Diagnostic Tests Flashcards
What is an X-Ray
A common imaging technique. The beam of radiation is scattered or absorbed in differing amounts by different tissues.
What are the 4 densities of X-Rays?
- ) Fat
- ) Water
- ) Air
- ) Bone
What is Computed Radiography
uses a laser and a computer to read and store the image from the plate
What is Digital Radiography?
digital x-ray sensors are used to transmit the image immediately to a computer. No plate required. Faster, and emits a lower dose of raditation.
What is Fluoroscopy and give an example
imaging tool that allows for the view of real time, moving parts of the body.
Example: barium moving through the intestine.
What are Contrast Agents? and give 3 examples.
allow for a better view of tubular or hollow structures.
Agents include:
- ) Barium
- ) Iodine
- ) Gadolinium
What is Nuclear Medicine?
Involves the use of small amounts of a short-lived radioactive substance (radioisotope) that is formulated and absorbed by targeted tissues
Nuclear studies are useful for?
imagining of bone, thyroid function, and hepatobiliary function.
What is an Ultrasonography
procedure that utilizes high-frequency sound waves to image soft tissue.
produce an image known as an ultrasound.
What is Hyperechoic, Hypoechoic, and Anechoic and give an example of the type of tissue they reflect
Hyperechoic - reflect large number of sound waves (Fat)
Hypoechoic - reflect small number of sound waves (Fluid)
Anechoic - absence of reflected sound waves (Fluid)
What are the advantages of US over MRI and CT scanning?
- ) Its ability to differentiate solid from fluid-filled structures
- ) Lower Cost
- ) Portability
- ) Accessibility
- ) No exposure to ionizing radiation
Limitations of US include:
- ) the skill of the ultrasonographer
- ) image resolution not as good as other techniques
- ) “noise” produced when US waves hit gas and bone
What are the different types of US techniques used to produce images?
A-Mode, B-Mode, M-Mode, and grayscale
A-Mode, B-Mode, M-Mode, and grayscale provide information on what?
structural size, motion, or both.
Doppler US
used to measure the velocity and direction of blood flow within the heart and blood vessels by measuring changes in pitch (sound-wave frequency)
Duplex Scan
combines the B-mode with Doppler US
CT scans
are created by passing a roating beam of x-rays into the individual and obtaining thousands of point images at specific depths
What is the advantage of CT scans over US and plain X-rays? and what is a disadvantage?
Produce higher quality images
Higher dose of ionizing radiation
Spiral or helical scanners
are faster, can have multiple rows of detectors, provide thinner slices, minimize motion artifact, and move continuously as the table moves.
What is an EBCT and what does it do?
ultrafast CT scans. Produce images of the coronary arteries despite the motion of the heart.
What is an MRI and what is an advantage of an MRI?
use a magnetic field to induce changes in proton spin within tissues.
produce unparalleled pictures of soft-tissue, organs, bone and other internal structures without ionizing radiation.
When is MRI preferred to CT
when soft tissue resolution is needed.
What is a PET scan? and how will abnormal and cancerous cells show up on the PET scan?
diagnostic images obtained from the decay of a positron emitting radionuclide agent.
will show up as different colors or degrees of brightness.
Limitations of PET scans include:
Hint: 6 of them
- ) cost
- ) accessibility
- ) short half life of radionuclide agent
- ) elevated serum glucose or insulin levels can adversely affect the results
- ) Limited sensitivity for tumors smaller than 10mm
- ) high degree of expertise is required
What is angiography?
imaging study used to visualize major blood vessels in the body. A catheter is inserted and contrast material is injected.
The gold standard for vessel imaging.
venogram
when angiography is done to image veins
arteriogram
when angiography is done to image arteries
What is a CTA and MRA and what are there advantages compared to a traditional angiography
Computed tomography angiography (CTA)
Magnetic resonance angiography (MRA)
- Less invasive
- less risk
- produce reasonably accurate images of the arteries and veins
What is an Endoscopy?
allows for the inspection of cavities and hollow organs.
Invasive procedure that employs the optical qualities of fiberoptic technology and a powerful lens system that allows light to travel and images to be transmitted through curved structures.
What is an Endoscopy used for
- ) instillation of drugs, air, or fluid
- ) suction, irrigation, and cauterization
- ) perform biopsies
What test for which diagnosis - Brain and Nervous System:
1.) Acute Head Trauma
CT scan
2.) Transient ischemic attack (TIA)
CT, MRI, Carotid US
3.) Brain abscess
CT or MRI with contrast
4.) Acute hemorrhage, acute hemorrhagic stroke
CT or MRI scan
5.) Sinus disease
CT or MRI scan
6.) Hydrocephalus
CT, MRI, or Cisternography
7.) Aneurysm, arteriovenous malformation
MRA or CTA
8.) Acute non-hemorrhagic stroke
MRI
9.) Tumor or Metastasis
MRI
10.) Multiple Sclerosis (MS)
MRI
11.) Alzheimer’s
MRI, or PET/CT scan
Carotid duplex ultrasound
measure the focal blood flow velocities in the carotid artery and provides an estimate of carotid stenosis and residual lumen diameter
US is used to estimate carotid intima-media thickening.
PET scan is valuable tool because:
- ) can identify the extent and spread of certain brain cancers, evaluate the efficacy of chemo, and identify recurrent lesions
- ) diagnose early Alzheimer’s Disease and differentiate this disease from different dementias
- ) localize epileptic foci
What is SPECT and what does it do?
single photon emission computed tomography.
uses a gamma camera, computer, and IV radionuclide to look at blood flow and provide 3D images.
Lumbar puncture (“Spinal Tap”) and what does it check for?
insertion of a needle into the subarachnoid space between the forth and fifth lumbar vertebrae to withdraw CSF for testing, checking for bacteria, protein, immunoglobulins, and RBCs and WBCs.
What is Cisternography?
radiographic imaging of the subarachnoid spaces that contain spinal fluid (cisterns)
What is Tilt table test used for?
used to evaluate fainting (syncope) particularly when cardiac testing and seizure evaluation have not provided a diagnosis
What do EEGs record?
alpha, beta, delta, and theta waves
alpha, beta, delta, and theta waves are influenced by?
an individuals alertness and level of consciousness
what is a Visual Evoked Potential (VEPs) and what is it used to diagnose?
Detect slowing of electrical conduction due to demyelination.
Diagnose: MS
Brainstem auditory evoked response (BAER) and what is it used to diagnose?
electrical response to a click or noise made in each ear.
diagnose: deafness (primarily in infants) and response is delayed in MS
Somatosensory Evoked Potentials (SSEPs) and what are they used for?
detect sequential activation of nerves along pathways.
used to monitor nerve function during surgery.
Radioactive Iodine Uptake (RAI) what is it used for?
determine the function of the thyroid
Cold Nodule
Less uptake than normal thyroid tissue and have an increased probability of malignancy.
Hot Nodule
Greater uptake than normal thyroid
How is Fine needle aspirate (FNA) done and what is it used for?
is done by inserting a needle into the thyroid nodule and obtaining cells and/or fluid for pathological diagnosis.
used to differentiate whether a cold nodule seen on a scan is benign or malignant
What Test for Which Diagnosis - NECK, CHEST and LUNGS
- Placement of tubes and in-dwelling lines
X-Ray
- Pneumonia, atelectasis
X-Ray
- SOB, Asthma, COPD, Interstitial lung disease, and chronic cough
X-Ray, PFTs, and CT scan
- Bronchiectasis
X-Ray, PFTs, Bronchoscopy, and CT scan
- Pneumothorax
X-Ray
- blebs and bullae
X-Ray, and CT
- Foreign body, aspiration
X-Ray
- Asbestosis
X-Ray
- Hemoptysis
X-Ray, CT, and Bronchoscopy
- Mediastinal mass
CT w/ contrast
11.Pulmonary Nodules
CT scan
- Lung Tumor
X-Ray, CT, and Bronchoscopy
- Localization of pleural effusion before thoracentesis
X-Ray, and US
- Interstitial lung disease
CT, PFTs
- Pulmonary embolus
X-Ray, V/Q scan, Angiography, and CT scan
A Bronchoscopy permits:
visualization of the trachae and vocal cords, as well as the main bronchial tubes and smaller branches but does not give a direct view of the lung parenchyma
A Bronchoscopy is used for:
Biopsy of tissue by bronchial washing, brushing, or direct tissue removal
What is a Ventilation Perfusion Scan?
study air flow (ventilation) and blood flow (perfusion) in the lungs
What does Oxygen Saturation measure?
% of RBCs “saturated” with oxygen
What do Pulmonary Function Tests (PFTs) do?
record the movement of air into and out of the lungs and plot it against time.
Forced vital capacity (FVC) is:
the maximum volume of air exhaled after deep inspiration
forced expiratory volume at 1 second (FEV1) is:
measurement made at 1 second after exhaling as hard and fast as possible
Diffusing capacity (DCLO)
ability of inhaled carbon monoxide to move out of the lungs and into the blood.
gives important info on the gas exchanging capacity of the lungs.
Polysomnography is used to diagnose what?
Obstructive sleep apnea-hypopnea syndrome
A polysomnography records all of the following:
Hint: 9 things
- ) EEGs
- ) record eye movement
- ) respiratory effort
- ) airflow
- ) oxygen saturation
- ) EKG
- ) body position
- ) submental and anterior tibialis movements
- ) noises, including snoring
Mammography
routine screening for breast cancer
Breast US
differentiate simple from complex cysts and cystic structures from nodules
What test for which diagnosis - Cardiovascular
1 - Most cardiac problems
Chest x-ray, EKG, stress test
2 - Left ventricular ejection fraction
gated radionuclide blood pool study, Echo, and SPECT
3 - Congestive heart failure (CHF)
chest x-ray, and echo
4 - thoracic aneurysm
CT w/ contrast, Transesophageal echo (TEE)
5 - Aortic aneurysm
CT w/ contrast
6 - congenital heart disease
chest x-ray, echo, cardiac cath
7 - endocarditis/pericarditis
echo
8 - valvular disease
echo
9 - PVD/claudication
Doppler US, ankle-brachial index
10 - Carotid Bruit
Doppler US
11 - DVT
Doppler venous US
Echocardiograms combined with US allows for:
assessment of chamber sizes, sizes of great vessels, valve structures, valve function and pressures within the heart.
TEE
Transesphageal echo allows for imaging of heart in all planes without the interference of the chest wall.
Holt Monitor
24 hour EKG recording done to diagnose arrhythmias
KUB stands for:
Kidney, Ureter, and Bladder
KUB is:
the most common x-ray of the abdomen
Barium Swallow
Involves the ingestion of contrast material that coats the esophagus, stomach, and small intestine for better visualization of these organs
Gastric emptying
How long it takes for an ingested meal, containing a small amount of radioactive isotope to pass out the stomach
Laparoscopy
C02 is pumped in to move the abdominal wall and separate surrounding structures.
Used for surgical procedures and biopsies
Colonoscopy
endoscope is inserted into the colon. It allows for biopsy and the removal of polyps and small tumors, and photographs are taken
Liver Biopsy
Sampling of liver tissue for pathology
What these for which diagnosis: Genitourinary
Calculus
KUB, CT
Hematuria
Intravenous pyelogram (IVP) Cystoscopy
Renal Trauma
CT w/ contrast
Hydronephrosis/Obstruction
US, IVP
Renal vein thrombosis
MRI
Probable cyst as incidental finding on IVP or CT
US
Probable mass found on IVP
CT with and without contrast, MRI
Polycystic kidney disease
CT, US
Bladder tumor
Cystoscopy, CT w/ contrast
Renal artery stenosis
Captopril renal scan, Duplex CT, MRA
What is an Intravenous pyelogram (IVP)
Contrast agent is used to provide detailed images of the collecting system, calyces, and renal pelvis of the kidneys and images the ureters
What does a renal scan do
evaluate blood flow to the kidneys
Cystoscopy
insertion of a flexible cystoscope into the bladder in order to look for causes of bladder dysfunction or for inflammation, or malignant causes of hematuria
what is a DEXA scan and what does it evaluate
Dual energy x-ray absorptiometry.
Evaluates bone mass
What test for which diagnosis - Musculoskeletal
Fracture, subluxation of the spine
X-Ray
Stress fracture, occult hip fracture
MRI
Bone/mineral loss
DEXA scan
Metastases
X-Ray, CT, Bone Scan, PET
Osteomyelitis
X-Ray, 3 phase bone scan, MRI
Back pain with radiculopathy, herniated disc
MRI, Myelography, CT
Arthritis
X-ray
Spinal tumor
MRI
Shoulder pain
X-ray, MRI
Neurogenic claudication
MRI and CT
Temporal bone, cholesteastoma
CT
Myelopathy
MRI
Carpal tunnel syndrome
nerve conduction tests
What is a Pap Test
Most common screening test for cervical cancer
What test for which diagnosis - Reproductive Organs
Pelvic or scrotal pain
US
Uterine fibroids
Pelvic US
Cervical, uterine, ovarian cancer
US, CT w/contrast, MRI
Abnormal Pap smear
Colposcopy
Abnormal uterine bleeding
Pelvic US, Transvaginal US
Endometriosis
US, Laparoscopy
Prostate
US
Testicular/scrotal masses
Doppler US
Postvoid residual urine
catheter insertion after voiding, US
