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Contrast Media Flashcards

1
Q

What are the two types of contrast media?

A
  • Radiolucent (negative)
  • Radiopaque (positive)
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2
Q

How many types of contrast media is there?

A

2

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3
Q

what type of contrast media is radiolucent?

A

Negative

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4
Q

What type of contrast media is radiopaque?

A

Positive

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5
Q

What is the purpose of contrast media?

A
  • Visualize anatomic detail
  • Distinguish between radiographic densities in anatomic tissues
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6
Q

What is contrast media?

A

Diagnostic agents that are instilled into body orifices or injected into the vascular system, joints, and ducts to enhance subjected contrast in anatomic areas where low subjects contrast exists

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7
Q

How many routes of administration are there for contrast media?

A

4

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8
Q

What are the routes of contrast administration?

A
  • Oral
  • Rectal
  • Retrograde
  • Parenteral (Intravenous, Intra-arterial, Intrathecal)
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9
Q

Where is the oral route taken?

A

Ingested by mouth

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10
Q

Where is the rectal route taken?

A

Administered rectally

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11
Q

Where is the retrograde route taken?

A

Administered against the normal flow

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12
Q

Where is the parenteral route taken? What are the routes?

A
  • Administered by injection using a needle
  • Intravenous (Administered into a vein)
  • Intra-arterial (Administered into an artery)
  • Intrathecal (Administered into a sheath)
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13
Q

What are some exams that are taken retrograde?

A
  • Cystogram
  • VCUG
  • Barium enema
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14
Q

What are some exams that are taken rectal?

A

Barium enema

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15
Q

What are some exams that are taken oral?

A
  • Upper GI
  • Esophagram
  • Rehab swallow study
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16
Q

What are some exams that are taken Intravenous (parenteral)?

A

IVU

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17
Q

What are some exams that are taken Intra-arterial (parenteral)?

A

Arteriogram

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18
Q

What are some exams that are taken Intrathecal (parenteral)?

A

Myelogram

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19
Q

What are some examples of negative contrast media?

A
  • Gas (Air)
  • Gas-producing tablets
  • Air-producing crystals
  • Carbon dioxide
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20
Q

What does negative contrast media look like on radiographs?

A

Dark

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21
Q

What is negative contrast media composed of?

A

Elements with low anatomic numbers

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22
Q

In negative contrast media x-ray photons are _______ through _______ contrast media

A
  • Easily transmitted or scattered
  • Radiolucent
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23
Q

What are examples of positive contrast media?

A
  • Barium sulfate (aka Barium)
  • Water-soluble iodinated contrast
  • Oil-based iodinated contrast
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24
Q

What does positive contrast media look like on radiographs?

A

Light

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25
Q

What is positive contrast media composed of?

A

Elements with high anatomic numbers

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26
Q

In positive contrast media x-ray photons are _______ by _______ contrast media

A
  • Absorbed
  • Radiopaque
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27
Q

Is barium radiolucent or radiopaque?

A

Radiopaque

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28
Q

What is the atomic number of barium?

A

56

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29
Q

What is the chemical formula for barium?

A

BaSO4

(1 atom of barium + 1 atom of sulfur + 4 atoms of oxygen)

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30
Q

What is barium sulfate?

A

A compound

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31
Q

Does barium sulfate dissolve in water?

A

No

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32
Q

Barium sulfate is ________ because its ______ in water

A
  • Relatively inert
  • Insoluble
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33
Q

Colloidal suspension is not a ______

A

Solution

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34
Q

What does barium sulfate mixed with create?

A

Colloidal suspension

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35
Q

What is used to create a colloidal suspension?

A

Barium sulfate and water

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36
Q

What is used to increase palatability in barium sulfate?

A

Flavorings and sweeteners

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37
Q

What will happen in a colloidal suspension when particles are left to sit for too long?

A

The particles suspended in water will settle out

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38
Q

How do you make thin barium?

A

1 part barium sulfate to 1 part water

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39
Q

What is the consistency of thin barium?

A

Thin milkshake

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40
Q

What happens when the thin barium mixture is cold?

A

The chalky taste is reduced

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41
Q

What does the flow of thin barium through the GI tract depend on?

A
  • Suspending medium & additives
  • Temperature
  • Consistency
  • Patient condition & GI tract
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42
Q

What does w/v mean?

A

Weight to volume

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43
Q

What is the w/v ratio of barium sulfate to water (thin barium)

A

30-50%

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44
Q

How is thick barium created?

A

3-4 parts of barium sulfate to 1 part water

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45
Q

What is the consistency of thick barium?

A

Cooked cereal

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46
Q

What is the w/v ratio of barium sulfate to water (thick barium)?

A

up to 250%

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47
Q

Which kind of barium is difficult to swallow?

A

Thick barium

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48
Q

Thick barium is more ______ than thin barium

A

Difficult to swallow

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49
Q

What kind of barium is better suited for the esophagus?

A

Thick barium

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50
Q

Thick barium is well suited for the _____

A

Esophagus

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51
Q

Why is thick barium better suited for the esophagus?

A

It descends slowly and coats the mucosal lining

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52
Q

Which kind of contrast descends slowly and coats the mucosal lining?

A

Thick barium

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53
Q

What are other forms of barium?

A
  • Barium paste
  • Barium pills
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54
Q

What are barium pills used to evaluate for?

A

Strictures in the esophagus

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55
Q

How are barium pills taken?

A

Orally

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56
Q

Which ways can barium paste be taken?

A

Orally & rectally

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57
Q

What can barium paste be used to evaluate for orally?

A

The function of the esophagus

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58
Q

What can barium paste be used to evaluate for rectally?

A

The function of the rectum

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59
Q

What exam is used to evaluate rectum function?

A

Defecography

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60
Q

How many contraindictions are there for barium?

A

11

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61
Q

What are the contraindictions for barium?

A
  • Suspected colon obstruction
  • Gastrointestinal perforation
  • Transesophageal fistula
  • Obstructing lesion of the small intestine
  • Inflammation or neoplastic lesions of the rectum
  • Pyloric stenosis
  • Paralytic ileus
  • Gastrointestinal hemorrhage
  • Toxic megacolon
  • Recent gastrointestinal biopsy or surgery (within 3-5 days)
  • Pre-op or pre-endoscopy
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62
Q

In what cases should water-soluble iodinated contrast media be used?

A

If theres any chance that contrast will escape into the peritoneal cavity

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63
Q

What kind of contrast should be used if theres any chance that contrast will escape into the peritoneal cavity?

A

Water-soluble iodinated contrast media

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64
Q

What are some examples of Water-soluble iodinated contrast media?

A
  • Gastrografin
  • Gastroview
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65
Q

What kind of contrast media is gastrografin or gastroview?

A

Water-soluble iodinated contrast media

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66
Q

What is the most common complication of barium administration?

A

Constipation

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67
Q

What are some complications of barium administration?

A
  • Constipation
  • Perforation (extravasation into the abdominal cavity)
  • Vaginal rupture by incorrect placement of the catheter for lower GI exams (very rare)
  • Fluid overload resulting from water absorption from the colon
  • Aspiration into the lungs (Can result in barium pneumonia)
  • Allergic reactions
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68
Q

What can constipation due to barium administration lead to?

A

Obstruction

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69
Q

What should you do after the patient recieves barium to avoid complications?

A

To drink plenty of fluids

70
Q

What can barium aspiration into the lungs result in?

A

Barium pneumonia

71
Q

Should a water-soluble iodinated contrast be used if a patient is sensitive to iodine?

72
Q

What is a water-soluble iodinated contrast used for?

A

To opacify the GI tract

73
Q

Which contrast is used to opacify the GI tract?

A

Water-soluble iodinated contrast

74
Q

Which way can water-soluble iodinated contrast be taken?

A

Orally or rectally

75
Q

What are some examples of water-soluble iodinated contrast?

A
  • Gastrografin
  • Gastroview
76
Q

What is the atomic number of iodine?

77
Q

What does water-soluble iodinated contrast contain?

78
Q

What will happen if water-soluble iodinated contrast leaks into the peritoneal cavity?

A

The body will absorb it

79
Q

Can barium sulfate be absorbed by the body?

80
Q

What kind of taste does water-soluble iodinated contrast have?

81
Q

Water-soluble iodinated contrast can be ______ or _____

A
  • Used as is
  • Diluted with water
82
Q

What contrast moves faster through the GI tract?

A

Water-soluble iodinated contrast

83
Q

How fast does water soluble iodinated contrast clear the stomach?

84
Q

How fast does water soluble iodinated contrast outline the colon?

85
Q

In what case should water-soluble iodinated contrast not be used?

A

If patient is sensitive to iodine

86
Q

What are some technologist responsibilities when it comes to giving the patient contrast?

A
  • Take patient history
  • Check lab values to assist kidney function
  • Room set up
  • Assist radiologist
  • Obtain requested radiographs
  • Present images to radiologist before letting the patient leave
  • Give post-procedural instruction to the patient
  • Clean up room
87
Q

What does BUN stand for?

A

Blood urea nitrogen

88
Q

What is the normal BUN range for males?

A

8-24 mg/dL

89
Q

What is the normal BUN range for females?

A

6-21 mg/dL

90
Q

What is the normal range for creatinine levels?

A

0.6-1.2 mg/dL

91
Q

Many facilities will not inject patients with a creatinine level of ________

92
Q

What does GFR stand for?

A

Glomerular filtration rate

93
Q

What is the normal GFR range for normal kidney function?

94
Q

What is the normal GFR range for moderate kidney damage?

95
Q

What is the normal GFR range for severe kidney damage?

96
Q

What is the normal GFR range for kidney failure?

97
Q

What is needed to increase penetrability?

A

Higher kVp

98
Q

Higher kVp is needed to ________

A

Increase penetrability

99
Q

________ is determined by the atomic number of the elements used in contrast media?

A

X-ray attenuation

100
Q

X-ray attenuation is determined by the ____________ used in contrast

A

atomic number of the elements used in contrast media

101
Q

What kVP is used in single-contrast barium studies?

A

110-120 kVp

102
Q

What kVP is used in double-contrast barium studies?

103
Q

What kVP is used in injected iodinated-contrast studies?

104
Q

What kind of contrast is rarely used?

A

Oil-based iodinated contrast media

105
Q

What has oil based contrast been replaced with?

A

Non-ionic iodinated contrast media

106
Q

What is oil based contrast made from?

A

Fatty acids found in plants and animals

107
Q

Oil based contrast is _____ in water and doesnt _______

A
  • Insoluble
  • Flow easily
108
Q

Oil based contrast decomposes when exposed to?

A

Light, heat or air

109
Q

What happen when oil based contrast is exposed to light, heat or air?

A

Decomposes

110
Q

What can oil based contrast be used for?

A
  • Lymphangiography (lymphatic system)
  • Bronchography (bronchial tree of lungs)
  • Sialography (salivary glands)
  • Dacrocystography (tear ducts)
  • Hysterosalpingography (female reproductive system)
  • Myelography (spinal cord)
111
Q

What are the common side effects for injectable iodinated contrast?

A
  • Temporary hot flash
  • Metalic taste in mouth
112
Q

What is extravasation?

A

The discharge of escape of fluid from a vessel into the surrounding tissue

113
Q

What is the discharge of escape of fluid from a vessel into the surrounding tissue called?

A

Extravasation

114
Q

What can occur with injected iodinated contrast?

A

Extravasation

115
Q

What can occur due to extravasation?

A

Acute, local inflammation

116
Q

What can extravasation lead to?

A

Ulceration and tissue necrosis

117
Q

how do you treat extrvasation?

A

With a cold compress followed by a warm compress to relieve pain and promote reabsorption of extravasated contrast media

118
Q

Isomolal results in a _________ solution

119
Q

Isomolal contains the _____________

A

Same number of particles as blood plasma

120
Q

Does non-ionic isomolal contrast cause fewer adverse reactions?

A

Yes, theoretically

121
Q

How many atoms of iodine does non-ionic isomolal contrast have?

A

6 atoms per two particles

122
Q

Non-ionic isomolal contrast has ______ the iodine concentration

123
Q

How is non-ionic isomolal contrast different from others?

A

Half the dose is needed compared to others

124
Q

What is an example of non-ionic isomolal contrast?

125
Q

What are some examples of lower-osmolality contrast?

A

-Omnipaque
- Isovue
- Amipaque
- Optiray

126
Q

What kind of contrast do radiology departments exclusively use?

A

Non-ionic iodinated contrast

127
Q

Lower osmolality contrast remains _____ when introduced ______

A
  • Intact
  • Into the blood or other body cavities
128
Q

How long will it take for water-soluble contrast to outline the colon?

129
Q

What does double contrast studies employ?

A
  • Both radiopaque and radiolucent contrast media
  • Barium sulfate + Air or carbon dioxide
130
Q

How do you introduce air into the body while patient is drinking barium?

A

Small pinholes are place in the straw

131
Q

What is introduce into the body when the patient swallows gas-producing crystals?

A

Carbon dioxide gas

132
Q

Carbon dioxide gas is introduced by ________

A

ingesting gas-producing crystals

133
Q

What are some examples of gas-producing cyrstals?

A
  • Calcium
  • Magnesium citrate
134
Q

What does the double contrast technique improve visualization of?

A

Stomach mucosal folds (rugae)

135
Q

What contrast technique improves the visualization of stomach mucosal folds?

A

Double contrast

136
Q

What can also be demonstrated with the double contrast technique?

A
  • Potential polyps
  • Diverticula
  • Ulcers
137
Q

What are the two types of injectable iodinated contrast media?

A
  • Ionic
  • Non-ionic
138
Q

What does injectable contrast media contain?

139
Q

What is osmollity?

A

A measure of the total number of particles in a solution per kilogram of water

140
Q

What is a measure of the total number of particles in a solution per kilogram of water?

A

Osmolality

141
Q

Whats viscosity?

A

Resistance of fluid to movement; measured by the amount of force required to move liquid under specific condition

142
Q

What is the resistance of fluid to movement; measured by the amount of force required to move liquid under specific condition called?

143
Q

_____ the temperature of a fluid ______ its viscosity

A
  • Increasing
  • Decreases
144
Q

What is a tri-iodinated molecule?

A

Contains 3 atoms of iodine and a cation and anion

145
Q

Is a cation positively charged or negatively?

A

Positively

146
Q

Is a anion positively charged or negatively?

A

Negatively

147
Q

What are some examples of higher osmolality contrast?

A

-Hypaque
- Conray
- Renografin

148
Q

What is higher-osmolality contrast?

A

Contrast with an increased number of particles in a solution (such as blood plasma)

149
Q

Higher-osmolality contrast is associated with ________

A

greater chance of adverse reactions

150
Q

Why is higher-osmolality contrast assosciated with an increase reaction rate?

A

Due to the disruption of homeostasis

151
Q

Why do higher-osmolality contrast have an increased number of particles?

A

The cation separated from the molecule resulting in two separate ions in the blood

152
Q

What kind of contrast contains no cations?

A

Non-ionic iodinated contrast

153
Q

Non-ionic iodinated contrast contain only _____

A

3 atoms of iodine

154
Q

Why is lower osmolality contrast associated with a decreased reaction rate?

A

Does not increase the osmolality of blood plasma

155
Q

Why is non-ionic contrast lower osmolality?

A

Molecules don’t dissociate into ions

156
Q

What are some contrainidicatations for injectable iodinated contrast?

A
  • Hypersensitivity
  • Anuria (anuresis)= abscence of urine
  • Multiple myeloma
  • diabetes (especially diabetes melitus)
  • Severe hepatic or renal disease
  • Congestive heart failure
  • Pheochromocytoma
  • Sickle cell anemia
  • Patients on certain diabetic medications (i.e. metformin, glucophage, avandament)
  • renal failure
157
Q

What is anuria?

A

Absence of urine excretion

158
Q

What is the absence of urine excretion called?

159
Q

How long should diabetic medication be witheld after iodnated contrast study?

160
Q

What does it mean to have a mild reaction?

A

Non-allergic

161
Q

What does it mean to have a moderate reaction?

A

True allergic

162
Q

What does it mean to have a severe reaction?

A

Vasovagal (life threatening)

163
Q

What are some mild reaction to injectable iodinated contrast?

A
  • Anxiety
  • Headache
  • Light-headedness
  • Cough
  • Nausea
  • Vomiting
  • Mild erythema
  • Itching
  • Mild, scattered hives
  • Sweats
  • Nasal stuffiness
164
Q

What are some moderate reaction to injectable iodinated contrast?

A
  • Urticaria (moderate to severe hives)
  • Wheezing
  • Dyspnea
  • Dysphagia
  • Bronchospasm
  • Chest pain
  • Tachycardia
  • Bradycardia
  • Hypertension
  • Mild hypotension
165
Q

What are some severe reaction to injectable iodinated contrast?

A
  • Anaphylactic shock
  • Profound hypotension
  • Severe bradychardia
  • Cardiac arrhythmia
  • Laryngeal swelling
  • Convulsion (seizures)
  • Loss of conciousness
  • Arrhthymia
  • Cardiac arrest
  • Respiratory arrest
  • No detectable pulse
166
Q

When do contrast reactions occur for injectable contrast?

A

First 5-10 minutes of contrast administration

167
Q

When injecting iodinated contrast the patient should be _________

A

Closely and constantly monitored

168
Q

What do mild reactions due to injected contrast require?

A

Observation but no treatment

169
Q

What do moderate reactions due to injected contrast require?

A

Immediate treatment and careful observation

170
Q

What do severe reactions due to injected contrast require?

A

Prompt recogntion, treatment, and hospitalization

171
Q

Moderate reactions due to injected contrast can progress to a _______

A

severe reaction

RAD (32 decks)

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