CH 19- GUIDED INTERVENTION

Question 0

WHAT ARE SOME OF THE DISADVANTAGES OF USING U/S DURING PROCEDURES?

Answer 0

• NOT ALL MASSES CAN BE SEEN
• BOWEL GAS OBSCURES AREA
• NEEDLE TIP CAN BE DIFFICULT TO SEE
• INEXPERIENCE OF SONOGRAPHER & RADIOLOGIST
• FIXED ANGLE WITH NEEDLE GUIDES

Question 1

WHAT ARE THE ADVANTAGES TO USING U/S DURING PROCEDURES?

Answer 1

• REAL-TIME VISUALIZATION OF BIOPSY NEEDLE
• PORTABILITY
• LACK OF RADIATION
• LOW COST
• SHORTER PROCEDURE TIME

Question 2

WHAT IS THE MOST COMMON REASON FOR A BIOPSY?

Answer 2

TO CONFIRM MALIGNANCY

Question 3

WHAT ARE THE CONTRAINDICATIONS FOR BIOPSY?

Answer 3

• UNCONTROLLABLE BLEEDING
• LACK OF SAFE NEEDLE PATH
• UNCOOPERATIVE PATIENT

Question 4

WHAT ARE THE ANTICOAGULANTS?

Answer 4

HEPARIN - 4-6 HRS PRIOR TO EXAM
COUMADIN 3-4 DAYS PRIOR TO EXAM
ASPIRIN 5-7 DAYS PRIOR TO EXAM

Question 5

HOW WILL THE ALPHA FETOPROTEIN (AFP) LAB RESULTS BE WITH A MALIGNANT LIVER LESIONS?

Answer 5

WILL BE INCREASED WITH HCC

Question 6

HOW WILL PROSTATIC SPECIFIC ANTIGEN (PSA) RESULTS APPEAR WITH PROSTATE CANCER?

Answer 6

ELEVATED

Question 7

INCREASED THYROGLOBULIN LEVELS IS INDICATIVE WITH?

Answer 7

THYROID CANCER

Question 8

_____ INCREASES WITH ABSCESS OR HEMATURIA WITH RENAL DISEASE.

Answer 8

WBC

Question 9

_____ ___ IS THE MOST COMMON, IS EFFECTED BY COUMADIN, VALUES BETWEEN 10-13 SECONDS.

Answer 9

PROTHROMIN TIME (PT)

Question 10

_____ _____ _____ IS EFFECTED BY HEPARIN, ASPIRIN, & ANTIHISTAMINES, VALUES ARE BETWEEN 60-70 SEC.

Answer 10

PARTIAL THROMBOPLASTIN TIME (PTT)

Question 11

THIS METHOD OF STANDARDIZATION WAS DEVELOPED DUE TO VARIABILITY OF PATIENT RESULTS. WAS DEVELOPED BY THE WORLD HEALTH ORG

Answer 11

INTERNATIONAL NORMALIZED RATION (INR)

Question 12

THE INR VALUES MUST BE ____ ___ TO ENSURE SAFE PROCEDURS.

Answer 12

<1.4

Question 13

____ ___ ____ USES THIN NEEDLES TO OBTAIN CELLS USING ____ TO ___ GAUGE NEEDLES.

Answer 13

FINE NEEDLE ASPIRATION (FNA); 20-25

Question 14

THIS UTILIZES AN AUTOMATED, SPRING - LOADED DEVICE CALLED A BIOPSY GUN.

Answer 14

CORE BIOPSY

Question 15

WHAT SIZE IS THE NEEDLE ON A BIOPSY GUN & HOW FAR IS THE THROW?

Answer 15

14 - 20 GAUGE

10 - 23 MM

Question 16

WHAT SIZE NEEDLE IS USED FOR ABSCESS OR FLUID COLLECTION DRAINAGES?

Answer 16

16 -22 GAUGE CENTESIS NEEDLE

Question 17

THIS METHOD USES NO GUIDE, RADIOLOGIST HOLDS TRD, MORE DIFFICULT TO ALIGN TRD & SOUND BEAM.

Answer 17

FREE - HAND TECHNIQUE

Question 18

THIS METHOD THE NEEDLE IS ATTACHED TO THE TRD SO THE NEEDLE & SOUND BEAM MOVE SIMULTANEOUSLY.

Answer 18

NEEDLE GUIDE

Question 19

THIS IS MANDATED BY JCAHO, IS PERFORMED PRIOR TO PROCEDURES.

Answer 19

“TIME-OUT”

Question 20

WHAT NEEDS TO BE STATED DURING A TIME OUT?

Answer 20

THE PATIENTS FULL NAME, ID # & CONFIRM, PROCEDURE TYPE

Question 21

WHAT COMPLICATIONS MIGHT ARISE FROM A BIOPSY?

Answer 21

• PAIN
• VASOVAGAL
• HEMATOMA
• BLEEDING, HEMORRHAGE, PNEUMOTHORAX, PANCREATITIS, SEEDING, DEATH

Question 22

HOW DOES THE NEEDLE APPEAR ON U/S?

Answer 22

AS AN ECHOGENIC DOT

Question 23

WHAT IS THE MOST COMMON ORGAN FOR BIOPSY?

Answer 23

LIVER

Question 24

WHAT IS THE SAFEST PLANE FOR LIVER BIOPSY?

Answer 24

SUBCOSTAL THEN INTERCOSTAL

Question 25

DURING A RENAL PARENCHYMAL BIOPSY, IF A PATIENT NEEDS TO PEE URGENTLY WHAT NEEDS TO BE DONE?

Answer 25

CK BLADDER AND CALL ANGIOGRAPHY STAT (THE RENAL ARTERY HAS BEEN KNICKED)

Question 26

WHAT POLE OF THE KIDNEY IS TYPICALLY BIOPSIED FOR RENAL ALLOGRAFT (TRANSPLANT) AND WHY?

Answer 26

UPPER POLE TO AVOID POSSIBLE LACERATION OF MAIN RENAL VESSELS AND URETERS.

Question 27

DURING A RENAL PARENCHYMAL BIOPSY WHICH KIDNEY IS BIOPSIED TYPICALLY AND IN WHAT PATIENT POSITION?

Answer 27

LEFT LOWER POLE | PRONE