior to the exam
A
prednisone (deltasone), acting as a anti inflammatory preventing or reducing allergic response
23
Q
technologist is preparing for a enhanced CT of the chest. the patient has a history of allergic response to IV contrast. what injection will optimize visulazation of contrast within the pulmonary vessels?
A
arterial contrast fills the pulmonary arteries during this phase giving optimal visualization because ww is wide enough to allow demonstration of all soft tissue including pulmonary vessels
24
Q
technologist is preparing for a enhanced CT of the chest. the patient has a history of allergic response to IV contrast. what ww and wl would best visualize the sternum
A
+325 ww & +50 WL
25
technologist is preparing for a enhanced CT of the chest. the patient has a history of allergic response to IV contrast. when reviewing the patients images at what level will the tracheal bifurcation best be seen
T4T5 (carina)
26
request of a chest xray on a patient that is 25 years old. he is experiencing chest pain and SOB. upon viewing the image the technologist notices a absence of markings in the right lung. what should be done next
check with the doctor before letting the patient leave the department because a tension pnemothroax can quickly become life threatening and needs to be treated before circulatory collapse occurs
27
doing a mobile chest xray. when making the exposure what should the technologist do to protect themselves from scatter radiation
wear proper protective apparel
28
4 year old cooperative child gets wrist xrays. patient motion is seen on the PA image. how should the tech proceed for the repeat image
use a compression band to hold the childs arm in place.
29
what factor would be the most useful in visualizing both lung and mediastinum on the PA chest projection?
high kv to allow for long scale contrast to adequately penetrate the lungs and mediastinum
30
what patient history would require a increase in exposure factors for a mobile exam
ascites (increase of fluid in the abdominal cavity)
31
a patient is having a cerebral angiogram and during the procedure begins to cry. how should the tech respond to the patient
address her concerns before continuing with the exam
32
which joint is best demonstrated on the 15 degree internal oblique view of the ankle (medial rotation)
talo fibular
33
tech is preparing for enhanced ct of infants head, what factor is essential in calculating dosage
weight of infant so as to not impair renal function
34
with a CR system the recommended technical factors for an AP projection of the knee are 4mAs and 60kvp.how will image quality be affected if the tech uses 1mAs at 60kvp instead
increase image noise; lowering the mAs will reduce the signal to noise ratio by creating more image noise
35
29 year old female patient with a history of chronic back pain is scheduled for a xray exam of lumbar spine. during the interview the patient states that she may be pregnant what is the techs best response
consult with the physician for futher instructions they may not be aware of the possible pregnacy
36
what will obsure the odontoid process when the neck is hyperextended for an AP open mouth projection
base of occipital bone because its projected inferiorly
37
when working with patients with chest drainage systems what should the technologist do to ensure that the system continues to work properly?
keep the system below the level of the patients chest to allow drainage to occur
38
what pathology should the technologist anticipate when elderly frail female client with kyphoysis arrives in the DI department with a request of consultation for a tspine xray
osteoporosis- a metabolic bone disease resulting in demineralization of bone most commonly seen in post menopausal women. result of kyphosis is from a collapse in thoracic vertebrae
39
what is required for the correct use of AEC
the region of interest must be positioned over the detector cell.directly over the ionization chamber
40
if images taken with AEC are consistently to noisy what adjustment should be made until the unit can be serviced
INCREASE THE DENSITY CONTROL to overcome slowly changing calibration or sensitivity of AEC without additional patient dose
41
when viewing a PA chest what would indicate to the technologist that the patient may have received more radiation than necessary for the exam?
collimation not evident
42
why is personnel radiation dosimeter worn under the lead apron during fluro?
to detect whole body exposure
43
upper GI series has been requested on a patient with a possible perforated ulcer. which contrast should the tech select to prepare
water soluable iodine because it is readily absorbed in the peritoneal cavity
44
what varies directly with the intensity of the radiation emitted from the xray tube
tube current,(direct relationhip) atomic number of target material (as increase the intensity also increased)
45
what is most likely to cause the tube current (mA) to increase erractially and become uncontrollable
loss of vacuum in the tube insert which affects electron flow from cathode to anode
46
what aspect of digital image is affected by changing wl while maintaining the ww?
density is controlled by wl
ww (contrast)
47
what view of the elbow will demonstrate minimal compression of the fat pads
lateral
48
AP projection of the lumbar spine is taken on a large male patient using AEC @ 80kv. the image was blurred what would be the result of the tech repeating the image at 95kvp
mAs will be decreased because with a higher kvp AEC will compensate with a decrease in mAs to maintain beam intensity
49
what describes one disc slipping over another
spondiolithesis which results in spondylosis
50
what exam should be done if asked to rule out legge calfes perthe (osteochrondosis)
hip
51
when removing clothes from a hemiparais patient how is it done
by using the affected side first so their is less movement on that side
52
patient arrives for xray of the elbow. the elbow has dressing covering a deep wound. should the dressing be removed for the exam
no the wound needs to stay clean
53
how do you pour sterile betadine onto a sterile tray
check the label, discard the first few drops then pour into a container
54
what is the recommended cardio compression to ventilation when performing a 2 recuser CPR on adult
30:2
55
the technologist checks the dosimeter report and sees in the past year she has accumulated 2msv is this a concern
no because it is below the dose limit of radiation workers dose limit for the whole body for the year is 20
56
what is the rationale for a regular quality control measure cycle of of CR imaging plates
to remove background radiation and scatter
57
to ensure the validity of mA linearity test which test must be performed?
timer accuracy
58
under what circumstances would would radiography of the chest be appropriate
acute abdominal series to rule out chest pathology detecting free air under the diapharm
59
what is the dominant interaction of in soft tissue of the breast during mammo?
photo electric because of low energies and see attenuation differences
60
during a digital imaging exam what occurs if the ww setting is 100 and the wl is 0
numbers between +50 and -50 appear grey
61
what is the most common reason for performing a pre MRI shoulder arthrogram
rotator cuff tear
62
how should the patient be positioned for a upright lateral view of the chest
MSP vertical
63
tech must do a mobile abd series in the patients room during visting hours. how should the tech provide protection for the vistors
request the vistors to wait outside
64
what is essential when transporting a patient with a urinary drainage
keep it lower than the bladder to prevent back flow
65
patient develops epitaxis during the xray. what position provides proper care for the patient
sitting with head forward and the nostrils pinched to prevent swallowing of blood
66
what feature of the image will be affected by selecting the edge enhancement during a digital subtraction peripheral angiogram
visibility of small structures, good for fractures and high contrast objects
67
what structure is the most radiosensitive during the acanthioparietal projection of the facial bones
optic lens
68
patient with dementia arrives for an xray. she is uncooperative and disorientated what is the best rationale for use of immobilization techniques for this patient
to reduce the probability of repeat expsoures
69
an erect cspine series has just been completed when the patient feels faint and asks to lie on the table. the tech decides that the LAO must be repeated. what view would be acquired with the patient in the recumbent position
RPO to visualize the left intervertebral foramina
70
what infection control practices should the 2 techs follow when performing a mobile supine chest on an unconscious patient with blood soaked clothing
both techs wear gloves to position the patient then one removes the gloves to handle the equipment. once the patient is positioned one tech should remove their gloves and wash their hands before handling the equipment
71
what is the most important consideration for the tech to remember when transferring a patient with a possible cspine injury
maintain immobilization of the head and neck
72
what is the correct procedure to follow when the tech is inserting the rectal tip prior to a BE?
ask the patient to take slow deep breathes and insert the tip during exhalation because the abdominal muscles relax on exhalation
73
a patient has fallen from a stretcher and as a result of the siderails being left down. what is the legal term for this occurance
negligence because it is the omission of reasonable care that results in injury to a patient
74
what view would best demonstrate a suspected epiglottis on a 2 year old child
soft tissue lateral neck erect because it affects the soft tissue of the larynx and the patient needs to be supported in the upright position
75
a patient who is paraplegic requires xrays on the left femur. how should the tech provide assistance while moving him from the wheelchair to the table
enlist the help from another tech to lift the patients legs while the other tech lifts the torso to prevent injury to the patient and lifter
76
why dose the use of collimation reduce dose to the patient
because the area of useful beam is restricted
77
what is the most significant symptom of shock
tachycardia increase in heart rate, pallor, restlessness, respirations, hypotension and confusion
78
a patient for a postoperative hip arthroplasty patient requires a mobile pelvic exam. how should the tech properly prepare for the patient prior to the log roll
place the arms across the chest
79
tech in charge of quality control has been performing repeat analysis for the new DR room. during a 1 mth period this room had a total output of 5000 images and 260 repeats so what is the repeat rate
5 you do 260/5000
| the number of repeat images divided by the total number of images multiplied by 100
80
while in the xray department the patient is rude and argumentative to the techs, at lunch in the cafeteria his family overhears the techs describing the patient as a homeless drug addict. what violation of the patients rights is this
slander- malicious verbal information
81
all enteries for procedures should include a
date and time
82
what is something that would be neglience
FAILURE TO CLEAN THE ROOM RIGHT AFTERA MRSA PATIENT , which puts other patients at risk
83
upon viewing a AP hip image taken to rule out osteoarthritis the tech notes that the femoral neck is foreshortened and the lesser trochanter is in profle what needs to be done to fix it
rotate the patients legs interally 15-20 degrees
84
what is the minimum shielding equalivancey for the hip exam
0.25 and should have 0.5 at 150 kvp
85
79 year old patient comes back for a repeat lateral lumbar spine xray. the tech reviews the previous exam and notes that on the lateral view of the L4-L5 and L5-S1 the intervertebral disc spaces are closed on the 3rd - 5th vertebral bodies are distorted. how can the tech ensure that the lateral repeat image is good
position a sponge under the patients waist to place the vertebral column parallel
86
tech has obtained routine lateral views for an elbow. the rad suspects a radial head fracture and requests an additional image how can it be seen
flex the elbow to 90 degrees with the hand pronated and the CR directed 45 degrees towards the shoulder to project the radial head anterior to the coronoid process
87
what kv should be used for a KUB for sthenic patient
70-80 to maximize subject contrast
88
86 years old patient brought to the hospital with a suspected hip fracture. she appears agitated and is worried about her dog being left alone. the tech feels the instructions are not being understood. how can the tech improve communication
speak slowly in a clear voice and ask the patient to respond to questions
89
what projection will show medial or lateral displacement of a fracture in the neck of the mandible
30 degree frontooccipital
90
a ct of a throax was requested to rule out medistinal pathology. to see the area the scan must include from apices to the level of what anatomical structure
diapharm
91
WBC are very sensitive to radiation a dose of
25 rads causes a drop
92
annual occupational dose is
5rads
93
neuroblas is one of the most
sensitive tissues to radiation
94
relative biological effect (RBE) ratio of dose of standard radiation necessary to produce a given effect to the dose of the
test radiation needed for the same effect
95
inherent infiltration general purpose is
0.5mm of AL
| collimator 1.0mm of AL
96
to meet required total filtration of 2.5 mm if AL all manufactor inserts need additional
1.0ml of al equaivalent between the xray tube housing and the collimator
97
lead gloves need a minimum of
0.25mm thickness for fluro procedures @ 150kvp
98
acute whole body exposure of 2Gy (200rads) is
hemopeotic death so below 10gy is infection and electrolyte inbalance
99
biological effects are
somatic and genetic effects
100
pubic dose is
1/10th of the occupational dose
101
dose equivalent for the lens of the eye is
150msv for the year occupational for the public its 15msv/year
102
occupational dose for the skin, hands and feet
500msv/year
103
whole body dose limit
50msv/yr
104
dose equivalent for the fetus
0.5msv/mth
105
a controlled area (booth) should limit exposure to yearly whole body exposure
5rem per year (50msv/year) 10rem/wk
106
minimial patient tube distance for fixed fluro units is
38cm for mobile 30cm
107
skin erythema
deterministic effect with a threshold of 2gy (200rads)
108
gonadal significant dose
20mRads
109
a femur will benefit from anode heel effect more than foot because this effect is
more prouncecd with larger films and shorter SID
110
effective focal spot is smaller
at the anode end
111
focal spot blur smaller at the
anode side
112
for magnification purposes small focal spot
should used less than 0.3mm
113
relative speed
mas and rs2
114
maintain density
mas & distance
115
penumbra
OID/SOD/FSS
116
primary factor affecting the brightness of fluro image is the
size or composition of the part
117
ABC is maintained by
adjusting kvp and mas
118
tube warm up should be done using
70-80kvp and ma smaller than 200 for 1-2s
119
when AEC is used for kvp higher than 50 xray exposure must be terminated
after 6s or 600 mas is reached for a kvp smaller than 50 the limit is 2000mas
120
drastic temp change in developer and fixer could cause
wrinkling reticuluation of the film
121
bending of the film makes
crescent marks artifacts
122
factors that affect contrast are
kvp (inversely proportional), screen speed, grid ratio and OID (directly proportional)
123
for techniques higher than 90kvp
12:1 grid is used
124
orthocromatic film is sensitive to
green or blue light (rare earth)
125
safe light for orthrochromatic is
red
126
ascities you need to increase
mas 50%,
127
for a pneumo, osteomyltis, obstructions decrease
kvp 8%
128
WBC are very sensitive to radiation a dose of
25 rads causes a drop
129
annual occupational dose is
5rads
130
neuroblas is one of the most
sensitive tissues to radiation
131
relative biological effect (RBE) ratio of dose of standard radiation necessary to produce a given effect to the dose of the
test radiation needed for the same effect
132
inherent infiltration general purpose is
0.5mm of AL
| collimator 1.0mm of AL
133
to meet required total filtration of 2.5 mm if AL all manufactor inserts need additional
1.0ml of al equaivalent between the xray tube housing and the collimator
134
lead gloves need a minimum of
0.25mm thickness for fluro procedures @ 150kvp
135
acute whole body exposure of 2Gy (200rads) is
hemopeotic death so below 10gy is infection and electrolyte inbalance
136
biological effects are
somatic and genetic effects
137
pubic dose is
1/10th of the occupational dose
138
dose equivalent for the lens of the eye is
150msv for the year occupational for the public its 15msv/year
139
occupational dose for the skin, hands and feet
500msv/year
140
whole body dose limit
50msv/yr
141
dose equivalent for the fetus
0.5msv/mth
142
a controlled area (booth) should limit exposure to yearly whole body exposure
5rem per year (50msv/year) 10rem/wk
143
minimial patient tube distance for fixed fluro units is
38cm for mobile 30cm
144
skin erythema
deterministic effect with a threshold of 2gy (200rads)
145
gonadal significant dose
20mRads
146
a femur will benefit from anode heel effect more than foot because this effect is
more prouncecd with larger films and shorter SID
147
effective focal spot is smaller
at the anode end
148
focal spot blur smaller at the
anode side
149
for magnification purposes small focal spot
should used less than 0.3mm
150
relative speed
mas and rs2
151
maintain density
mas & distance
152
penumbra
OID/SOD/FSS
153
primary factor affecting the brightness of fluro image is the
size or composition of the part
154
ABC is maintained by
adjusting kvp and mas
155
tube warm up should be done using
70-80kvp and ma smaller than 200 for 1-2s
156
when AEC is used for kvp higher than 50 xray exposure must be terminated
after 6s or 600 mas is reached for a kvp smaller than 50 the limit is 2000mas
157
drastic temp change in developer and fixer could cause
wrinkling reticuluation of the film
158
bending of the film makes
crescent marks artifacts
159
factors that affect contrast are
kvp (inversely proportional), screen speed, grid ratio and OID (directly proportional)
160
for techniques higher than 90kvp
12:1 grid is used
161
orthocromatic film is sensitive to
green or blue light (rare earth)
162
safe light for orthrochromatic is
red
163
ascities you need to increase
mas 50%,
164
for a pneumo, osteomyltis, obstructions decrease
kvp 8%
165
accepted blooming for 1.0mm focal spot
40% (fss 0.8-1.5)
166
accepted blooming for fss smaller than
0.8-50%
167
developer is alkaline
ph higher than 7 (10-11.5)
168
fixer is acidic and a ph
smaller than 7 (4-4.5)
169
turn ratio of a step up transformer
v2/v1- # of turn s
170
window level
density
171
window width
contrast
172
b + F allows for a variation of
+/- 0.05
173
intensity with constant technical factors (reproducibility) should not be more than
5%
174
reciprocity and linearity is
+/- 10%
175
kvp variation is
+/-2%
176
preservatives in the developer
retard or oxidaize
177
hyperglycemia
induced insulin overdose, from inadequate food intake, increased exercise, nutritional imbalances that can lead to insulin shock.
symtoms- diaphoresis, confusion, walking difficulty, weakness, double, vison or blurred so give food with sugar (orange juice)
178
mets the tissue is more
radiolucent (dark)
179
safelight should be placed at least 3feet
from the film bin
180
diaphroresis
the patient is pale, cold clammy skin, sweaty, cause shock , diabetes, ilnnes
181
if the wrong exam is performed then its
battery
182
tort is
intentional or not intentional act performed based on unreasonable conductex commiting battery or assault
183
deglutition
swallowing
184
to reduce the patient dose place the II on
top of the patient and as close as possible to reduce scatter
185
semicircular canal
balance
186
RAO demos
duodenal bulb and loop in profile in a double contrast study
187
communited fracture
many pieces
188
compound fracture
open
189
restrainers keep reducing agents from developing
unexposed crystals (potassium bromide)
190
intrathecal injection
spinal cord
191
spore bacteria is the most
resistant to asepsis
192
emphysema is
dilation of the alveoli most comfortable position for the patient is sitting
193
orthopena
ability to breathe better while sitting
194
assault
threatening someone verbally
195
battery
touching someone without permission
196
CPR the sternum is depressed
1.5-2"
| child- 0.5-10."
197
EG tubes are used to
inject nutrition into the stomach for patients who cannot swallow
198
average rate of compressions for adult CPR is
80-100/min
199
enema bag is plced
30" above the table and
18'24 above the patients hip
tip is not inserted more than 10cm
200
neurogenic shock
pooling of blood in peripheral vessels aka vasogenic shock seen in severe trauma
201
septic shock
blood stream exposed to bacteria
202
nasal cannula oxygen rate
2-3L/min
203
urticarial-
hives
204
blood pressure
adult systolic- 110-140 diastolic 60-90
| if below 90 the shock is accompanied by hypotension and a faster pulse rate
205
CPR the best place to check a pulse
adult- carotid artery
| child- brachial artery
206
before myelography CSF fluid is aspirated to check for
syphylis
207
IV filtration
pull the needle out and apply a cold or warm compression
208
average pulse rate for infants is
120 BEATS/MIN
209
adult normal pulse rate
80-100beats per min and above 100 is tachycardia
210
hypervolemia during a BE study can be prevented by adding
2tbps of salt to the solution because can lead to edemarenal failure death
211
grieving process
denial, anger, bargaining, depression, acceptance
212
orthostatic hypertension
sudden change of pressure when moving from the recumbent to sitting position syncope of fainting
213
normal adult respiratory rate
12-20 breathes per min
child- 20-30
under 1year- 30-60
214
hyperglycemia
induced insulin overdose, from inadequate food intake, increased exercise, nutritional imbalances that can lead to insulin shock.
symtoms- diaphoresis, confusion, walking difficulty, weakness, double, vison or blurred so give food with sugar (orange juice)
215
during the seldinger technique
anesthetics are used to prevent vasospam most often lidocaine and epinephrine to reduce bleeding
216
enteric isolation
to prevent spread of infection thru fecal material
217
rescue breathing to adult with respiratory arrest
1 breathe every 5sec
| child 1 breathe every 3 sec
218
patient is coming down for a post op hip xrays and is experiencing a high pulse rate of 120 beats per min may be experiencing a
pulmonary embolism one of the operative complication s on long extremities or hip
219
for a plaster cast you need to
increase mas 50% or 8% in kvp
220
fiberglass cast
no change is needed
221
ammonia smell in the developer is
oxidation
222
fat is the least attenuated compared to
water, muscle, bone, liver
223
excessive filtration decreases
contrast and density
224
to decrease exposure time
decrease SID, increase kvp, decrease the back up timer
225
increase film speed
higher contrast and density
226
restrainers keep reducing agents from developing
unexposed crystals (potassium bromide)
227
dyes are added to improve resolution
reflective backing is added to increase speed
228
AEC used with too tight collimation
over exposed image
229
sella
CR 0.75 anterior and superior to EAM lateral
| AP- IOML perpendicular CR 37 degree caudad
230
activators cause emulsion to swell
sodium carbonate
231
when changing from table top technique with no grid to a bucky technique with a grid
mas should be multiplied by 3
232
lateral femoral condyle is more flat
than medial
233
lateral femoral condyle is
higher than medial on axial knee
234
for every 0.25" of misalignment adjust CR
angle by 5degrees
235
nosocomial infection
acquired during care at the hospital
236
areas most affected by ulcerations
scapula, sacrum, trochanters, knees, heels
237
CPR neonate
2 breathes use 2 fingers for compressions , 0.5# sternum
| 120 compressions per minute
238
CPR for adult
15 compressions for 2 breathes
239
CPR under 1 year
1 ventilation, 5 compressions
240
analyphatic shock
allergic reaction
241
ketoacidosis
no sufficient insulin body is not able to metabolize glucose
242
hyperosmolar non ketoacidotic syndrome or coma
complication of mild type 2 diabetes mellitus or it may occur in an elderly patient with known diabetes that had a recent acute illness or had undergone dialysis
243
body temp for 1-3yrs
37.2- 37.7deg C,
| 5-13- 36.7-37C
244
fever causes
increased pulse and respiration rate
245
hypothemia
less oxygen is needed
246
when pulse is increased
blood pressure is low
247
normal pulse is
60-90 beats per min radial
248
120 beats per min
infant
249
90-100 beats per min
4-10yrs and apical is most accurate
250
atherosclerosis
increased BP aka arterialscleroiss
251
sphygmomanometer
measure BP
252
nasal cannula
1-4L adults
| 0.25-0.5l min child
253
mask is
above 5l/min
254
PA mandible to demonstrate the body
CR exits the lips AML perpendicular to the IR
255
mandible PA
oml perpendicular to the IR and to see the body rami and medial / lateral displacement
256
axiolateral oblique mandible
area of interest is parallel with film, rami patients head in true lateral position (IPL perpendicular to the IR)
body rotate head 30 degrees toward IR
symph- rotate head 45 degrees towards the IR
257
smv
ioml parallel with the IR, CR perpendicular midway between mandibular angles
demo coronoid and conduloid process of the rami
258
TMJ AP Axial
OML perpendicular, CR angled 35 degree caudad, 3" above the nasion
demos the condyles and fossa if the mouth is open condyles will be projected below the petrosa
259
TMJ axiaolateral open;closed
IPL parallel to IR, CR angled 25-30 caudad 0.5" anterior and 2" superior to unaffected EAM
260
sinuses are overpenetrated
obliterate pathology and underpenetrated simulates pathology (70-75, 28mas waters 8mas lateral with a small focal spot
261
lateral sinuses
IOML perpendicular to IR 1-1.5" posterior to outer canthus
262
Caldwell sinuses
CR must be horizontal OML 15 degrees with the IR and CR exits nasion demon a frontal and anterior ethmoid sinsuses
263
calcaneous
40degree cephalad for axial projection CR at base of the 5th metatarsal
264
knee distance from ASIS to film
18cm or lower 5 degree caudad
19-24- 0 degrees
24 & up- 5 degree cephalad
265
lateral patella
cant bend knee more than 10 degrees
266
sella
CR 0.75 anterior and superior to EAM lateral
| AP- IOML perpendicular CR 37 degree caudad
267
normal towne for cranium
CR 2.5" above glabella
268
towne for zygoma
CR 1" superior to nasion or glabella
269
lateral lumbar spine
long axis is parallel with table angle 8 degrees caudad for women and 5 degrees caudad for man 1" inferior to the crest
270
oblique lumbar
1.5" down from the crest and 2" medial to elevated ASIS
271
L5-S1 spot
2"posterior to ASIS and 1" inferior from crest
272
thoracic lateral spine
10 degrees for females and 15 degrees cepahlad for males because of broader shoulders
273
if the pedicles are to anterior
patient was not rotated enough
274
SI jts
patient elevated 25-30 degrees CR 1" medial to elevated ASIS
275
lateral sacrum
3.5" posterior to ASIS
276
lateral coccyx
3.5" posterior to ASIS and 2" inferior from ASIS
277
scoliosis
demon thoracic and lumbar 1" crest SID 60"
278
SI jts AP
30 degrees cephald 1.5" superior to symphysis
279
cranium lateral
CR 2" above EAM
280
bladder
10-15 degrees caudad CR 2" superior to upper border of symphysis if the patient is lordotic decrease angle
281
PA if prostate
area of interest 20-25 degrees cephald CR 1" inferior to tip of coccyx
282
to see ureters and bladder
RPO/LPO 40-60 degrees
283
to demo neck of the bladder and male urethra
35-40 degrees body rotation superior border of symkphysis
284
mean lethal dose
1-2GY
285
cell with the highest sensitivity
in G2 & Mphase
286
acute effects of radiation are
inflammation, edema, bleeding and stripping of mucosa
287
every xray tube must be contained within the housing that reduces
radiation leakage to less than 100mR/hr at a distance of 1m
288
1-10Gy
bone marrow damage with 2Gy threshold
289
10-100Gy GI system damage
especially small bowel
290
above 100GY
CNS damage
291
stages of response
prodromal - before the disease NVD
latent- healthy appearance
manifest illness- dose dependant person is ill
292
stocastic
no threshold increased dose increased probablitay
293
deterministic
threshold increased dose increased severity
294
somatic effect
cancer, congential defect, cateracts,
295
genetic
mutation
296
cataract
threshold 2GY acute, 10Gy chronic
297
sterility
threshold 2GY, temporary, 5Gy permamnet
298
fetus
preimplantation (0-10days) increased mitotic rate very radio sensitive prenatal death if born exencephaly brain hernia
299
major organgenesis
10days to 6wks with congential abnormalities most common is CNS damage increased neonate death most radiosensitve
300
fetal growth
above 6wks late effects like cancer
301
increased density and fog
no starter added to new soluition
302
fixer
clearing agent preservtibe, buffer, activator
303
fixor acts upon not trapped in specs silver haldies
needs more than 2 silver BR and 2 sensitivity specs
304
hardening happens in
developer and fixer
305
damp film
hardner problem or blowing problem
306
to enhance subject contrast
compression, decrease kvp, small field size, use a grid
307
diagnosticically useful densities
0.25 + B + F
308
single emulsion film is used
duplication and in mammo
309
unexposed film
under 20 degrees C, 30-60 humidity
310
exposed film
15-27C- 30-50 degrees humidity
311
left UV junction best demo in
RPO position with 30 degree body rotation
312
oblique view of sternum
best technique is 60kvp, 80ma and 2.5sec shallow breathing
313
ap shoulder external rotation
demo greater tuberacle
314
bone age
most common left hand and wrist sometimes left knee
315
arm venogram
contrast from wrist up to SVC
316
tacky film
exhausted hardner in fixer
317
developer temp accepted variance
+/- 0.5 degree C
318
C spine shoot through with no grid
70kvp and 5mas
319
spatial resolution in DR is limited
by size of the pixel
320
advanatage of DR
increased contrast and increase latitude
321
all repeats and rejects but not all rejects
are repeats
322
personal reject rate
total # of repeats and total # of films used
323
acceptance within
4-5%
324
every xray tube must be contained within the housing that reduces
radiation leakage to less than 100mR/hr at a distance of 1m
325
70kvp and up filtration is
2.5mm AL between 50-70 kvp is total filtration and must be 1.5 mm AL and below 50kv 0.5mm AL
326
image intensifier assembly acts as a primary protective barrier and must be
2mm Pb equaivalent
327
protective curtain is
0.25mmPB
328
fluro intensity of xray beam at the table top
shoud not exceed 2.1 R'min for each ma of operation at 80kvp
329
total intensity must not exceeed
10r/min
330
body thickness is 20cm , ese at 100cm SID is 110msv. what is the ese when the new SID is 60cm
SODI= 100cm-20cm-80cm
SOD2= 60cm-20cm-40cm
100/new ese= 40 x 40/ 80 x 80
new ese 440msv
331
dense bone ct #
1000
332
muscle ct #
50
333
white matter ct#
45
334
gray matter ct #
40
335
blood ct #
20
336
CSF ct#
15
337
water ct #
0
338
fat ct #
-100
339
lungs ct #
-200
340
air ct #
-1000
341
what is pitch
couch movement every 360 degrees/ slice thickness
342
preferred detectors in ct
solid state with 80% detection efficiency
343
1gy
100rads
344
blue sensitive film, safe light is
amber
345
digital radiography
static images produced with either fan xray beam intercepted by a linear array of radiation detectors or an area of xray beam intercepted by a photostimulable phosphor plane or direct capture solid state device
346
dose equivalent
radiation quantity that is used for radiation protection and that expresses dose on a common scale for all radiations. it is expressed in rems or SV
347
dose limit for preganant tech is
0.5msv/mth
348
dose limit for the fetus
4msv for the period of pregnancy, 2 TLDS must be worn during pregnancy
349
flux gain
number of output light photons / # of input light photons
350
minification gain
diameter of input phosphor squared / diameter of output phosphor
351
brightness gain
minification gain x flux gain
352
image receptor in CR is
composed of europium activated barium fluor halide compunds which are energized when exposed to light of xrays
353
sensitivity is equal to 200 speed screen film combination . the latent image consists of valence electrons stored in high energy traps. it manifests exposure to very narrow high sensitity laser beam
red. the laser beam causes electrons to return to their original state the valance band with the emission of blue light (OSL). the blue light is by the ultra sensitive multipier then it is digitzed and stored
354
spatial resolution of CR is not as
good as CR but contrast is greater and wider latitude is allowed. patient dose is less
355
TLD made of
litium fluoride crystals that are heated up to emit light
356
if the calcenous obsures the mortise jt then
dorsiflex the foot
357
axiallary part of the right upper ribs
RPO 45 deg or LAO PA away
358
x table knee the flim is
on the medial side angle 5 degree caudad
359
swimmers view the CR is centered at
JUGULAR NOTCH
360
what is road mapping
continuous real time subtraction
361
bony detail ct lspine
2200 ww and 400wl
362
ivp optimal kvp is
66-75
363
uneven light fog along on edge is
light fog the cassette was not closed properly
364
90 kvp AEC back up timer set at 50mas
image is underexposed
365
what is the variable in AEC and what is fixed
patient and the grid never moves always in the center of the image
366
what chambers are selected for a abdomen with barium
all 3
367
what chambers are selected for chest
outer 2
368
what chambers are selected for a knee
middle
369
if you have an upside down grid what is the error
it will be like a inverted skunk. fine in the middle and crap on the 2 outer sides
370
falling 3 phase generator
max setting is 500ma, 400speed, 8:1 stationary grid, focused to 100cm, 2.5mm filtration, 1.5mm FSS, 115kvp, AEC the right cell activated at 180cm
371
safe infusion rate to avoid edema
15-20 drops per min
372
crohns affects
ileum, string sign
373
nephrostogram
75kvp and 3.5ma fluro
374
if horizontal fracture of the patella is present
do not perform infra superior projection
375
16:1 grid is focused to 100cm what is the safe distance without primary loss of radiation
95-105cm
376
small bowel obstruction
dilated loops stacked coins
377
temp of barium most comfortable for patient is
29-30 deg C
378
why co2 instead of air
more rapidly absorbed
379
metareaction
unexpected or exacerbated effect from drug first time a patient receives it
380
teratogenic effect
drug that adversely affects the fetus causing abnormal develppment
381
idiosyncratic reaction
allergic reaction of metareaction
382
thyroid collar for fluro is
0.5mmlead
383
anticholineric drugs are used
in GI series to paralyze smooth muscles and to better demo the duodenum
384
topical routes are
eyes, nose, mouth, respiratory muscosa, vagina, rectum
385
speed point is
1+B+F
386
if density varies by 0.05
unsafe light time in the dark room
387
recto sigmoid patient is prone
30-40caudad
388
sphenoid sinus is located immediately
anterior and inferior to sella turica
389
greatest risk for breast cancer is
child birth after age 30
390
when more than one cell is activated the cell receiving the most radiation will
contribute the greatest electrical signal and therefore have the most overall influence on the exposure
391
what characteristic allows a CCD to provide better contrast resolution than a television camera tube?
higher sensitivity to light (DQE)
392
when is the mask image obtained during a digital subtraction angiography?
before the contrast injection if the patient is positioned
393
exam being done for spondylolysis of L5 the patient should be positioned at 60 degrees posterior oblique
CR enters midway between the crest and ASIS to best demonstrate this position
394
HVL is dependent on?
tube voltage
395
the biciptal groove of the humerus lies
between the lesser tuberacle and greater tuberacle
396
what effect does a enlarged SFOV have on a CT image
may make the individual pixels less visable
397
what is venipuncture
inhert catheter 15 degree angle to avoid nerve damage and avoid using volar aspect of the wrist or dorsal
398
why is there a considerable extension in density range for CR as to computed flim imageing
CR has one D max curve
399
what seperates the cerebral hemispheres of the brain
longitiudinal fissue
400
oral ingestion of contrast is used for visualization of
esophageal varices , the valsava maneuver can be used to increase portal pressure therefore showing it
401
lossy is how much lost
1/3
402
lostless is how much lost
1/20th
403
from what solution is silver reclaimed in most recovery systems
fixer
404
what documentation do you find compelte information on a specific chemical product
MSDS
405
how is HIV infection tramsmitted
direct contact
406
permament filtration mm of al is
less than 50- 0.5mm of al
50-70= 1.5mm of al
more than 70- 2.5mm of al
407
what angle is used for the scaphoid?
20
408
what is the beste projection to view the pisiform
ap oblique wrist
409
edge enhancement shows
smaller details better
410
the only long bone to ossify by intramembraneous ossification is
the clavicle
411
structure that connects the lateral ventricles to the 3rd ventricle in the brain in regards to the flow of CSF is
interventricular formina
412
structure of the nasal septum that continues superiorly as the cristia gali is
perpendicular plate
413
mengies that protect the spinal cord and brain from the outer layer is
dura mater, arachnoid and pia me mater
414
noise is the main limiting factor for
contrast resolution acquiring CT images
415
what is the radiography sign of ulcerative colitis
polypoid lesions along the bowel wall
416
birds beak
volvulus
417
RA of epidural hematoma on unenhanced ct
lens shaped area with increase in brightness
418
prefetching and on demand in PACS means
studies awaiting interpretation by the radioliogist
419
test tool used for quality control to elevaluate electronic display devices for luminence and luminance uniformity
photometer
420
barium sulphate mixture for a double contrast BE
75% weight volume & below 30C
421
what is pyrexia
fever increased respiratory rate, chills, flushed skin
422
lead apron on the II is
0.25mm of lead
423
volvulus is seen in
cecum & sigmoid as birds beak
424
celiac disease is a
malabsorption disorder
425
2 right lung fissures are
horizontal & oblique
426
1 left lung fissue is
oblique fissue
427
trachea divides into the primary bronchi at the
carina T4-T5
428
endotracheal tube for intubation should be positioned
5-7cm above the carnia
429
oxygen flow rate for the average patient is
2-5L/min
430
trauma patient in shock
10L/min
431
patients with a chronic lung disease need oxygen at a slower rate like emphysema oxygen at
less than 3L/min
432
oxygen to child with a nasal cannula is
1/2-1/4 L/min because they have a higher respiration rate they need lower oxygen rate so as to note over inflate their lungs
433
chest tube is placed into
intrapleural space between the parietal pleura and visceral pleura
434
what is a peripherally insertered central catheter
inserted into a vein into the patient arm and advanced until the tip lies in the SVC
435
PICC line used for
medications, fluids, draw blood short or long term, ICU, chem patients dialysis, total parenteral nutritioin
436
average heart beat per min
60 to 100 beats/min
437
adult respiration
12-20/min
438
child respiration
20-24/min
439
baby respiration
24-36/min
440
polydacly is
extra finger
441
what is the fat pad by the thumb called
thenar eminence
442
ankylosis spondolysis is
bamboo spine or marie strumple
begins at the sacroiliac joint with bilateral and symmetric, widening of the joints
bone fusion and calcification seen on the ap lumbar
443
spondolothesis is
defect in pars artericularis seen on the oblique views, between the superior and inferior articular process of the vertebrae on the lamina
most common in L5
clefts are bilateral
444
spondoloithesis is
displacement in pars interacrticularis with anterior displacement of L5 over S1
445
for lateral t spine centering is
to T7 for the lateral and you do not need C7
446
ap tspine
if you have the adams apple on your centered to high
447
tuberacle on the clavicle is seen on the
axial
448
increase technique for the axial clavicle
because your shooting through thicker tissue
449
clavicle is a
long bone with no medullary cavity, has cancellous bone with compact on the outside, red marrow
450
on the lateral foot view the sinus tarsi is
more closed
451
when you stand 90 degrees from the patient you get
the least amount of scatter
