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P3.2 > Diagnostic Imaging > Flashcards

Diagnostic Imaging Flashcards

1
Q

What are the modalities that use ionizing radiation?

A
  • Radiograph
  • CT
  • Fluoroscopy
  • Angiography
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2
Q

What are the modalities that do NOT use ionizing radiation?

A
  • Ultrasound

- MRI

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3
Q

Bergoine and Tribondeau’s law

-What are the characteristics of tissues that have increased radio-sensitivity?

A
  • Cells are undifferentiated
  • Greater proliferative capacity
  • Divide more rapidly
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4
Q

What are the adverse effects of ionizing radiation?

A
  • Carcinogenesis-leukemia, thyroid, breast, lung, skin

- Genetic consequences-gonadal irradiation

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5
Q

What are some clinical considerations/contraindications of ionizing radiation?

A
  • Previous allergy to contrast
  • Renal patients
  • Pregnant patients (days 16-45 are critical)
  • Children
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6
Q

What medication is contraindicated with ionizing radiation and why?

A

Metformin-beware of the lactic acidosis

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7
Q

What is the point of contrast?

A

Increases difference in density between anatomic structures

-3 ways to administer-PO, IV, PR

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8
Q

What is used for GI contrast?

A

GI contrast-Barium and gastrograffin

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9
Q

What is used for IV contrast?

A

IV contrast-Iodine based

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10
Q

What is used for MRI contrast?

A

MRI contrast-Gadolinium

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11
Q

Contrast reactions

A
  • Hypersensitivity rxns
  • Chemotoxic rxns
  • Vasovagal rxns
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12
Q

What are the symptoms of hypersensitivity rxns?

A
  • Hives, anaphylaxis, urticaria, pruritis, angioedema
  • Immediate = less than 1 hour
  • Delayed = greater than 1 hour to days
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13
Q

What is the Pre-Tx for hypersensitivity rxns to contrast?

A

prednisone w/ diphenhydramine

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14
Q

What is the rapid Tx for hypersensitivity to contrast?

A

epi, saline, and albuterol

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15
Q

Chemotoxic reactions to contrast

A

Self limited symptoms-nausea, vomiting, and flushing

-Very common

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16
Q

Vasovagal reactions to contrast

A

Vasovagal rxns to contrast

  • Increased vasovagal tone
  • Decreased SA and AV node conduction
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17
Q

How do ultrasounds work?

A

Ultrasounds use high frequency sound waves to generate an image
Coupling gel-aids in wave transmission

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18
Q

hat are the pros and cons of ultrasounds

A

-Pros-no radiation, cheaper than other modalities
-Cons-Bowel gas and lung tissue hinder the image, technician skills variable
Can body habitus affect results?

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19
Q

Common clinical uses of ultrasounds

A
  • Trauma
  • RUQ pain
  • RLQ pain
  • Acute pelvic pain
  • Cardiac concerns
  • Pregnancy
  • Evaluate blood flow (duplex/doppler)
  • Procedures
20
Q

AST exam-primary views or windows

A

FAST exam

  • Subxiphoid
  • RUQ
  • LUQ
  • Suprapubic
21
Q

How do X-rays work?

A

X-ray

  • Patient placed between film cassette and X-ray machine
  • Pass through body and become attenuated
  • X-rays + fluorescent coated film -> photochemical reaction -> light particles -> IMAGE
22
Q

Pros and cons of X-rays?

A

X-rays

  • Pros-Cheap, easily accessible, fast, excellent screening tool
  • Cons-2D pic, radiation exposure, poor detail of soft tissue
23
Q

Radiographic densities

-Air?

A

Air = Black

24
Q

Radiographic densities

-Fat?

A

Fat = Dark gray

25
Q

Radiographic densities

-Soft tissue/fluid?

A

Soft tissue/fluid = Light gray

26
Q

Radiographic densities

-Mineral?

A

Mineral = Off white

27
Q

Radiographic densities

-Metal?

A

Metal = Bright white

28
Q

adiograph clinical uses

-Chest?

A

Chest-Assess lung pathology

29
Q

Radiograph clinical uses

-Skeletal?

A

Skeletal-Examine bone structure

30
Q

Radiograph clinical uses

-Abdomen?

A

Abdomen-Assess for obstruction, free fluid, free air

31
Q

Radiograph clinical uses

-Dental?

A

Dental-Assess and detect pathology

32
Q

CT scans

A

3D image of the body-X-rays on steroids

33
Q

What are the pros and cons of CT scans?

A
  • Pros-Widely available, quick, painless, somewhat reasonable price
  • Cons-potential contrast reaction, exposure to radiation (up to 100x radiation from normal X-ray), diagnosis limitations
34
Q

What are some common clinical uses of CT scans?

A

Neuro

  • Pulmonary
  • GI
  • When an MRI is contraindicated or cannot be performed
35
Q

How do MRIs work?

A
  • Use of magnetic field to generate image-hydrogen atoms align
  • Tissues generate different signals based on H composition
36
Q

What are some MRI precautions?

A
  • Cardiovascular devices-pacemakers, stents, mechanical valves, IVC filters
  • Unstable patients
  • Claustrophobic and agitated
  • Large body habitus
37
Q

What are the pros and cons of MRIs?

A
  • Pros-Safe, no radiation, extremely precise with incredible detail of soft tissue
  • Cons-not widely available, costly, body habitus, patient must have patience
38
Q

MRI clinical uses

A
  • Neuro
  • Musculoskeletal
  • Repro
39
Q

Gadolinium considerations

A

Gadolinium considerations

  • Contrast induced nephropathy
  • Nephrogenic systemic fibrosis
40
Q

Gadolinium considerations

-Contrast induced nephropathy

A
  • Within 24-48 hrs of contrast administration
  • Increased sCr
  • Decreased GFR with oliguria (< 500 mL UOP/day)
41
Q

Gadolinium considerations

-Nephrogenic systemic fibrosis

A
  • Advanced renal failure or dialysis patients (GFR < 30 mL)
  • 2 days-18 months post-exposure
  • Symptoms-thickening and hardening of skin, head spared
42
Q

What is angiography?

A

Angiography-Injection of contrast media directly into artery or vein via needle or catheter

  • Invasive-percutaneous (think cardiac catch lab-fluoroscopy)
  • Non-invasive-CT or MRI
43
Q

What are the clinical uses of angiography?

A
  • Neurological
  • Pulmonary
  • Cardiovascular
44
Q

What is fluoroscopy?

A

Modality that uses continually emitted x-rays and allows for real time visualization
-Images are intensified - decreased radiation exposure

45
Q

What are the clinical uses of fluoroscopy

A
  • Esophagram
  • Upper GI study
  • Small bowel follow through
  • Barium enema
  • Cardiac
  • Vascular

P3.2 (11 decks)

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