Week 2: Patient Prep and Contrast Agents Flashcards

Question

Isomolar agents compared to blood (IOCM)

Answer 1

same compared to blood (290 most/Kg H20

Answer 2

2 times compared to blood

Answer 3

-brand -temperature -concentration of CM

Answer 4

thickness or friction of luid as it flows

Answer 5

injectability of CM through small-bore IV catheters/needles

Answer 6

molecules that will form ions in solutions

Answer 7

molecueles that dont disassociate

Answer 8

not metabolized but excreted almost fully by kidneys

Answer 9

half life in patients 2 hours (eject 50%)

Answer 10

- Warmth - Feeling of urination - Funny taste (metallic) - Few hives - Minor itchiness - Oral contrast may cause diarrhea

Answer 11

by iodine concentration and volume delivered

Answer 12

- Major hives - Breathing problems - Swelling of face, throat or tongue - LOC (loss of consciousness)

Answer 13

Result from the physiochemical properties of CM, dose & speed of injection

Answer 14

- All other reactions, largely unpredictable - often within an hour - mimic allergic reactions but are rarely because of an allergy

Answer 15

short duration and self limiting

Answer 16

no immediately life threatening but an progress to

Answer 17

potentially or immediately life threatening

Answer 18

-glomerular filtration rate GFR -Effective renal Plasma flow ERPF -Serum Creatine SeCR as index of GFR : fast and inexpensive -estimated glomerular filtration rate (eGFR): gaining more attention, potentially better marker of CIN risk - SeCR and eGFR most commonly used

Answer 19

-previous CM reaction -asthma - history of allergies to food/drugs - NOT risk factor: seafood allergy

Answer 20

The inability of the kidneys to maintain homeostasis, resulting in the accumulation of nitrogenous wastes

Answer 21

Renal function is abnormal but capable of sustaining essential bodily functions

Answer 22

- any condition or disease affecting the kidneys - sometimes used synonymously with renal impairment

Answer 23

- IV contrast media that affects kidney function - Progressive rise in SeCr within 24 hrs & typically nonoliguric (high urine output) - CM can result in significant nephrotoxic effects in high-risk patients for nephropathy.

Answer 24

an acute impairment of renal function that occurs within 48 hours of intravascular administration of contrast material.

Answer 25

-eGfr less than 30 -history of DM and recent IV CM -Large volume of CM -History of congestive heart failure

Answer 26

-identify patients at high risk -use LCOM or IOCM -ensure patient hydration -minimize CM volume -allow 48 between CM procedures -discontinue nephrotoxic medication before procedure

Answer 27

-CM can result in CIN, patient taking metformin who go into renal dysfunction can have an accumulation of lactic acidosis - if eGFR less than 60 metformin should be temporarily discontinued after CM and can be resumed after 48 hours

Answer 28

- If dialysis is temporarily DO NOT give CM to patient - if the patient is on end-stage renal failure CM can be given and can continue their routine dialysis schedule

Answer 29

- normal thyroid = no effect - hypothyroidism = insignificant effect - hyperthyroidism = CM may precipitate thyroid storm (thyroid hormone reaches dangerously high level, life threatening)

Answer 30

-bronchospasm -pulmonary arterial hypertension -pulmonary edema - to reduce risk use LOCM

Answer 31

-pulmonary hypertension -bronchial asthma -heart failure

Answer 32

- can provoke seizures in patients who have disease that disrupts blood-brain barrier - control or reduce risk of seizure by administering 5-10 mg of diazepam 30 minutes before CM

Answer 33

- reactions that occur 1hr to 1 week after CM - skin reactions primarily (red spots, hives, welts or bumps) - salivary glad swelling possible (more common in patients who have under gone chemotherapy)

Answer 34

- help to distinguish loops of bowel from cyst, abscess, or neoplasm - oral CM: used for most abdomen and pelvis CT (use Ba-sulfate or more commonly iodinated water-soluble solution) - Rectal CM: useful for some indications. includes air, Ba-sulfate or 1-3% iodinated water-soluble solution

Answer 35

- DO NOT use if bowel perforation suspected because that could lead to peritonitis and risk of death -Most commonly used are positive agents that contain a 1% to 3% barium sulfate suspension (BaSO4) formulated to resist settling - in general the higher the dose the better the bowel pacification (typically used minimum of 500 mL diluted barium sulfate given 45 min-2hrs before exam)(additional 200mL can be given just before scanning the stomach and the small bowel)

Answer 36

- resembles water on image - o.1% brim sulfate solution - measures 15-30 HU - advantages: improved bowel distention (compared to water), faster transit than standard CM barium, more effective visualization of both bowel wall and mucosa

Answer 37

- HOCM and LOCM: positive agents, can be diluted and administered orally. stimulate peristalsis and cause diarrhea - 2-5% solution normally used, 1000-1500 mL over 1-3 hrs immediately before scan to descend stomach and small intestine

Answer 38

- Sometimes used in place of a positive agent - It does not obscure mucosal surface - Transits rapidly - Distends the bowel poorly

Answer 39

- Produces very high negative contrast - Administered rectally - Particularly useful in CT colonography/ Virtual colonoscopy - Both room air and CO2 provide reliable colonic distention (CO2 is better tolerated by most patients)

Answer 40

iodinated contrast agents injected into the intrathecal space surrounding the spinal cord