EX 3 Flashcards
Pregnant workers working in MRI must follow which of the following restrictions?
Avoid exposure of magnetic fields greater than 200mT
Do not move faster than 1T/s in the MRI environment
Do not stay in the MRI room during acquisition
All of the choices
Do not stay in the MRI room during acquisition
What is another name for quadrature RF exposure?
Circular polarized
Linear
Parallel
None of the choices
Circular polarized
A patient is pregnant. How should we scan our patient?
Image them at 7T or less
Use a circularly polarized exposure
Keep acquisition to no more than 2 hours
All of the choices
Use a circularly polarized exposure
The amount of RF exposed averaged over 10 seconds is defined by what?
SAR
B1+rms
T/m
Tesla
B1+rms
A pacemaker is considered a / an _____ implant.
Active
Passive
Active
An implanted pain pump is considered a / an ______ implant.
Active
Passive
Active
A loop recorder is considered a/an ____ implant.
Active
Passive
Active
A joint replacement is considered a/ an ______ implant.
Active
Passive
Passive
Which of the following is the riskiest implanted device listed?
Pacemaker
Deep brain stimulator
Loop recorder
Aneurysm clip
Deep brain stimulato
Patients with deep brain stimulators are at a higher risk of injury if conditions are not followed.
True
False
True
Which of the following can cause a burn on our patient?
External fixator
Aneurysm clip
Heart stent
Cloth hernia repair
External fixator
External fixator devices are contraindicated for MRI imaging.
True
False
False
A patient has a medication patch, what do we need to look for when reducing risk to the patient?
Type of medication
Metallic backing
Size of the patch
All of the choices
Metallic backing
What situation would potentially cause a patient burn?
Foiled backed medication patch
A cardiac stent
Aneurysm clip
bone screw
Foiled backed medication patch
Which of the following would be MR safe?
Metallic stent
Plastic stent
Pacemaker
Carbon fiber fixator rod
Plastic stent
A patient codes during an MRI exam. What do we do first
CPR to stablize patient
Remove patient from room
Bring crashcart to patient
Call for help
CPR to stablize patient
Screening of a patient must be done by whom before they enter zone 3?
Level 1 MR personnel
Level 2 MR personnel
Non-MR personnel
Patient
Level 2 MR personnel
A written screening sheet is sufficient for a patient to be considered MR screened.
True
False
False
What is true before scanning a patient?
Change patient into cotton gown
Leave patient in there street clothing
Change patient into gown with snaps
Make sure they are wearing yoga pants
Change patient into cotton gown
It is acceptable for patients to wear which of the following for their MRI exam?
Yoga pants
Cotton gown
Layers of clothing
Street clothing
Cotton gown
All the following should be visualized according to the line of sight rule except what?
Scanning console
Level 1 MR Personnel
Patient
Door to zone 4
Level 1 MR Personnel
What is the purpose of the line of sight rule?
To make sure any threats to the patient are monitored
To make sure the patient does not get a burn
To make sure we have the correct patient
To make sure we are charting the correct information on the patient
To make sure any threats to the patient are monitored
The level 1 MR personnel can escort a patient through what zones?
Zone 1 and 2
Zone 1, 2, and 3
Zone 1 only
Zone 1, 2, 3, and 4
Zone 1 and 2
The level 1 MR personnel can not escort a patient into what zones?
Zone 1 and 2
Zone 3 and 4
Zone 2, 3, and 4
Zone 4 only
Zone 3 and 4
patient receives contrast and immediately begins to feel nausea. This is an example of a _______ reaction.
Allergic
Non-Allergic
Non-Allergic
A patient has a fresh tattoo. What can we do to reduce the risk of a burn?
Cover the area with a towel
Place a heatsink on the tattoo
Move the tattoo into isocenter
Tattoos can not be scanned
Place a heatsink on the tattoo
Which of the following is an example of a heat sink?
Ice pack
Warm towel
Medication patch
All are heat sinks
Ice pack
A patient has a joint replacement. Which of the following are true when scanning this implant?
Only scan a 3T
Only scan at 1.5 T
Stay in normal operating mode
Do not scan
Stay in normal operating mode
A patient is pregnant. Which of the following are true when imaging this patient?
Scan at 1.5 T
Stay in normal operating mode
Keep scan time to a minimum
All are correct
Scan at 1.5 T
Stay in normal operating mode
Keep scan time to a minimum
What can we do to reduce the risk of a proximity burn?
Place a towel between a patients arms and the bore
Avoid hands touching
Place a pad of at least .5 to 1cm between the patient and the bore
All the choices
Place a pad of at least .5 to 1cm between the patient and the bore
How thick of a pad is needed to prevent a proximity burn?
.5 to 1 cm
1 cm to 2 cm
.25 to .5 cm
2 cm to 3 cm
.5 to 1 cm
A patient may experience magnetophosphenes when?
Moving towards the MRI scanner
Being advanced into the scanner
During gradient coil activation
All the choices
Moving towards the MRI scanner
Being advanced into the scanner
During gradient coil activation
Which of the following is unique to the static magnetic field?
Burns
Noise
Heating
Magnetohydrodyanmic effect
Magnetohydrodyanmic effect
It is common for implant conditions to include vertical B0 in their conditions.
True
False
False
A patient exposed to a changing magnetic field induces a current within them. This can be described by what?
Lenz Law
Lorentz forces
Ohm’s law
Faraday’s law
Faraday’s law
Who is responsible for the maintenance of the quench vent in the room?
Manufacturer engineer
Site engineer
MRI technologists
MRI Physicist
Manufacturer engineer
How often should MR safety policies be reviewed?
Monthly
Quarterly
Semiannually
Annually
Annually
What are we most concerned with when it comes to patient heating?
Increased core temperature
PNS
magnetophophenes
All of the choices
Increased core temperature
Which of the following can cause a larger risk of thermal injury to our patient when it comes to SAR?
Patients with fevers
Patients taking medication that inhibit temperature regulation
Patient with blankets
All of the choices
Patients with fevers
Patients taking medication that inhibit temperature regulation
Patient with blankets
A radiologist wants use to give gadolinium contrast to our pregnant patient. What agent should we give?
Group 1
Group 2
Group 3
Group 2
Which of the following agents would be best to give to a pregnant patient?
Magnevist
Omniscan
optimark
Multihance
Multihance
It is thought that a tattoo placed before ____ is at a higher risk of burns.
10 weeks
8 weeks
6 weeks
4 weeks
8 weeks
We are scanning at 3T, which of the following implants would have the greatest chance of burns?
10 cm internal wire
5 cm internal wire
15 cm internal wire
25 cm internal wire
10 cm internal wire
I am scanning a thoracic spine at 3T and the patient has an abandoned lead measuring 13 cm. What is the level of risk to our patient?
High risk
Low risk
High risk
A patient has a copper IUD. What is the level of risk to the patient?
High risk
Low risk
Low risk
An oxygen tank was accidently brought into zone 4. Someone was hurt. When does this need to be reported to the FDA MedWatch program?
12 hrs
24 hr/1 business day
48hr/2 business days
60 hr/3 business days
24 hr/1 business day
A ferrous wrench was brought into zone 4 and became a missile. Noone was hurt. Does this need to be reported to the FDA MedWatch program?
Yes
No
Yes
In order to calculate the most accurate SAR, what is needed from our patient?
Height
Weight
Gender
All the choices
Height
Weight
Gender
A person who is responsible for the day-to-day and had enough MR safety knowledge to take care of the patient and maintain a safe MRI environment is?
Level 1 MR personnel
MR responsible person
Non-MR personnel
Patient
MR responsible person
This individual has enough MR safety knowledge to take care of only themselves in an MRI environment
Level 1 MR personnel
Level 2 MR personnel
Non-MR personnel
Patient
Level 1 MR personnel
This individual can not accompany a patient into zone 3 or 4, but can still enter that area themselves.
Level 1 MR personnel
Level 2 MR personnel
Non-MR personnel
Patient
Level 1 MR personnel
A housekeep who cleans the MRI suite at night may be designated as what?
Level 1 MR personnel
Level 2 MR personnel
Non-MR personnel
Patient
Level 1 MR personnel
A floor nurse who rarely comes to MRI could be labelled as a?
Level 1 MR personnel
Level 2 MR personnel
Non-MR personnel
Patient
Non-MR personnel
Who is responsible for an overall injection of contrast media?
Nurse
Ordering physician
Radiologist
Management
Radiologist
Which of the following define dB/dx?
Gradient field
Spatial gradient field
RF field
Cryogen system
Spatial gradient field
The spatial gradient field refers to what?
B1
B0
Gradient field
All the choices
B0
A patient has a nitinol alloy stent. Is this implant at risk of translational or rotational forces?
Yes
No
No
A patient has an unknown cardiac stent. What is the risk of scanning this patient at 1.5T
Don’t scan
Moderate Risk
Low Risk
Scan
Scan
A patient has a 2cm nitinol alloy esophageal stent that migrated out of place. What is the risk of scanning this patient?
Don’t scan
Moderate Risk
Low Risk
Scan
Low Risk
A patient has an MR conditional stimulator placed and additional leads were used to extend the current leads. What is the level of risk
Don’t scan
Moderate Risk
Low Risk
Scan
Don’t scan
patient has a loop recorder and an MR conditional bladder stimulator. You can meet the MR conditions of the stimulator. What is the level of risk associated with scanning a brain?
Don’t scan
Moderate Risk
Low Risk
Scan
Low Risk
A patient has an MR conditional pain pump. We can meet the MRI conditions, but the battery is dead. What is the level of risk when scanning this?
Don’t scan
Moderate Risk
Low Risk
Scan
Scan
Who is responsible for overseeing safe execution of MRI examinations on every patient/human subject under their jurisdiction?
MRMD/MRRD
MRSE
MRI system operators
MRSO
MRMD/MRRD
Who must be readily accessible to MRI system operators, enforce safety policies and procedures, ensure adequate written safety procedures and instructions, and educate personnel on safety requirements?
MRSO
MRSE
MRMD/MRRD
MRI system operators
MRSO
Who is responsible for providing safety advice on purchasing, testing, and marking of equipment, provide MR safety education and training, and advise on selection, procurement, and installation of MR-related equipment?
MRI system operators
MRMD/MRRD
MRSE
MRSO
MRSO
Who provides high-level advice on safe use of MR equipment, develops rules and procedures for safe use, and advises on modification of MR protocols?
MRSE
MRI system operators
MRMD/MRRD
MRSO
MRSE
Who is responsible for managing hazards posed by MR equipment, ensuring appropriate measures are taken to protect against hazards, maintaining records of educated personnel, and consulting with MRMD/MRRD or MRSE as needed?
MRSO
MRI system operators
MRSE
MRMD/MRRD
MRMD/MRRD
Who is responsible for testing MR equipment prior to use, advising on performance testing procedures, and establishing and maintaining links with appropriate bodies?
MRSO
MRI system operators
MRMD/MRRD
MRSE
MRSE
Who must ensure safety, quality assurance, and risk assessment programs are implemented and investigate incidents or safety-related events?
MRMD/MRRD
MRSE
MRI system operators
MRSO
MRSE
A patient is wearing colored contact lenses. What is our biggest concern?
Heating
Moving
Vibrating
Susceptibility artifacts
Susceptibility artifacts
A patient has an cardiac occluder made of MP35N. How would you handle this?
Don’t scan
Moderate Risk
Low Risk
Scan
Scan
A patient has a stimulator that states to scan at only 128MHz. What is the level of risk scanning this implant at 1.5T.
Don’t scan
Moderate Risk
Low Risk
Scan
Don’t scan
A patient has a Foley catheter with a temperature sensor in it. If we disconnect it from the monitoring equipment, what is the level of threat to our patient if we are scanning a cervical spine?
High risk
Moderate Risk
Low Risk
Moderate Risk
What is the range of adverse event rate for GBCM administered at clinical doses?
0.07% to 0.2%
0.07% to 0.7%
0.07% to 2.4%
0.004% to 0.2%
0.07% to 2.4%
What is the usual manifestation of an allergic-like reaction to a GBCM?
Coldness, warmth, or pain at the injection site
Nausea with or without vomiting
Headache and dizziness
All of the above
Coldness, warmth, or pain at the injection site
Nausea with or without vomiting
Headache and dizziness
What is the frequency of severe lifethreatening anaphylactic reactions to GBCM?
0.07% to 0.2%
0.07% to 0.7%
0.001% to 0.01%
0.004% to 0.7%
0.001% to 0.01%
What is the frequency of allergic-like reactions to gadolinium chelate agents?
0.07% to 0.2%
0.07% to 0.7%
0.001% to 0.01%
0.004% to 0.7%
0.004% to 0.7%
What is the correct classification of an allergic-like contrast reaction?
Anaphylactic
Allergic
Idiosyncratic
Immunologic
Idiosyncratic
What is the minimum number of MR Personnel required when two machines are in use during scheduled hours?
One Level 1 and one Level 2
Two Level 1s
Two Level 2s
Three Level 1s
Two Level 2s
What should be done for research and volunteer subjects before they are allowed into Zone III?
Written informed consent
Plain-film radiography
MR screening process
Questioning by Level 2 Personnel
Questioning by Level 2 Personnel
What is the safety of MRI at field strengths higher than 1.5 T during pregnancy?
It has been thoroughly assessed and no harmful effects have been found
It has been thoroughly assessed and some harmful effects have been found
It has not been thoroughly assessed, but no harmful effects have been found
It has not been thoroughly assessed, and some harmful effects have been found
It has not been thoroughly assessed, but no harmful effects have been found
What is the risk-benefit analysis that should accompany the decision to administer an MR GBCA to pregnant patients?
A well-documented and thoughtful risk-benefit analysis.
A well-documented and thorough risk-benefit analysis.
A thorough and thoughtful risk-benefit analysis.
A thorough and well-documented risk-benefit analysis.
A well-documented and thoughtful risk-benefit analysis.
What should be the primary focus when dealing with a medical emergency in Zone IV?
Stabilizing the patient
Quenching the magnet
Moving the patient to Zone III
Evacuating the patient from Zone IV
Stabilizing the patient
What is the location of the magnet poles and therefore maximal SFG?
The center of the magnet
The outer edges of the openings or entrance(s) to the magnet bore
The middle of the magnet
The inner edges of the openings or entrance(s) to the magnet bore
The outer edges of the openings or entrance(s) to the magnet bore
What is the primary difference between thermal load and focal RF-related thermal injury?
Thermal load is dissipated over time, while thermal injury is not
Thermal load is dissipated over space, while thermal injury is not
Thermal load is experienced by the patient, while thermal injury is not
Thermal load is reported in joules per kilogram, while thermal injury is not
Thermal load is dissipated over time, while thermal injury is not
What should the instructions for use draw attention to regarding RISK factors for the MR WORKER?
That possible physiological effects of exposure to RF is heating
That possible physiological effects of exposure to the GRADIENT OUTPUT is PNS
That possible physiological effects of exposure to static magnetic field are dizziness, vertigo, and a metallic taste in the mouth
All of the above
That possible physiological effects of exposure to RF is heating
That possible physiological effects of exposure to the GRADIENT OUTPUT is PNS
That possible physiological effects of exposure to static magnetic field are dizziness, vertigo, and a metallic taste in the mouth
What is the maximum SAR that can be used for MRI scans of coronary artery stents?
1.5 W/kg
2 W/kg
3 W/kg
4 W/kg
2 W/kg
When can coronary artery stents be scanned using MRI?
Immediately after placement
After a few weeks
After a few months
After a year
Immediately after placement
What is required to restrict the magnetic field plot?
Structural steel
Magnetic shielding
RF-shielded assemblies
Uninterruptible power supplies
Magnetic shielding
What is the requirement for Level 2 MR Personnel when Non-MR Personnel are in Zones III or IV?
They must be accompanied by, or under the immediate supervision of, a Level 1 MR Personnel
They must be accompanied by, or under the immediate supervision of, a Level 2 MR Personnel
They must be accompanied by, or under the immediate supervision of, another Non-MR Personnel
They must be accompanied by, or under the immediate supervision of, another Level 2 MR Personnel
They must be accompanied by, or under the immediate supervision of, a Level 2 MR Personnel
What should all MR Personnel do as part of their employment agreement?
Undergo an MR screening process
Immediately report any trauma, procedure, or surgery to the MRMD
Provide written informed consent to Non-MR Personnel
Scan nonambulatory patients using MR scanning equipment
Undergo an MR screening process
What screening is required for conscious, nonemergency patients before they are allowed into Zone III?
Written informed consent
Plain-film radiography
MR screening process
Questioning by Level 2 Personnel
Questioning by Level 2 Personnel
What should be documented before an MR examination of a patient with an intracranial aneurysm clip?
The manufacturer, model, and type of aneurysm clip
The static magnetic field strength, static magnetic field gradient, and orientation of the aneurysm clip
The rate of motion through the static magnetic field gradient
All of the above
The manufacturer, model, and type of aneurysm clip
What has been the majority of published material regarding the acoustic safety of fetal scanning?
It has found deleterious effects on newborn hearing if exposed to MRI in utero.
It has found no deleterious effects on newborn hearing if exposed to MRI in utero.
It has found potentially deleterious effects on newborn hearing if exposed to MRI in utero.
It has found potentially beneficial effects on newborn hearing if exposed to MRI in utero.
It has found no deleterious effects on newborn hearing if exposed to MRI in utero.
What is the main concern for metallic implants, devices, and foreign bodies in the 7 T environment?
Damage
Interference
Resonant circuit-induced heating
Malfunction
Resonant circuit-induced heating
What should be done when determining whether a certain questionable device should undergo MRI?
Risk-versus-benefit assessment
Standardized testing
Screening
Labeling
Risk-versus-benefit assessment
What is the difference between SAR and SED?
SAR is the rate of energy absorption, while SED is the total dose of energy
SAR is the total dose of energy, while SED is the rate of energy absorption
SAR is the rate of energy absorption, while SED is the thermal load
SAR is the thermal load, while SED is the rate of energy absorption
SAR is the rate of energy absorption, while SED is the total dose of energy
What is the effect of certain medications on the patient’s thermoregulatory responses to a heat load?
Synergistic
Antagonistic
Neutral
Inverse
Synergistic
What should be done with skin staples or leads near the area to be irradiated?
Ensure that only the portion of the lead pathway within the volume of the coil is irradiated
Apply cold compresses or ice packs to patients head
Position the leads or wires as near to the inner walls of the MR scanner as possible
Cover them with a cold compress or ice pack
Cover them with a cold compress or ice pack
