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radiology > Diagnostic Imaging > Flashcards

Diagnostic Imaging Flashcards

1
Q

Radiation safety

A
  • Radiation is energy
  • cannot be seen, felt or tasted
  • Most common form of radiation exposure is sunlight (UV radiation)
  • It is the APN responsibility to determine risk vs. benefit

ALARA= as low as reasonably achievable

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2
Q

X-ray

A
  • A stream of high energy photons produced by an x-ray
  • The shortwave length produced by this light energy is unique b/c it penetrates opaque object.
  • The density of the material determines penetration of light energy
  • Uses low dose radiation**

The image is a result of the amount of x-ray being absorbed by the density of the tissue/ organ as it passes to the receptor

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3
Q

Radiolucent

A

no interference with flow of x-ray particles (decreasing density = black: empty space/air)

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4
Q

Radiopaque

A

something lies between the beam and the cassette that causes the beam to absorb or disperse (increasing density = white)

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5
Q

Chest Radiography

A

post-ante (PA) & lateral (LAT) UPRIGHT > best view**
If patient unable > AP (supine)

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6
Q

Order PA & LAT on

A
  • Any patient with FUO (fever unknown origin),
  • infants < 6 months with fever
  • Any obvious airway compromise
  • Pain with SOB
  • suspected aspiration
  • chest pain
  • Rib films not usually done routinely
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7
Q

Abdomen x-ray KUB

A

shows ileus,
obstruction,
neoplasm,
gallstones,
adhesions, stenosis,
hernias,
volvulus & intussusception (intestinal folding)

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8
Q

Upright Abdominal film or

A

L LAT decubitus with upright PA & LAT of chest.
–important to show bowel gas patterns, anatomical bony structure, soft tissue, bases of lungs > check for FREE AIR under diaphragm = RED FLAG

Free air under the diaphragm is a serious condition, which is usually caused by a perforation.

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9
Q

Computed Tomography (CT)

A
  • Computerized axial tomography “CAT” scan (high dose radiation)
  • A diagnostic procedure that takes multiple images at one time to create a cross-sectional anatomical images/ axial slices
  • Images produced using x-ray technology and specialized computer software
  • 10-100 times the radiation of plain radiograph
  • Mainly for brain & abdomen
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10
Q

CT scan

A

No contrast if cerebral bleed suspected
For abdomen/pelvic CT > standard of care is use of contrast (oral or IV)

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11
Q

CT scan w/contrast

A

No allergy to shellfish
Not with renal impairment  get baseline BUN & creatinine
If DM & on metformin hold metformin before exam & for 48 hours after

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12
Q

Evaluation of GFR/ serum creatinine

A

within 45 days of receiving contrast in:
- Patients with diabetes, older than 60, history of renal disease, hypertension
GFR 60 or greater: proceed with contrast examination

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13
Q

GFR 45-59

A

non-diabetic patients may proceed with examination. Consult the radiologist for risk/benefit of the study if the patient is diabetic

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14
Q

GFR 0-44

A

Consult the radiologist prior to contrast administration

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15
Q

CT scan indications

A
  • Complicated fractures
  • Tumors (malignant and benign)
  • Thrombosis
  • Heart disease
  • Internal bleeding
  • Obstructions
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16
Q

Other CT scan indication

A
  • Suspected CVA
  • New onset seizure disorder, confusion, or behavior change
  • Head trauma with AMS (altered mental status), skull deformity, raccoon eyes, Battle’s sign, vomiting & lethargy
17
Q

Magnetic Resonance Imaging (MRI)

A
  • Produces a computerized sectional image
  • Uses hydrogen molecules in the body to produce the image (no radiation)
  • A radiofrequency pulse transmitted through coils causes some hydrogen molecules to absorb energy and spin in a different direction from the other hydrogen ions (resonance).
  • 2D image used to view lesions
    3D and 4D MRI is now available
18
Q

MRI considerations

A

Claustrophobia
weight

19
Q

MRI Indications

A

Visualization of soft tissue, anatomic structure & vasculature (i.e. torn ligament, tumor, necrotic hip)
- For patient with negative plain films, with continued pain or loss of functional ability

20
Q

MRI highly sensitive

A

to neoplastic areas, vascular abnormalities & inflammation
- brain tumor
- Diagnosis MS
- CNS pathology
- Differentiate benign vs. malignant

21
Q

MRI: Absolute contraindications

A
  • Cochlear implant– old
  • Swan-gantz catheter with thermodilution tip–old ones
  • Implanted metal devices including neuro stimulators and cardiac pacemakers
  • Metal or foreign body in the eyes
  • Shrapnel near a vital organ
22
Q

Ultrasound

A
  • Uses high frequency waves to visualize organs and structures inside the body.
  • No radiation
  • Painless, safe, and non-invasive

Less accurate in the obese.
Need FULL bladder and EMPTY bowel

23
Q

Ultrasound positioning

A

The technologist positions the transducer over the specific area of interest. The transducer sends sounds waves which bounce off the structures within the body. The transducer then captures the rebounding sound wave creating the ultrasound image.

24
Q

Ultrasound indications

A
  • Abnormalities of the heart, blood vessels, kidneys, livers, and other organs
  • Suspected cholecystitis, appendicitis, testicular torsion, hydrocele
  • DVT
  • Fetal abnormalities/Fetal dating
  • Fluid collections
  • Masses
  • Heart Valves
  • Test of choice for OB, pediatrics, gynecology & testicular studies

*Transvaginal preferred to R/O ectopic or spontaneous abortion

25
Q

Special Concerns with Children

A
  • RED FLAG: Risk of missing epiphyseal fracture related to stages of bone growth
  • Correlate clinical exam findings with X-ray
    • If x-ray “normal” BUT focal tenderness, limited ROM swelling over epiphyseal plate splint & refer to Ortho
26
Q

Special Concerns with Children instructions

A

Instruct patient & family (& document) need for repeat films in 7-10 days if not pain free > order “? occult fracture” or “possible epiphyseal fracture”

27
Q

Special Concerns with Pregnancy

A
  • Any female in childbearing years needs to be screened for pregnancy prior to any radiation testing. unless indicated/hysterectomy
  • Red Flag: With pregnant or women of child-bearing age, carefully consider type of test ordered
  • Do not irradiate abdomen, pelvis, lumbar spine or hips unless clearly medically indicated
28
Q

Special Concerns with Pregnancy if pt is prego

A
  • the provider needs to determine the risk vs. Benefit of performing the exam.
  • Defer exam whenever possible or use non-radiation test
  • Limit number of views ordered with pregnant patients

radiology (7 decks)

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