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rte contrast media > Contrast media, ivp, and cystogram > Flashcards

Contrast media, ivp, and cystogram Flashcards

1
Q

how is contrast introduced for a cystogram

A

retrograde through catheter

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2
Q

Anything in the abdominal cavity must be

A

removed

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3
Q

do you have to remove a bra?

A

yes

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4
Q

contrast starts from:

A

kidneys to bladder

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5
Q

Do a scout……… injecting contrast

A

before

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6
Q

Currently we use ionic or nonionic contrast?

A

non-ionic contrast

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7
Q

Non ionic was first introduced in:

A

1984 (cost more)

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8
Q

What are the two methods to administer contrast? and which is more common?

A

1)Bolus and 2)Drip infusion. The most common one is Bolus

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9
Q

2 most common types of needles used for bolus injection of contrast media

A
  1. Butterfly

2. Over the needle catheter

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10
Q

The structure that considered to be most posterior

A

Kidneys

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11
Q

TRUE or FALSE: The patient must sign an informed consent form before a venipuncture procedure is performed on a pediatric patient

A

True

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12
Q

For most IVUs, veins in the ___ are recommended for venipuncture

A

Antecubital Fossa

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13
Q

The most common size of needle used for bolus injections on adults

A

18 to 22 gauge

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14
Q

TRUE or FALSE: The bevel of the needle needs to be facing downward during the actual puncture into a vein

A

FALSE, upward

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15
Q

TRUE or FALSE: If extravasation occurs during the puncture, the tech should slightly retract the needle & then push it forward again

A

FALSE, needle should be withdrawn and pressure applied

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16
Q

TRUE or FALSE: If unsuccessful during the intial puncture, a new needle should be used during the second attempt

A

TRUE

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17
Q

TRUE or FALSE: The radiologist is responsible for documenting all aspects of the venipuncture procedure in the patient’s chart

A

FALSE, the person who performs it is responsible

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18
Q

Name the iodinated contrast media from the charactertistics listed: Uses a parent compound of a benzoic acid; creates a hypertonic condition in the blood plasma; Poses a greater risk for disruptiing homeostasis, may increase the severity of side effects

A

Ionic

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19
Q

Name the iodinated contrast media from the characteristics listed: Doesn’t significantly increas osmolality in blood plasma; is more expensive; is near a isotonic solution; uses a parent compound of an amide or glucose group

A

Nonionic

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20
Q

Name the first 3 steps of a venipuncture procedure in order

A
  1. Wash hands and put on gloves
  2. Select site, apply tourniquet & cleanse the site
  3. Initiate puncture
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21
Q

Name the last 3 steps of a venipuncture procedure in order

A
  1. Confirm entry and secure needle
  2. Prepare and proceed with injection
  3. needle or catheter removal
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22
Q

The compound is a common anion in ionic contrast media

A

Diatrizoate or iothalamate

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23
Q

Leakage of contrast from the vein to the surrounding soft tissue

A

IV contrast extravasation

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24
Q

Confirm correct content and expiration date before:

A

Injecting

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25
Q

Document expiration date, lot number, amount of contrast injected and Radiologist name on request

A

True

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26
Q

Contrast agents have been around since the

A

1950s

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27
Q

Organic iodinated contrast media (ICM) have been amongst the most ……….used prescribed drugs in the history of modern medicine.

A

Commonly

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28
Q

ICM have a good

A

Safety track record

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29
Q

Adverse effects from intravascular administration are generally

A

mild and self limiting.

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30
Q

The kidneys & ureters are located in the ___ space

A

Retroperitoneal

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31
Q

The ___ glands are located directly superior to the kidneys

A

Suprarenal (Adrenal) glands

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32
Q

The structures that create a 20 angle between the upper pole & lower pole of kidney

A

Psoas Major muscles

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33
Q

The specific namefor the mass of fat that surrounds each kidney

A

Perirenal fat or adipose capsule

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34
Q

The degree of rotation from supine that is required to place the kidneys parallel to the IR

A

30

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35
Q

2 Landmarks that can be palpated to locate the kidneys

A

xiphoid process and iliac crest

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36
Q

The term that describes an abnormal drop of the kidneys when the patient is placed erect

A

nephroptosis

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37
Q

3 functions of the urinary system

A
  1. remove nitrogenous waste
  2. regulate water levels
  3. Regulate acid base balance
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38
Q

A buildup of nitrogenous waste in blood

A

Uremia

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39
Q

The longitundinal fissure found along the central medial border of the kidney

A

Hilum

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40
Q

The peripheral or outer portion of the kidney

A

Cortex

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41
Q

The term that describes the total functioning portion of the kidney

A

Renal parenchyma

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42
Q

The microscopic functional & structural unit of the kidney

A

Nephron

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43
Q

The structure of the medulla that is made up of a collection of tubules that drain into the minor calyx

A

Renal pyramids

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44
Q

Another name for the glomerular capsule

A

Bowmans capsule

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45
Q

TRUE or FALSE: The glomerular capsule & proximal & distal convoluted tubules are located in the medulla of the kidney

A

False, cortex

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46
Q

TRUE or FALSE: The efferent aterioles cary blood to the glomeruli

A

FALSE, afferent

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47
Q

Name structures located in the cortex of the kidney

A

Distal & proximal convoluted tubule, Glomerular capsule, Afferent & Efferent arterioles

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48
Q

Name structures located in the medulla of the kidney

A

Loop of henle, Descending & Ascending limb, Collecting tubule

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49
Q

2 processes that move urine through the ureters to the bladder

A

Perisalsis and Gravity

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50
Q

The structure that is located more anterior as compared with the others

A

Urinary bladder

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51
Q

The name of the junction found between the distal ureters & urinary bladder

A

ureterovesical junction

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52
Q

The name of the inner, posterior region of the bladder formed by the 2 ureters entering & the urethra exiting

A

Trigone

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53
Q

The name of the small gland found just inferior to the male bladder

A

Prostate Gland

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54
Q

The total capacity for the average adult bladder

A

350 to 500 ml

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55
Q

The structure that considered to be most posterior

A

Kidneys

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56
Q

2 ways intravenous contrast media is administered

A
  1. Bolus injection

2. Drip infusion

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57
Q

Any disruption in the physiological functions of the body that may lead to a contrast media reaction is the basis for this theory

A

Chemotoxic theory

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58
Q

The normal creatinine level of an adult

A

0.6 to 1.5 mg/dl

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59
Q

Normal BUN levels for an adult

A

8 to 25 mg/100 ml

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60
Q

Metformin hydrochloride is taken for this condition

A

Diabetes mellitus

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61
Q

Metformin should be withheld for ___ hours following a conttrast media procedure

A

48 hours

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62
Q

4 general categories of contrast media reactions

A
  1. mild
  2. moderate
  3. severe
  4. organ specific
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63
Q

This type of reaction is a true allergic response to iodinated contrast media

A

Anaphylactic reaction

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64
Q

This type of reaction is due to the stimulation of the vagus nerve by introduction of contrast media, which causes heart rate & bp to fall

A

Vasovagal reaction

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65
Q

TRUE or FALSE: Vasovagal reactions are not considered to be life threatening

A

false

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66
Q

TRUE or FALSE: Acute renal failure may occur 48 hours following an iodinated contrast media procedure

A

true

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67
Q

Hypersensitivity to iodinated contrast media, Anuria, multiple myeloma, diabetes mellitus, sever hepatic renal disease, congestive hear failure, pheochromocytoma, patient taking metformin, renal failure, acute or chronic are contraindications of what?

A

Contraindications that may prevent from having a contrast media procedure performed

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68
Q

List symptoms for a mild reaction to contrast media

A

Lightheadedness, mild hives

69
Q

List symptoms for a moderate reaction to contrast media

A

Tachycardia, angioedema

70
Q

List symptoms for a severe reaction to contrast media

A

Brachycardia, hypotension, Laryngeal swelling, cardiac arrest

71
Q

List symptoms for a Organ specific reaction

A

Anuria

72
Q

TRUE or FALSE: Mild level contrast media reactions do not usually require medication or medical assistance

A

true

73
Q

TRUE or FALSE: Urticaria is the formal term for excessive vomiting

A

FALSE, hives

74
Q

The leakage of contrast media from a vessel into the surrounding tissues

A

Extravasation

75
Q

provides a better assessment of bladder pathology and residual urine

A

Post Void

76
Q

Nephrogram visualizes the renal parenchyma

A

1 minute

77
Q

Early visualization of the upper collecting system (calyces, renal pelvis, and upper ureters)

A

5 minute

78
Q

Late visualization should include the lower ureters and bladder.

A

15-20 minutes

79
Q

Before the contrast is injected, to evaluate renal calcifications.

A

Plain Tomograms

80
Q

After injection, assess renal outline and fine calcifications

A

Tomograms

81
Q

NPO ……hours after injection

A

4

82
Q

*** Glomerular filtration rate (GFR) is considered by medical professionals to be the best measure of

A

Kidney function

83
Q

Symptoms /Reactions from contrast

A

Mild – inconvenience (itching/hives)

Moderate- requires treatment for the symptoms & patient comfort

Severe - Life threatening

Emergency-(cardiac arrest)

84
Q

AP scout KUB

A

Cr angle= none

Cassette= 14 x 17 LW

Pnt. Position= supine

Center= at the iliac crest

85
Q

AP bladder shot cystogram

A

Cr angle= 10-15 caudad

Cassette= 10 x 12 CW

Pnt. Position= supine

Center= 2” superior to pubis symphysis

86
Q

Oblique bladder RPO and LPO for cystogram

A

Cr angle= none

Cassette= 10 x 12 CW

Pnt. Position= supine

Center= 2” below the pubis symphysis and 2” medial to the ASIS
(45-60 rotation)

87
Q

Lateral (optional) for cystogram

A

Cr angle= none

Cassette= 10 x 12 CW

Pnt. Position= true lateral

Center= 2” superior and posterior to the pubis symphysis

**place lead apron behind patients sacrum to reduce scatter

88
Q

Voiding cystogram

A

Cr angle: none

Cassette: 10 x 12 CW

Pnt. Position:

  • *AP for Females & 30 degrees RPO for Males
    • Foley catheter is removed before patient can VOID and the exposure is made while patient is voiding.

Center: perpendicular to the symphysis pubis.

89
Q

Which of the following refers to the gauge of a needle?

A

Diameter size of needle

90
Q

When selecting a vein puncture site it is preferable to select the most …… Site in which the desired size needle can be accommodated

A

Distal

91
Q

When performing an intravenous injection you should first?

A

Check the patients identification

92
Q

When performing an intravenous injection when should the tourniquet be removed?

A

After the insertion of the needle before injection

93
Q

Large amount at one time

A

Bolus

94
Q

A typical flow rate for drip infusion is

A

10-20 drops per minute

95
Q

How does negative contrast appear on a radiograph?

A

Less dense than surrounding tissue

96
Q

When you may be exposed to patients blood you should

A

Act as if the patient may have a blood borne disease

97
Q

What does the prefix “contra” mean?

A

Against

98
Q

Non ionic water soluble iodinated contrast media

A

Does not dissolve into charged particles

99
Q

A water soluble iodinated contrast media whose osmolality is high:

A

Has more particles in solution and increased adverse reactions

100
Q

Allergic reactions to water soluble iodinated contrast media is thought to be due to the release of ….by cells in the body

A

Histamine

101
Q

…..is the number of particles in a solution per kilogram of water

A

Osmolality

102
Q

When charting drug information, which of the following is not necessary ?

A

Gauge of needle used

103
Q

Medication that is administered sublingually is put

A

Under the tongue

104
Q

Which of the following reactions to contrast media does not usually require treatment?

A

Nausea and vomiting

105
Q

Which of the following may help make veins more prominent on patients whose veins are difficult to locate?

A
  1. Pat or rub area
  2. Apply hot packs
  3. Allow arm to hang

All of the above

106
Q

Which of the following patient factors is not a consideration for the administration of contrast media?

A

Gender

107
Q

The primary disadvantage of oil based iodinated contrast media is :

A

It isn’t absorbed in the body

108
Q

Oil based iodinated contrast media is commonly used during a

A

Sialogram

109
Q

A very high creatine level is

A

A contraindications for an IVU

110
Q

The preferable water soluble iodinated contrast media would be:

A

Noionic with low osmolality

111
Q

In what order should the following be done to discontinue a contrast media administration?

A
  1. Place sterile gauze over puncture site
  2. Quickly smoothly and gently remove cannula from the vein
  3. Elevate extremity and apply pressure until all bleeding stops

3,2,&1

112
Q

After the administration of contrast media which is true?

A
  1. Do not recap the needle

3. Do not remove a needle from a disposable syringe

113
Q

What does the root word “nephr” mean?

A

Kidney

114
Q

What is the condition called when a patients kidney cannot excrete any urine?

A

Anuria

115
Q

Root words for “renal pelvis”

A

Pyel

116
Q

Another name for kidney stone

A

Renal calculus

117
Q

What is hematuria?

A

Blood in urine

118
Q

Condition in which, an obstructed ureter will cause the renal pelvis to dilate with urine.

A

Hydronephrosis

119
Q

Wilms tumor involves which of the following ?

A

Kidney

120
Q

Which of the following defines dysuria?

A

Painful urination

121
Q

What is an inflammation of the kidney and renal pelvis called?

A

Pyelonephritis

122
Q

Which of the following relates to the outer layer of the kidney?

A

Cortex

123
Q

Cystitis would be an inflammation of which of the following organs?

A

Urinary bladder

124
Q

Subject contrast relates to

A

The patient

125
Q

Ureters

A

Lie on psoas muscles ,
28-34 cm long
1mm to 1cm in diameter

126
Q

Ureters enter ….,bladder

A

Posterolateral

127
Q

Points of constriction

A
  1. Ureteropelvic junction
  2. Pelvic brim
  3. Ureterovesical junction
128
Q

Minor calyces are ….. To major calyces

A

Superior

129
Q

Major calyces are superior to

A

Renal pyramids

130
Q

Cone down of kidneys

A

14 x 17 CW bottom of IR is at top of iliac crest

131
Q

Nephogram

A

14 x17 CW
Supine
Is a blush or outline of the kidneys, it must be taken as soon as they have injected the contrast 45 sec-1 minute

132
Q

Ivp RPO—Obliques 30 degrees

A

14 x 17
Cr is perp. To iliac crest
RPO- shows RIGHT kidney and ureter but LEFT kidney in profile

133
Q

Ivp LPO–Obliques 30 degrees

A

14 x 17
Cr is perp. To iliac crest
LPO- shows LEFT kidney and ureter but RIGHT kidney in profile

134
Q

Ap cone down bladder

A

10 x 12 supine

Cr is perp. To a point 1& 1/2 above the pubic bone

135
Q

Ap or pa KUB post void

A

14 x 17 LW
Supine/erect
Cr is Perp to iliac crest

136
Q

Avg adult bladder holds …..ml of liquid

A

500

137
Q

For cystogram a Foley catheter

A

Must be inserted and clamped

138
Q

Tomography …. The area above and below the plane of interest

A

Blurs

139
Q

2 types of tomography

A

Linear and pluridirectional

140
Q

Linear tomography

A

Blurs the structures above and below the fulcrum

141
Q

The greater the tube angle

A

The thinner the tomo cut

142
Q

The smaller the tube angle

A

The thicker the tomo cut

143
Q

3 elements of a tomographic system

A

The X-ray tube
The object
And the image receptor

144
Q

Fulcrum

A

The pivot point, grossman principle

145
Q

Exposure amplitude, angle or ARC

A

The total distance the tube travels

146
Q

Thicker cut

A

Less than 10 degrees

147
Q

Thinner cut

A

Bout 50 degrees

148
Q

Post void must include entire bladder to evaluate…?

A

Enlarged prostate or prolapse

149
Q

For Ivp you must clamp

A

The Foley catheter

150
Q

Which kidney is more inferior?

A

The right kidney

151
Q

two common side effects

A

Metallic taste and warm, flush sensation

152
Q

what to do to the patient for a mild reaction

A

reassure and observe them

153
Q

a “true allergic reaction” catagory

A

moderate section

154
Q

What is moderate reaction; moderate to severe hives ex:

A

urticaria

155
Q

What is age -related enlargement of the prostate gland

A

Benign Prostatic Hyperplasia(BPH)

156
Q

We do expiration to get the diaphragms

A

Up and out if the way

157
Q

Which slices are better for tomography?

A

Thinner slices

158
Q

The more you oblique the patient

A

The more you get the ureter on top of the spine

159
Q

Retrograde urography is usually done in OR and is injected

A

From the bottom , up

160
Q

When there is contrast filled what structures do u see?

A

Renal pelvis, calyces, and ureters

161
Q

Common reasons to do an IVP?

A

Kidney stones ,
Hematuria
Renal problems

162
Q

Cystogram is only in the

A

Bladder

163
Q

Why do you do the lateral cystogram?

A

To see Extravasation ESP for someone with a ruptured bladder

164
Q

For a voiding cysto the patient must void on the

A

Table

165
Q

For males in a voiding cysto

A

Must see entire right urethra, recumbent or 30 degrees RPO

166
Q

For females voiding cysto

A

There AP and must extend and slightly separate legs

167
Q

Prolapse bladder us typically for

A

Older people

168
Q

For a voiding cysto the Cather must

A

Come out

169
Q

For a cystogram we use …. Contrast

A

Ionic, because is just reaches the bladder not the bloodstream

rte contrast media (1 decks)

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