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Computed Tomography (CT) > CT Exam > Flashcards

CT Exam Flashcards

1
Q

Why may lab tests be required for a patient prior to a CT exam?

A

To determine the blood’s ability to coagulate and to generally asses liver function

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2
Q

What are some lab tests that may be ordered to determine blood coagulation and liver function?

A 
Prothombin time (PT)
Partial thromboplastin time (PTT)
International normalized ratio (INR)
D-dimer
Platelet count
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3
Q

What the typically accepted values for PT?

A

10-14 seconds

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4
Q

What the typically accepted values for PTT?

A

20-40 seconds

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5
Q

Which lab test is used as a way to standardize the prothombin time for patients who are taking oral anticoagulant medications (Coumdain/Heparin)?

A

INR

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6
Q

A high INR level of around _____ indicates whats?

A

5.0, high chance of bleeding

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7
Q

A low INR level of around _____ indicates whats?

A

0.5, high chance of having a clot

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8
Q

What is the normal INR range for a healthy person?

A

0.9-1.3

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9
Q

Patients on anti-coagulant drugs should have an INR of:

A

2.0-3.0

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10
Q

Patients who have a high risk of clot formation should have an INR of:

A

2.5-3.5

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11
Q

Why are D-dimer tests ordered?

A

To help rule out, diagnose, and monitor diseases (ex. DVT/PE) and conditions that cause hypercoagulability, a tendency to clot inappropriately

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12
Q

What does it mean if a patient has a positive D-dimer test?

A

Abnormally high level of fibrin degradation products in the body

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13
Q

What is generally the normal values of a D-dimer?

A

Less than 500 micrograms/liter fibrin equivalent units

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14
Q

What is the range for a normal platelet count?

A

150K-400K mm^3

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15
Q

What are some lab tests that may be ordered to determine renal function prior to receiving IV contrast?

A

Blood urea nitrogen (BUN)
Creatinine
Glomerular filtration rate (GFR)

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16
Q

What kind of information does BUN provides?

A

The kidney’s ability to remove impurities from the blood

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17
Q

What is the typically accepted values for BUN range from?

A

5-25 mg/dl

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18
Q

What is the typically accepted values for creatinine range from?

A

0.6-1.7 mg/dl

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19
Q

What does the GFR determine?

A

The flow rate of filtered fluid through the kidney

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20
Q

What is the normal GFR range from?

A

95-120 mL/min/1.73m^2

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21
Q

what are some preparatory instructions may there be for a patient receiving a CT exam with contrast media?

A

Drinking oral contrast media
Fasting before the exam
Premedicating to minimize contrast reactions

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22
Q

What kind of medication should patients withhold from taking following the procedure?

A

Metformin (for 48 hrs)

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23
Q

What is the final step in the screening process of the patient?

A

If the patient can verify the reason for the CT exam

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24
Q

When might a patient be positioned in a prone fashion?

A

For coronal head studies

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25
Q

Most CT exams requiring IV contrast is usually administered at a rate of:

A

2-3 cc/sec (100-150 cc)

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26
Q

For a CT head exam, when might a scan be delayed following the completion of the injection, and for how long?

A

When scanning patients with metastatic lesions, MS plaques, and AIDs by 45 minutes

27
Q

The localizer image in a CT head exam is usually acquired in a _____ orientation.

28
Q

“_____” slices should be positioned perpendicular to the “transverse” slices during a CT head exam.

29
Q

Why are maxillofacial studies usually performed?

A

Due to trauma

30
Q

What kind of scan is used for a maxillofacial study?

A

Helical scan with overlapping reconstructed slices, contrast media is unnecessary

31
Q

An oblique sagittal view is difficult to obtain on a CT study of:

A

The temporomandibular joint (TMJ)

32
Q

What would be the best way to perform a TMJ study on a CT scanner?

A

Acquire the slices transversely with a helica scan, and then multi-planar reconstructions can be performed at any oblique orientation

33
Q

What are some indications to a CT of the neck?

A

Evaluation of tumors, inflammation/infection, and developmental anomalies

34
Q

What are not enhanced in the neck by the IV contrast media?

A

Lymph nodes

35
Q

What are some indications to a CT of the spine?

A

Evaluate trauma, intraspinal tumors, disk herniation, spinal infection, spinal stenosis, metastatic disease and fractures

36
Q

When might IV contrast be administered for a CT exam of the spine?

A

If a mass is suspected, for infection, or for evaluation of a post-surgical spine

37
Q

In what orientation(s) should the localizer image be collected for a CT spine study?

A

Lateral and AP

38
Q

A localizer image for the shoulder should be obtained in what orientation?

39
Q

What is the best view to demonstrate a scaphoid fracture?

40
Q

In a bent knee position, the foot will be imaged in a _____ plane while the ankle is being imaged in a _____ plane.

A

Transverse / Coronal

41
Q

With the toes pointing straight up, the foot is being scanned in the _____ plane while the ankle is being scanned in the _____ plane.

A

Coronal / Transverse

42
Q

What are CT chest exams more routinely ordered for?

A

Mediastinum / Lungs

43
Q

For a patient having a chest CT with IV contrast, what determines how long the delay is before scanning?

A

Volume of contrast media
Rate at which it is injected
Patient’s blood flow rate

44
Q

If a patient is receiving about 100cc of contrast at a rate of about 3 cc/sec, how long should we wait before scanning?

A

20-25 seconds

45
Q

Where are the transverse slices collected in a chest CT?

A

Between the sternal notch and the adrenals

46
Q

What is not administered for abdominal CTA or detection of ureteral calculi?

A

Oral contrast

47
Q

What might be done prior to injection of IV contrast when visualizing the abdomen?

A

Pre-contrast scan (to compare pre-/post-contrast images)

48
Q

For evaluation of possible appendicitis, how may some facilities administer the contrast?

A

Rectally, up to the cecum

49
Q

When evaluating the stomach wall, what may some imaging facilities do post-oral contrast so that the dense contrast does not obscure the stomach wall?

A

Have the patient drink some water / milk

50
Q

What kind of contrast is required for a pelvis exam?

A

Both IV and oral

51
Q

Does a patient need to breath-hold in a pelvis exam?

52
Q

What is the difference between CTA and regular chest CT?

A

CTA evaluates the vessels

53
Q

What is the recommended contrast injection rate for CTA?

A

3-5 cc/sec

54
Q

What is the most common post-processing technique used for CTA?

A

Maximum intensity projection (MIP)

55
Q

What does CT perfusion assess for?

A

Strokes (flow to the brain)

56
Q

During a CT brain perfusion, a high iodine concentration is recommended along with a high flow rate of:

A

5-8 ml/sec

57
Q

Which CT exam would be beneficial for the detection of adenomatoous polyps?

A

CT colonography

58
Q

What are three aspects to properly prepare the colon for examination?

A

Colon cleansing
Fecal tagging
Colon distension

59
Q

How would you prepare to colon cleanse?

A

High fluid, low residual diet
Dedicated dietary kit beginning 1-2 days prior
Laxatives
Evacuating immediately prior to scan

60
Q

How would you prepare to fecal tag?

A

Consumption of a fecal / fluid tagging agent with meals prior to the exam

61
Q

How would you prepare for colon distension?

A

Administer a gaseous agent rectally

62
Q

For a CT colonography, how should we position the patient?

A

Supine / Prone

63
Q

What are some clinical applications of PET/CT?

A

Ovarian cancer
Hodgkin’s Lymphoma
Lung cancer
Cardiac perfusion study

Computed Tomography (CT) (8 decks)

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