Contrast Media- Iodinated Agents

Question 1

What studies are iodinated contrast media used for?

Answer 1

GI tract
Urography
Biliary tract ie, ERCP
Circulatory
Spinal studies
Hysterosalpinography

Question 2

How is iodinated contrast administered?

Answer 2

Ingestion-gastrografin and gastroview
Intravascular
Catheter/tube
Intrathecal

Question 3

What is the atomic weight of iodine?

Answer 3

127

Question 4

How many carbon atoms are on a benzene ring?

Answer 4

6

Question 5

At what points is iodine added to the benzene ring?

Answer 5

2-4-6

Question 6

By adding iodine to a benzene ring what happens to the molecular density?

Answer 6

It increases the molecular density

Question 7

What does trio-iodo refer to?

Answer 7

Refers to the number of iodine atoms on the benzene ring = 3

Question 8

What is iodine substituted for on the benzene ring?

Answer 8

Hydrogen

Question 9

What are the requirements for patients on metformin when receiving contrast media?

Answer 9

Pt must stop metformin 24 hours prior to contrast and stop metformin for 24 hours after contrast studies

Question 10

What is density?

Answer 10

The weight of a substance per volume per unit

Question 11

What is the primary influencer on the weight of the iodinated benzene molecule?

Answer 11

The number to iodine molecules

Question 12

Explain the significance of the concentration of the contrast agent.

Answer 12

The concentration is determined by the quantity of the solute or the particles in the mixture… Not the liquid

Question 13

What does a changing concentration indicate?

Answer 13

Either osmosis or diffusion of the solution

Question 14

What is osmosis?

Answer 14

The movement of a liquid or solvent from a region of low concentration to high concentration

Question 15

What is diffusion?

Answer 15

The movement of a liquid or solvent from a region of high concentration to low concentration

Question 16

What is osmolarity?

Answer 16

The number of particles in a solution

Question 17

What happens to an ionic agent when placed in solution?

Answer 17

• It undergoes ionization and dissociates into cation and anion particles
• it increases the number of particles in the blood stream

Question 18

What is dissociate?

Answer 18

The splitting of compounds into smaller particles

Question 19

What happens with osmolarity with non ionic agents?

Answer 19

• they are non ionizing so they don’t dissociate into particles in solution

Question 20

Why are non ionic agents preferred for people who have a history of adverse reactions to contrast?

Answer 20

Because they have lower particles and less impact on fluid shifts

Question 21

How does the osmolality of iodinated CM compared to plasma?

Answer 21

CM has a higher osmolality than plasma

Question 22

What is the difference between a monomer and a dimer?

Answer 22

The number of benzene rings in the molecular structure

• dimer has two molecules
• monomers have one molecule

Question 23

What is the difference between ionic and non ionic?

Answer 23

Ionic monomers and dimers contain salt

Question 24

What are the advantages of a dimer?

Answer 24

• They have more iodine which means a higher density

- They have a higher ratio which means a lower osmolality

Question 25

What is a mild adverse reaction to CM?

Answer 25

Metallic tastes, warm feeling

Question 26

What is a moderate reaction to CM?

Answer 26

Nausea and swelling

Question 27

What are severe reactions to CM?

Answer 27

Heart failure and laryngeal swelling

Question 28

What are cardiovascular and pulmonary effects of CM?

Answer 28

-Dyspnea, chest tightness, and coughing
- hyper/hypotension
-bradycardia
Shrinkage of RBCs

Question 29

What is a true allergic reaction?

Answer 29

-requires an initial exposure-sensitize

Question 30

What is a pseudo allergy?

Answer 30

Mild local reactions such as hives