ABD II Test Interventional, Breast, & Pediatrics Flashcards
What is the primary advantage of using ultrasound in procedures?
To have continuous real-time visualization of the biopsy needle, allowing for adjustment of the needle as needed
pg. 495
What is PTT?
Partial Thromboplastin Time
- Can be used to evaluate effects of heparin, aspirin, and anti-histamines on the blood-clotting process.
- Evaluates factors found in intrinsic and common pathways
- Normal values typically between 60 and 70 seconds
pg. 497
What is PT?
Prothrombin Time
- Used to evaluate factors found in extrinsic pathway, which may be affected by patients on Coumadin
- Normal values typically between 10 and 13 seconds
pg. 497
What is INR?
International Normalized Ratio
- a method developed to standardize PT results among laboratories by accounting for the different thromboplastin reagents used to determine PT
pg. 497
What is included in a time out?
Correct name, birth date, doctor, site, procedure,sterile field, and proper hand washing
What are some post biopsy complications?
Post-procedural pain/discomfort
Vasovagal reactions- profuse sweating, complaining of feeling faint/lightheaded, and nausea
Hematomas
Serious but rare complications- bleeding, hemorrhage, pneumothorax, pancreatitis, biliary leakage, peritonitits, infection and possibly death
pg. 503-504
What gage size of needle is used for a thyroid?
25
During a biopsy, a spring loaded gun is used to get a ___ sample.
Core
pg. 498
Before a procedure, what do you need to do to be ready?
Before a procedure you need to have a preprocedure picture with pt name and birth date. Also mark the area where the needle needs to be guided in. (Also have consents signed, proper supply’s for doctor, go over med list with pt, and proper hand washing)
What is the most common organ biopsied?
The liver??
pg. 517
What is a specific complication of a renal biopsy?
Perinephric hematoma and hematuria
pg. 519
How is the patient positioned for a thoracentesis?
Pt sits on the side of the bed and is leaning on a bedside table with pillow for comfort. This opens up the space between the ribs to be able to get the needle in to drain the fluid.
What are the 3 layers of the breast?
- Subcutaneous layer- usually quite thin and consist of fat surrounded by connective tissue septa
- Mammary (glandular) layer- includes the functional portion of the breast and the surrounding supportive (stromal) tissue
- Retromammary layer- same as subcutaneous layer
All three of these layers are located between the skin and the pectoralis major muscle on the anterior of the chest wall.
pg. 550
What are structures in the breast, called the fibrous skeleton, that help maintain the shape made up of?
Cooper’s ligaments
pg. 551
As a woman ages, glandular tissue in the breast is replaced by ___.
Fatty tissue
pg. 553
What are the characteristics of Cooper’s ligaments?
Sonographic characteristics are echogenic and are dispersed in a linear pattern. Best identified when beam strikes the ligaments at a perpendicular angle.
pg 552
If a woman comes to you, and she has lumpy, bumpy, painful, tender breasts, what does she have?
fibrocystic breasts
What is the most common benign tumor of the breast?
Fibroadenoma , they occur primarily in young women
pg. 575
What is the most common malignant tumor of the breast?
Scirrhous Carcinoma
pg. 581
Invasive Ductal Carcinoma (IDC)
Per Beth’s power point….
Skin dimpling is a sign of ___.
breast cancer
pg 571
What is the primary purpose of breast screening?
The detection and diagnosis of breast cancer in its earliest and most curable stage
pg. 559
The American Cancer Society states women should have a mammogram by age ___.
40
pg. 559
What is it called when a male has big breasts?
Gynecomastia
pg. 556
What are the sonographic signs of breast cancer?
- Margins indistinct fuzzy and spiculate
2.Grow through tissue without compressing adjacent tissue and may cause retraction of nipple or skin dimpling - Shape sharp, angular microlobulations
4 .Orientation taller than wide, radial growth suspicious for intraductal lesions - Echo pattern hypoechoic, weak internal echoes, clustered microcalcifications
- Strong attenuating
- Mobility firmly fixed
- Compressibility rigid noncompressible
- Hypervascular, feeder vessel may be identified
pg 571
When mammography sees microcalcifications, ultrasound does not identify them. This is not a reason to do a biopsy.
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What are some good reasons to do a breast ultrasound?
- Further characterization of mammogram mass (cystic or solid)
- Eval of a palpable breast lump
- Pregnant or lactating pt
4.Pt with breast augmentation - Difficult or compromised mammogram
- Imaged guided procedure
- young women
pg 568
What might a cancerous mass look like?
Taller than wide, Fuzzy, Spiculated, Shape sharp and angular microlobulation, weak internal echoes, fixed, rigid, hypervascular
pg 571
What is TIPS?
Transjugular Intrahepatic Portal-systemic Shunt
-Created to lower portal pressure (portal hypertension)
-Shunt is placed by using a jugular access; it is placed between a hepatic vein and a portal vein (typically in the RHV and RPV)
Per transplant packet
What is the material used for TIPS?
GORE Viatorr endoprosthesis, this is a wire reinforced PTFE covered conduit
Per transplant packet
How many liver transplants are done each year in the United States?
Approx. 5000
Per transplant packet
What is the leading cause for chronic hepatitis and cirrhosis?
Hepatitis C
Per transplant packet
What is the acronym for the system that is used to prioritize liver transplant recipients?
MELD (The Model for End-Stage Liver Disease)
Per transplant packet
What is the most common cause for end stage renal disease?
Diabetes
Per transplant packet
What is the Resistive Index for a renal transplant?
> 0.8 = transplant dysfunction
Per transplant packeet
What is hepatoblastoma?
Clinical findings: most common malignant tumor, less than 5 years of age, palpable abdominal mass, elevated serum alpha-fetoprotein levels, fever, pain
Sono findings: hepatomegaly, calcifications may occur, solitary heterogeneous mass, area around mass is hyperechoic, portal vein thrombosis, doppler shows high velocity and low resistance flow
pg 694
What is pyloric stenosis?
Clinical findings: Male infants, projectile vomiting, dehydration, weight loss
Sono findings: Distended stomach, hypertrophied pyloric muscle with a canal >16mm, pyloric wall muscle >3.5mm
pg 694
What is intussusception?
Clinical findings: Colicky abdominal pain, vomiting, bloody stools, abdominal mass
Sono findings: Alternating hypoechoic and hyperechoic rings surrounding an echogenic center (target sign), free peritoneal fluid
pg 694
What is Wilm’s tumor?
Clinical findings: Hypertension, palpable abdominal or flank mass, weight loss, fever, anemia, pain,
Sono findings: Complex mass in kidney, well circumscribed mass, isoechoic to echogenic, may have califications, look for tumor extensions into the renal vein or IVC
pg 715
What is the most common sonography interventional procedure?
~
What is the most common indication for a biopsy to confirm the mass of what cells?
Malignancy in a mass?
Pg. 496
