Contrast Media - Review 2 Flashcards
Ingested by mouth
Route: Oral; Example: Upper GI, Esophagram,
Rehab swallow study
Administered rectally
Rectal; Barium enema (BE)
Administered by injection
using a needle
Parenteral
Administered directly into
a vein
Parenteral-Intravenous; IVU
Administered directly into
an artery
Parenteral-Intra-arterial; Arteriogram
Administered directly into
a sheath
Parenteral-Intrathecal; Myelogram
Administered against the
normal flow
Retrograde; Cystogram, VCUG, BE
Anatomic areas filled with negative contrast media will
appear ________________ on radiographs.
dark
List examples of positive contrast media.
barium sulfate & iodinated contrast media
What is the atomic number of barium?
56
This makes it radiopaque
What is the chemical formula of barium sulfate?
BaSO4
1 atom of barium + 1 atom of sulfur + 4 atoms of oxygen
Describe a colloidal suspension.
Particles are suspended in the water
and will settle out when allowed to
sit for too long
What type of barium is best suited to coat the
mucosal lining of the esophagus?
Thick barium
What are barium pills used for?
to evaluate for strictures in the
esophagus
List contraindications for the administration of
barium.
Suspected colon obstruction Gastrointestinal perforation Transesophageal fistula Obstructing lesions 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
A patient must undergo a small bowel series today and is
scheduled for abdominal surgery tomorrow. What type of oral
contrast should be used?
Oral iodinated contrast media
Gastrografin or Gastroview
What is the most common complication of
barium administration?
Constipation
List other complications of barium
administration.
Perforation (extravasation into the abdominal cavity)
Vaginal rupture caused 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 (rare)
What is the atomic number of iodine?
53
A double contrast study involves the
administration of what types of contrast media?
radiopaque (positive) and radiolucent
(negative) contrast media
Define osmolality.
A measure of the total number of
particles in a solution per kilogram of
water
Define viscosity [tính nhớt
•tính dẻo, tính dính
cua chat long]
Resistance of fluid to movement; measured by the
amount of force required to move liquid under
specific conditions
Commonly referred to as the “thickness” of a fluid
What is the difference between ionic contrast
media and non-ionic contrast media?
Ionic contrast – iodine molecules dissociate in a
solution; greater chance of adverse reaction
Non-ionic contrast – iodine molecules do NOT
dissociate in a solution; less chance of adverse reaction
What type of contrast media contains the
same number of particles as blood plasma?
Isomolal
Visipaque is an example
List some common side effects of injectable
iodinated contrast media.
Temporary hot flash
Metallic taste in the mouth
What is extravasation? How is it treated?
Extravasation is the discharge or escape of fluid from a
vessel into the surrounding tissue resulting in acute,
local inflammation.
Treat with a cold compress followed by a warm
compress to relieve pain and promote reabsorption of
extravasated contrast media
Question: 27 to 36: For each reaction to injectable iodinated contrast media,
indicate whether the reaction is Mild, Moderate, or Severe.
Vomiting:
Mild [nhe]
Arrhythmia
SEVERE [thiet nang]
Tachycardia
MODERATE [trung binh]
Urticaria
MODERATE
Nausea [chong mat]
MILD
Anaphylactic Shock
SEVERE
Dyspnea
MODERATE
Dysphagia
MODERATE
Laryngeal swelling
SEVERE
Anxiety
MILD
List some contraindications [su cho ngai] of injectable
iodinated contrast media.
Hypersensitivity to iodinated contrast media
Anuria (a.k.a. anuresis) - absence of urine excretion
Multiple myeloma
Diabetes, especially diabetes mellitus
Severe hepatic or renal disease
Congestive heart failure
Pheochromocytoma
Sickle cell anemia
Patient on certain diabetic medications (i.e. Metformin,
Glucophage, Avandament, etc.)
Medication should be withheld for 48 hours after the completion
of the iodinated contrast media study
Renal failure (acute or chronic)
What is the kVp range used for the following
contrast studies?
Single-contrast barium studies – 110-120 kVp
Double-contrast barium studies – 90 kVp
Injected iodinated contrast studies – 80-85 kVp
Questions 39 - 41:
Measures of Kidney Function:
-BUN (blood urea nitrogen)
Normal Range*:
8 – 24 mg/dL for adult men
6 – 21 mg/dL for adult women
Creatinine Level
Normal Range: 0.6 – 1.2 mg/dL
(many facilities will not inject
patients with a level above 1.5)
GFR (glomerular filtration rate)
Normal range: Normal kidney function = 90-130 Mild kidney damage = 60-90 Moderate kidney damage = 30-60 Severe kidney damage = 15-30 Kidney failure = 0-15
Describe the valsalva maneuver that can be
used during an esophagram.
Patient takes in deep breath and holds
breath in while bearing down as if trying
to move the bowels
What kind of patient preparation is needed
for an UGI?
Food and water withheld after midnight for 8
to 9 hours before examination (NPO)
Stomach should be empty
Which view in the UGI series is best for
evaluation of a hiatal hernia?
PA
A small bowel series is considered complete
when the contrast is seen in the ________
Cecum
must pass the ileocecal valve
When the balloon of the retention tip used for a barium enema
is inflated with one squeeze, how much air will fill the balloon?
90 mL of air
Most barium enema bags have a capacity of
mL and the tubing is approximately feet long.
3000 mL (3 quarts) 6 feet
What temperature should the barium be for a
barium enema?
85 - 90 F
Barium that is too warm can injure the intestinal
tissues and be hard for the patient to retain
Barium that is too cold can cause cramping
Describe the Sims position
Patient is instructed to roll onto the left side, then
roll forward about 35-40 degrees, and rest the flexed
right knee on the table above and in front of the
slightly flexed knee
What should the height of the barium bag be
for a barium enema?
Height of bag should be 19-24 inches above
the level of the anus
Why is it important to void the bladder prior
to an intravenous urogram (IVU)?
A bladder that is too full could rupture, especially if
compression is used.
Urine already present in the bladder dilutes the
contrast media that accumulates there.
When using compression for an IVU, at what
level is the compression placed on the patient?
Compression is centered over level of anterior
superior iliac spine (ASIS)
What are some contraindications to using
compression for an IVU?
Urinary stones Abdominal mass Aortic aneurysm Colostomy Suprapubic catheter Traumatic injury Recent abdominal surgery Severe abdominal pain
A nephoromogram is done to visualize the :
renal parenchyma (nephrons and collecting tubes)
When performing the RPO view for an IVU,
which kidney is best seen?
Right
side closest to IR
